Bitter Pills:Medicines & The Third World Poor | Page 61

advances in bio-engineering and other fields. In September 1982 the British industry
held a conference on the expected "Second Pharmacological Revolution". But
the "revolution" is apparently mainly of interest to the rich. George Teeling-Smith
of the Office of Health Economics explains: "... we took a fundamental planning
decision that this meeting should be concerned only with pharmaceutical
innovation relevant to the advanced world. We are always conscious of the risk
of trying to cover too wide a front on any one occasion and felt that we could
not do justice to the very important Third World issues if we simply tried to tack
them on to a meeting dealing with very high technology '21 Century'
innovation." <56) The implication seems to be that "21 Century innovation" is
not relevant to the needs of two-thirds of the world's population. A further
symposium is planned for later to look at the "equally important problems of
health care for the world's poor". (57)
There is no straightforward answer to the intractable problem of who can afford
to pay for research into new drugs for tropical diseases. Both industry and
international agencies see the best hope for the future in joint collaboration. By
contrast the Third World's need for low-cost generics is clear-cut. Some years
ago WHO officials estimated that if world drug consumption reached $42,533
million (£18,254 million) by 1980, the poor world would be paying the rich a
contribution of over $800 million (£343 million) towards research and development
costs. l581 World consumption has more than doubled that figure and the poor
continue to shoulder the bill.{591

AN IRREVERSIBLE TREND TO GENERICS
Poor countries are not forced to buy brand name drugs at uncompetitive prices
from the research-based companies. There are alternatives. Working in the Third
World's favour is the fact that there is a growing demand for generics. A CibaGeigy policy document explains: "The amount of products no longer enjoying
patent protection is becoming more and more important, giving way to increased
competition, specially with regard to prices, and thus encouraging the production
of the so-called generics." (60)
Much of the impetus is coming from within rich countries, as governments and
health insurance funds attempt to curb spiralling drug bills. For these reasons
Ciba-Geigy sees the trend towards generics as "an irreversible course of action,
which the pharmaceutical industry will not be able to keep at bay". (61) In the US,
generic prescriptions now represent about 14% of all new prescriptions written
and some forecasts suggest that, by 1989, generics will account for nearly half
of the total US market. Not surprisingly, 15 out of 20 major research-based
companies in the US are now involved to some extent in generics production. (621
Clearly their strategy, as outlined by Ciba, is to hold on to the market: "Our main
aim remains innovation through research. Where generics have already captured
a very large share of the market and represent a threat to our traditional business
or in cases where additional markets can be opened up by means of generics, we
are prepared to enter into the business of generics." (63) (our emphasis)
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