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.
2002年 一群為愛滋病治療積極奔走的活躍人士 聚在一起討論飛機早期的發展 萊特兄弟在上世紀初 首次成功實現 人工飛行 萊特兄弟還為飛機的核心部件 申報了大量的專利 當時 並非只有萊特兄弟這麼做 這種做法在業界普遍存在 而這些飛行器專利的持有者 大力維護自己的專利權 對競爭者的任何侵權行為一定控訴到底
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.
實際上這種做法不利於航空工業的發展 而當時 美國政府又特別希望 可以大幅提高 軍用飛機的產量 所以矛盾也就出現了 美國政府決定採取行動 強迫專利持有者 將其持有的專利與他人共享 從而實現飛機的量產
So what has this got to do with this?
那麼這兩者 又是如何產生聯繫的呢?
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.
2002年 一位名叫Nelson Otwona的肯尼亞社會科學家 被發現攜帶HIV病毒 需要接受治療 醫生告訴他愛滋病是無法治愈的 愛滋病是一種致命的疾病 沒有可以治愈愛滋病的療法 但實際上 當時在富裕的國家治療方法是存在的 愛滋病已經變成一種慢性病 在歐洲在北美 在我們的國家 攜帶HIV病毒的人們也可以健康地生活 但對於Nelson情況卻不是這樣 Nelson不是有錢人 他三歲的兒子更不是 在Nelson被診斷出HIV病毒後一年 他的兒子也被查出攜帶HIV
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決定成為一名治療活躍人士 並加入了其他團體 在2002年 他們面臨的是一場不同的戰鬥 ARVs是一種用於治療HIV的藥物 而當時ARVs的價格高達每名患者每年一萬兩千美元 西方的一些製藥公司 持有這些藥物的專利權 而這些製藥公司並不太希望 將持有的專利與他人共享 只要持有專利便可以限制他人 製造或是生產 廉價的產品 比如說 生產廉價的藥品 很顯然 這種做法觸發了 全球範圍內的專利戰
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.
幸運的是 這些專利並非無處不在 有一些國家 比如像印度 並不承認醫藥產品專利 一些印度製藥公司 開始生產所謂的 通用版和廉價版的抗逆轉錄藥物 並將這些藥物投放到發展中國家 一年之內 這些藥物的價格便從 每名患者每年一萬美元 下降到每名患者每年350美元 而今天每名愛滋病患者每年只需花費60美元 便可以接受三聯雞尾酒療法 當然 產生的影響是巨大的 越來越多的患者 將能夠負擔起藥物費用 有可能接受治療 有能力支付費用 並且服用抗逆轉錄藥物患者的 人數開始大幅增長
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.
現在有800萬人口 能夠拿到抗逆轉錄藥物 而感染HIV病毒的患者有三千四百萬 這個數字是前所未有的 但事實上這是好消息 因為這意味著人們的死亡率在降低 能夠獲得藥物治療的人便可免於一死 除此之外 病毒攜帶者也不會繼續傳染給其他人 最新的科學研究已經表明了這一點 這就意味著 我們已經有辦法可以抑制愛滋病毒的傳播
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.
那麼 問題是什麽呢? 嗯 情況已經變了 首先 規則變了 現今 所有國家都必須為藥物申報專利 每項專利的時限最少為20年 世貿組織的知識產權法 促成了這一結果 所以 印度的做法不再可行 其次 持有專利的公司也改變了自己的做法 這張圖顯示的是 世貿組織出臺知識產權法規之前 也就是1995年之前 抗逆轉錄藥物出現之前 藥物專利申報的情況 而這張圖顯示了現在藥物專利的申報情況 這是在發展中國家 也就意味著 除非我們能夠慎重考慮 馬上採取一些行動 否則要不了多久就會發現 我們將面臨另一場藥物價格危機 因為不斷在開發新藥 不斷有新藥投入市場 但這些藥物都有專利限制 而且這些專利被更多國家認可 因此 除非我們現在馬上採取行動 否則很快我們便將面臨 一些人所說的治療時間炸彈
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.
不僅僅是申報專利藥物的數量 使得通用製藥商退避三舍 還有一些其他的因素 從這裡 可以看到專利分佈圖 這是一種藥物的專利分佈圖 因此 可以想像如果你是一家通用製藥公司 正要決定是否投資開發一項產品 那麼除非你知道 確實可以獲得 這項產品的專利許可 否則你可能另有打算 再次強調 我們必須慎重考慮並採取行動
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.
因此 可以肯定的是 如果通過成立一個專利聯盟 可以大幅提升軍用飛機的量產 那麼我們也應該能夠用類似的方式 解決HIV或愛滋病毒的傳播
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.
我們確實做到了 2010年 國際藥品採購機制(UNITAID)成立了 HIV藥物專利聯盟 它的運作方式是這樣的 研發新藥物的專利持有者 藥物發明者 為新發明的藥物 申報專利 但向藥物專利聯盟開放這些新藥物的專利許可權 藥物專利聯盟再將這些專利許可權 授權給任何有需要的人 可能是通用製藥商 也可能是非盈營利藥物開發機構 等等 然後這些製藥商便能夠以極低的價格 向有需要的人和治療計劃 出售這些藥物 通過銷售營利 他們向專利持有者支付版權費用 因此專利持有者也因為 分享自己的知識產權獲得報酬
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.
這與飛機專利聯盟 唯一不同的地方在於 藥物專利聯盟是一個自發的機制 飛機專利持有者並沒有選擇的餘地 無論是否願意 他們都不得不授權自己的專利 藥物專利聯盟沒有權力強迫任何人 完全依賴製藥公司的自願自發 向他人授權自己的專利權 為他人所用
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."
今天 Nelson Otwoma可以健康地生活 他能夠接受抗逆轉錄藥物的治療 他的兒子也馬上要14歲了 Nelson是藥物專利聯盟 專家顧問團的一員 不久前他曾告訴我 “Ellen 在肯尼亞以及許多其他的國家 我們全都依賴藥物專利聯盟 確保我們能夠獲得新藥 確保我們能夠及時地獲得新藥物”
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.
這已經不再是空想 這已經是現實 我和大家分享一個實例 今年8月 美國藥品局 批准了一個新的四合一愛滋病藥物 擁有該藥物專利權的Gilead公司 已經向藥物專利聯盟授權該專利的使用許可 今天 僅僅兩個月後 聯盟已經在和通用製藥商合作 確保這個產品 可以最低的成本 在需要的時刻地點 投放市場 這是前所未有的 以前從未發生過 在以前 一劑新藥面世後通常需要十年的時間 才能投放發展中國家市場 以前從未有過 Nelson有非常高的期望 也是理所當然的 他和他的兒子這終其一生中都需要 下一代以及再下一代更新的 抗逆轉錄藥物 這樣他和許許多多生活在肯尼亞和其他國家的人們 才能夠健康積極地生活下去
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)
現在 我們依賴的是藥物公司的自願自發 我們依賴的是這些藥物公司能夠明白 由對立轉向協作 這不僅僅是符合全球利益的 也是符合他們自身利益的 通過藥物專利聯盟 這一切都有可能實現 當然他們也可以選擇不合作 但是可能會落得 上世紀初萊特兄弟一樣的下場 政府將會採取強制措施 所以 最好還是現在就行動 謝謝(掌聲)