Thana Cristina de Campos, The Von Hugel Institute, at St Edmund’s College/Cambridge
28th January 2015
As of this month, almost 8,000 people have lost their lives to Ebola, the majority in the desperately poor conditions of Sierra Leone, Liberia and Guinea. The number is escalating and the virus is spreading across international boundaries. Clearly, the Ebola epidemic is a global emergency that calls for humanitarian intervention and an urgent effective global response. But the current Ebola crisis is not just another natural disaster: it is also the manifestation of a major structural problem in our global institutions. In this sense the Ebola outbreak is a moral catastrophe, linked to one specific moral problem: the failure of the intellectual property rights regime to incentivize medical research and development (R&D) on diseases afflicting mainly the poor – the so-called ‘neglected diseases’. Ebola is one such neglected disease. The lack of a vaccine or a cure is directly traceable to the lack of incentive for medical discoveries.
The current international intellectual property rights regime (also known as the TRIPs) provides adequate market incentives for R&D on most diseases and exclusive rights (i.e. patent) for inventors to exploit their invention commercially. Medical R&D is a lengthy, uncertain, complex and costly process, and the TRIPs regime is crucial to foster it. It succeeds because of the inventors’ expectation of high profits in compensation for earlier expensive R&D investments. The TRIPs regime therefore ties R&D incentives to high profit prospects derived from high market prices. But the main producers of medical knowledge conducive to medical treatment—research institutions and pharmaceutical companies—do not have sufficient market incentives to devote costly R&D resources to making medicines for those poor populations afflicted by Ebola (and other neglected diseases), who cannot afford them. The crux of the Ebola crisis is therefore a systemic market failure in incentivizing and dispersing medical knowledge within the intellectual property rights regime. The international community – including wealthy countries (such as Canada, USA, UK, Switzerland), pharmaceutical firms (such as GSK), and research institutions (such as the University of Oxford, the Wellcome Trust, the Medical Research Council) – have now been stirred into action to start research into the Ebola virus because the disease has spread into wealthy countries: efforts to create a vaccine for the hemorrhagic fever have been fast-tracked. However, even if a vaccine or cure for Ebola is discovered and developed over the next months, it will still be true that the current incentive structure generated by the international regime of intellectual property rights is not apt for generating medical knowledge for diseases affecting predominantly the poor.
There is a moral duty to reform the current TRIPs system where it fails. Many reform proposals have been discussed at international organizations, particularly the World Health Organization (WHO), the World Trade Organization (WTO), and the World Intellectual Property Organization (WIPO). Recently, all three international organizations published a joint report analysing the neglected diseases problem on a global scale, and discussing intellectual property rights and public health policy questions that the problem raises. The report assessed 22 proposals that address the problem according to a set of criteria including public health impact, efficiency, technical feasibility, technology transfer and capacity building. The report classifies the proposals, distinguishing between those proposals that have met the criteria well, and those that, in spite of having met the criteria less well, are still promising. The next step that these three international organizations hope to achieve is the implementation of the key recommendations contained in the report through the negotiation of a binding international instrument by member-states of these international organizations. It is high time for global players to take this step towards a feasible and reasonable reform of the existing TRIPs system where it is dysfunctional, taking into consideration both the intellectual property rights of research institutions and pharmaceutical companies, on the one hand, and the basic human right to health of those poor people in developing countries, on the other. As a moral catastrophe the Ebola outbreak has made the need for such systemic reform irrefutable.
1. WHO.Doc.A65/24, Report of the Consultative Expert Working Group on Research and Development: Financing and Coordination, 20 April 2012