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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 December 1; 335(7630): 1111.
PMCID: PMC2099563

Drug companies are ignoring health crisis in poor countries, Oxfam says

The drug industry is “burying its head in the sand” when dealing with health in developing countries and denying poorer people access to life saving drugs, a report claims this week.

A critical report by the international agency Oxfam says that the drug industry is refusing to change the way it does business in poor countries, despite promising that it would, and is undermining its own future.

Oxfam's report looks at the world's top 12 drug companies, including their drug pricing policies, their record in developing drugs that are relevant to health care in poor countries, and their stance on protecting intellectual property rights.

The report says that the industry shows various shortcomings, including:

  • Failure to implement a systematic and transparent tiered pricing policy that is based on people's ability to pay
  • Continuing to neglect research and development concerning diseases that affect developing countries, and
  • Inflexibility in protecting intellectual property, which includes challenging poor countries in court to stop them using legal safeguards to protect public health.

Oxfam interviewed 12 companies in preparing the report: Abbott, AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Eli Lilly, Johnson & Johnson, Merck, Novartis, Pfizer, Roche, Sanofi-Aventis, and Wyeth.

In 2002 Oxfam, Save the Children, and Voluntary Service Overseas published Beyond Philanthropy, a report calling for the drug industry to contribute to solving the health crisis in developing countries. The new Oxfam report assesses what has changed since then and says that the industry has made only “halting progress” in some areas.

Oxfam's head of research, Sumi Dhanarajan, said, “The industry is operating in a shortsighted way, because it could gain enormous benefits from emerging markets, including lower research and development costs and cheaper manufacturing. The industry is burying its head in the sand.”

On drug pricing Oxfam said that some companies are offering differentiated prices but only in an extremely limited way and mainly for treatments for high profile diseases such as HIV and AIDS.

It gives the example of Abbott Laboratories, which was selling lopinavir with ritonavir (Kaletra), a second line antiretroviral, at $2200 (£1060; €1480) per patient per year in 45 low income and lower to middle income countries, such as Guatemala, where the average annual wage is $2400. It reduced the price of the drug worldwide to $1000 per patient per year around the same time that Thailand, in response to the needs of poor HIV patients, issued a compulsory licence to certain manufacturers to produce a cheaper version of the drug.

Dirk Van Eeden, director for HIV communication and policy at Abbott International, said that the move was not prompted by Thailand's decision to issue a compulsory licence. He said, “That price was reduced in April in all 45 countries and wasn't specific to Thailand nor was it in response to Thailand.”

The International Federation of Pharmaceutical Manufacturers and Associations, responding on behalf of the 12 drug companies, said that Oxfam had acknowledged that the industry was now doing more to cater to the healthcare needs in the developing world.

“We believe the new report understates the industry contribution,” said a spokesman, “but that is perhaps understandable: Oxfam's aim is to stimulate industry to do more.”

Mr Van Eeden said, “The report neglects to mention a number of measures that we have taken in order to get medicines to the developing world.”


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