In 2002, a group of treatment activists met to discuss the early development of the airplane. The Wright Brothers, in the beginning of the last century, had for the first time managed to make one of those devices fly. They also had taken out numerous patents on essential parts of the airplane. They were not the only ones. That was common practice in the industry, and those who held patents on airplanes were defending them fiercely and suing competitors left and right.
Godine 2002, grupa aktivista za lečenje sastala se da razgovara o ranom razvoju aviona. Braća Rajt su, početkom proteklog veka, prvi put postigla da jedna od tih naprava poleti. Takođe su iznedrili brojne patente ključnih delova aviona. Nisu bili jedini. To je bila uobičajena praksa u toj industriji, a oni koji su posedovali patent nad avionom žestoko su ih štitili i tužili konkurenciju sa svih strana.
This actually wasn't so great for the development of the aviation industry, and this was at a time that in particular the U.S. government was interested in ramping up the production of military airplanes. So there was a bit of a conflict there. The U.S. government decided to take action, and forced those patent holders to make their patents available to share with others to enable the production of airplanes.
To zapravo nije bilo tako sjajno za razvoj vazduhoplovne industrije, a to je bilo baš u vreme kada ja vlada SAD-a bila zainteresovana da pojača proizvodnju vojnih aviona. Dakle, tu je postojao izvestan konflikt. Vlada SAD-a je rešila da preduzme mere i primorala nosioce patenta da omoguće da njihove patente drugi mogu da dele kako bi se omogućila proizvodnja aviona.
So what has this got to do with this?
Pa, kakve to veze ima sa ovim?
In 2002, Nelson Otwoma, a Kenyan social scientist, discovered he had HIV and needed access to treatment. He was told that a cure did not exist. AIDS, he heard, was lethal, and treatment was not offered. This was at a time that treatment actually existed in rich countries. AIDS had become a chronic disease. People in our countries here in Europe, in North America, were living with HIV, healthy lives. Not so for Nelson. He wasn't rich enough, and not so for his three-year-old son, who he discovered a year later also had HIV.
Godine 2002, Nelson Otvoma, sociolog iz Kenije, otkrio je da ima HIV virus i bio mu je potreban pristup lečenju. Rekli su mu da lek ne postoji. Sida je, kako je saznao, smrtonosna, a lečenje se ne može omogućiti. To je bilo u vreme kada je to lečenje postojalo u bogatim zemljama. Sida je postala hronična bolest. Ljudi u zemljama u Evropi, u Severnoj Americi, vodili su zdrave živote sa HIV virusom. To nije bio slučaj sa Nelsonom. Nije bio dovoljno bogat, a isto je bilo i sa njegovim sinom starim tri godine, za koga je godinu dana kasnije saznao da takođe ima HIV virus.
Nelson decided to become a treatment activist and join up with other groups. In 2002, they were facing a different battle. Prices for ARVs, the drugs needed to treat HIV, cost about 12,000 [dollars] per patient per year. The patents on those drugs were held by a number of Western pharmaceutical companies that were not necessarily willing to make those patents available. When you have a patent, you can exclude anyone else from making, from producing or making low-cost versions, for example, available of those medications. Clearly this led to patent wars breaking out all over the globe.
Nelson je rešio da postane aktivista za lečenje i priključio se drugim grupama. Godine 2002, naišli su na drugačiju bitku. Cena ARV, lekova koji su potrebni za lečenje HIV-a, godišnje iznose oko 12 000 dolara po pacijentu. Pravo na patent nad tim lekovima su čuvale brojne zapadne farmaceutske kompanije koje baš i nisu bile voljne da učine te patente dostupnim. Kada imate patent, možete da zabranite svima ostalima da naprave, proizvode ili, na primer, učine dostupnim jeftine vezije tih lekova. Očito da je to dovelo do izbijanja ratova oko patenata širom planete.
Luckily, those patents did not exist everywhere. There were countries that did not recognize pharmaceutical product patents, such as India, and Indian pharmaceutical companies started to produce so-called generic versions, low-cost copies of antiretroviral medicines, and make them available in the developing world, and within a year the price had come down from 10,000 dollars per patient per year to 350 dollars per patient per year, and today that same triple pill cocktail is available for 60 dollars per patient per year, and of course that started to have an enormous effect on the number of people who could afford access to those medicines. Treatment programs became possible, funding became available, and the number of people on antiretroviral drugs started to increase very rapidly.
Srećom, ti patenti nisu svuda postojali. Bilo je zemalja koje nisu priznavale patente na farmaceutske proizvode, kao što je bila Indija, a indijske farmaceutske kompanije počele su da proizvode tzv. generičke verzije, jeftine kopije antiretroviralnih lekova i učinile su ih dostupnim u zemljama u razvoju, a za godinu dana je cena pala sa 10 000 dolara godišnje po pacijentu na 350 dolara godišnje po pacijentu, a danas je ta ista kombinacija tri pilule dostupna za 60 dolara godišnje po pacijentu, što je, naravno, počelo da dovodi do ogromnih posledica za veliki broj ljudi koji su mogli da priušte da dođu do tih lekova. Omogućeni su programi lečenja, finansiranje je postalo dostižno, a broj ljudi koji su uzimali antiretroviralne lekove počeo je da raste vrlo ubrzano.
Today, eight million people have access to antiretroviral drugs. Thirty-four million are infected with HIV. Never has this number been so high, but actually this is good news, because what it means is people stop dying. People who have access to these drugs stop dying. And there's something else. They also stop passing on the virus. This is fairly recent science that has shown that. What that means is we have the tools to break the back of this epidemic.
Danas, osam miliona ljudi ima pristup antiretroviralnim lekovima. HIV-om je zaraženo 34 miliona. Taj broj nikada nije bio veći, ali to su zapravo dobre vesti, jer to znači da ljudi prestaju da umiru. Ljudi koji imaju pristup ovim lekovima prestaju da umiru. A postoji još nešto. Takođe prestaju da prenose virus. To je relativno skoro pokazala nauka. To znači da imamo sredstva da stanemo na put ovoj epidemiji.
So what's the problem? Well, things have changed. First of all, the rules have changed. Today, all countries are obliged to provide patents for pharmaceuticals that last at least 20 years. This is as a result of the intellectual property rules of the World Trade Organization. So what India did is no longer possible. Second, the practice of patent-holding companies have changed. Here you see the patent practices before the World Trade Organization's rules, before '95, before antiretroviral drugs. This is what you see today, and this is in developing countries, so what that means is, unless we do something deliberate and unless we do something now, we will very soon be faced with another drug price crisis, because new drugs are developed, new drugs go to market, but these medicines are patented in a much wider range of countries. So unless we act, unless we do something today, we will soon be faced [with] what some have termed the treatment time bomb.
U čemu je onda problem? Pa, stvari su se promenile. Pre svega, pravila su se promenila. Danas su sve zemlje u obavezi da obezbede patente za farmaceutske proizvode koji traju bar 20 godina. To je proizašlo iz pravila intelektualne svojine Svetske trgovinske organizacije. Dakle, više nije moguće ono što je Indija uradila. Drugo, promenila se praksa kompanija koje su vlasnici patenata. Ovde vidite praktikovanje patenata pre pravila Svetske trgovinske organizacije, pre '95. godine, pre antiretroviralnih lekova. Ovo je ono što možete videti danas, a to je u zemljama u razvoju, tako da to znači da, ako ne preduzmemo nešto promišljeno i ako ne preduzmemo nešto sada, uskoro ćemo se naći pred drugom krizom cena lekova, jer se razvijaju novi lekovi, novi lekovi dolaze na tržište, ali ti lekovi su patentirani u mnogo širem opsegu zemalja. Stoga, ako ne krenemo u akciju, ako ne učinimo nešto danas, uskoro ćemo se suočiti sa onim što neki nazivaju tempiranom bombom lečenja.
It isn't only the number of drugs that are patented. There's something else that can really scare generic manufacturers away. This shows you a patent landscape. This is the landscape of one medicine. So you can imagine that if you are a generic company about to decide whether to invest in the development of this product, unless you know that the licenses to these patents are actually going to be available, you will probably choose to do something else. Again, deliberate action is needed.
Nije samo stvar u broju lekova koji su patentirani. Postoji još nešto što zaista plaši proizvođače generičkih lekova. Ovo vam daje prikaz stanja stvari kod patenata. Ovo je prikaz kretanja jednog leka. Možete zamisliti, ako ste generička kompanija koja treba da odluči da li da uloži u razvoj ovog proizvoda, osim ako znate da će dozvole za ove patente zaista biti dostupne, verovatno ćete odlučiti da uradite nešto drugo. Još jednom, potrebna je promišljena akcija.
So surely if a patent pool could be established to ramp up the production of military airplanes, we should be able to do something similar to tackle the HIV/AIDS epidemic.
Svakako, ako se udruživanje patenata može uspostaviti da bi se povećala proizvodnja vojnih aviona, trebalo bi da možemo da uradimo nešto slično da bismo se pozabavili epidemijom HIV virusa.
And we did. In 2010, UNITAID established the Medicines Patent Pool for HIV. And this is how it works: Patent holders, inventors that develop new medicines patent those inventions, but make those patents available to the Medicines Patent Pool. The Medicines Patent Pool then license those out to whoever needs access to those patents. That can be generic manufacturers. It can also be not-for-profit drug development agencies, for example. Those manufacturers can then sell those medicines at much lower cost to people who need access to them, to treatment programs that need access to them. They pay royalties over the sales to the patent holders, so they are remunerated for sharing their intellectual property.
To i jesmo uradili. Godine 2010, UNITAID je uspostavio udružene patente na lekove za HIV. Ovako to funkcioniše. Vlasnici patenta, pronalazači koji razvijaju nove lekove patentiraju te izume, ali učine te patente dostupnim Zajedničkom fondu patenata na lekove. Zatim Zajednički fond daje dozvolu onome kome je potreban pristup tim patentima, a to mogu biti generički proizvođači. To takođe mogu biti neprofitne agencije za razvoj, na primer. Ti proizvođači mogu zatim prodati te lekove po mnogo nižoj ceni ljudima kojima su potrebni, programima za lečenje kojima je potreban pristup njima. Isplaćuju autorsku naknadu razlike od prodaje vlasnicima patenta, tako da oni dobijaju obeštećenje za to što dele svoje intelektualno vlasništvo.
There is one key difference with the airplane patent pool. The Medicines Patent Pool is a voluntary mechanism. The airplane patent holders were not left a choice whether they'd license their patents or not. They were forced to do so. That is something that the Medicines Patent Pool cannot do. It relies on the willingness of pharmaceutical companies to license their patents and make them available for others to use.
Postoji jedna ključna razlika kod udruženih avionskih patenata. Zajednički fond patenata na lekove predstavlja dobrovoljni mehanizam. Vlasnici avionskih patenata nisu imali izbor da li će dozvoliti korišćenje svog patenta ili ne. Bili su primorani na to. To Zajednički fond patenata na lekove ne može. Oslanjaju se samo na dobru volju farmaceutskih kompanija da dozvole korišćenje svojih patenata i učine ih dostupnim za druge.
Today, Nelson Otwoma is healthy. He has access to antiretroviral drugs. His son will soon be 14 years old. Nelson is a member of the expert advisory group of the Medicines Patent Pool, and he told me not so long ago, "Ellen, we rely in Kenya and in many other countries on the Medicines Patent Pool to make sure that new medicines also become available to us, that new medicines, without delay, become available to us."
Danas je Nelson Otvoma zdrav. Ima pristup antiretroviralnim lekovima. Njegov sin će uskoro imati 14 godina. Nelson je član savetodavne grupe eksperata Zajedničkog fonda patenata na lekove i rekao mi je nedavno: „Elen, mi u Keniji i mnogim drugim zemljama se pouzdamo u Zajednički fond patenata na lekove da bismo obezbedili da novi lekovi postanu dostupni i nama, da nam novi lekovi neodložno postanu dostupni.“
And this is no longer fantasy. Already, I'll give you an example. In August of this year, the United States drug agency approved a new four-in-one AIDS medication. The company, Gilead, that holds the patents, has licensed the intellectual property to the Medicines Patent Pool. The pool is already working today, two months later, with generic manufacturers to make sure that this product can go to market at low cost where and when it is needed. This is unprecedented. This has never been done before. The rule is about a 10-year delay for a new product to go to market in developing countries, if at all. This has never been seen before. Nelson's expectations are very high, and quite rightly so. He and his son will need access to the next generation of antiretrovirals and the next, throughout their lifetime, so that he and many others in Kenya and other countries can continue to live healthy, active lives.
To više nije samo fantazija. Daću vam primer. Avgusta ove godine, agencija za lekove iz SAD-a odobila je novi lek za sidu „četiri u jednom“. Kompanija Gilijad, koja je nosilac patenata, dala je dozvolu na intelektualno vlasništvo Zajedničkom fondu patenata na lekove. Fond radi već danas, dva meseca kasnije, sa proizvođačima generičkih lekova da bi se postarali da ovaj proizvod može da bude pušten na tržište po niskoj ceni kada i gde je to potrebno. Ovome nema presedana. To se nije radilo nikada ranije. Po pravilu, novom prozvodu treba oko deset godina čekanja da stigne na tržište zemalja u razvoju, ako uopšte stigne. Ovo nikada nije ranije viđeno. Nelsonova očekivanja su velika, i to sa pravom. Njemu i njegovom sinu će biti potreban pristup sledećoj generaciji antiretroviralnih lekova i sledećoj, kroz njihov životni vek, tako da on i mnogi drugi u Keniji i drugim zemljama mogu da nastave da vode zdrav, aktivan život.
Now we count on the willingness of drug companies to make that happen. We count on those companies that understand that it is in the interest, not only in the interest of the global good, but also in their own interest, to move from conflict to collaboration, and through the Medicines Patent Pool they can make that happen. They can also choose not to do that, but those that go down that road may end up in a similar situation the Wright brothers ended up with early last century, facing forcible measures by government. So they'd better jump now. Thank you. (Applause)
Računamo na dobru volju kompanija lekova da se to ostvari. Računamo na te kompanije da razumeju da ovo nije samo u interesu globalnog dobra, već i u njihovom interesu, da bismo se odmakli sa konflikta ka saradnji, a one to mogu ostvariti kroz Zajednički fond patenata za lekove. Takođe mogu odlučiti da to ne urade, ali one koje krenu tim putem mogu završiti u sličnoj situaciji kao i braća Rajt početkom prošlog veka, kada su se suočili sa prinudnim merama vlade, tako da bi im bilo bolje da priskoče sada. Hvala.