disease and climate

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“Where have all the flowers gone? – A crack vendor machine” -painting from an AIDS and drugs abuse prevention week in Oberallgäu, pseudonyms of the young artists: “Leyla N. and Marckii – the sad one”

Tomorrow is World Aids day (WAD). On monday the thirteenth session of the Conference of the Parties (COP) to the United Nations Framework Convention on Climate Change (UNFCCC) is taking place at Bali, Indonesia from December 3–14, 2007, reason enough to talk about health issues.

Last but not least on the occasion of the World Aids Day UNAIDS (the UN programme on HIV/AIDS) published the 2007 AIDS epidemic update (which seemed to have gotten an add-on update today).

The UNAIDS update is terrible enough to read and since societal changes, like e.g. the catholic churchs policy on condoms seem to need a lot of time one asks oneself about progress on an AIDS vaccine.

Unfortunately there is no good news.

In particular the International Aids Vaccine Initiative IAVI recently released this article about a vaccine trial:
A STEP back?
Additional data released from the STEP trial raises questions about whether the vaccine may have increased the risk of HIV infection

Moreover besides these medical problems a prospected AIDS vaccine suffers from financial problems. In the International Aids Vaccine Initiative IAVI pressrelease from 21 Sep 07 titled:
The International AIDS Vaccine Initiative Applauds the Governments of India, the United Kingdom, and South Africa for their Commitment to Exploring New Financial Incentives to Accelerate AIDS Vaccine R&D one can read:

Although US$800 million is spent annually on research, AIDS vaccine funding still remains inadequate. The International AIDS Vaccine Initiative (IAVI) and the Global HIV Vaccine Enterprise estimate that about US$1.2 billion is needed per year. “This gap is not going to be filled,” said Mr. Chidambaram, “without innovative financing mechanisms, without drastic interventions from our governments and without either committing more public money to vaccine R&D or creating incentives for greater private investments.” Among the proposals Mr. Chidambaram raised were greater funding for public-private product development partnerships, such as IAVI, and extending tax credits and fiscal incentives for those investing in AIDS vaccines.

So in short – there seems to be not enough money for R&D on AIDS vaccines.

And of course there is not enough money for treatment of already infected people, which affects also preventing the spread of the disease, as an Anti-Retroviral (ARV) Treatment of pregnant women with HIV supresses the transmission of the virus to the unborn child. For more see e.g. here the
Questions of Economics, Equity and Ethics regarding Anti-Retroviral (ARV) Treatment by World Bank AIDS Economics which is part of the International AIDS Economics Network (IAEN).

In view of all this it is sensible to ask: WHY is vaccine development/medication so expensive? There are multiple reasons, among others ARV treatment seems to need extensive doctoral supervision (the above world bank site discusses this as well). Nevertheless I am asking myself how much of the money needed for drugs/ailments/vaccines is going into the preservation etc. of intellectual property rights – in short: patents and such.

Unfortunately I couldnt find actual numbers on that issue, but a quick search on patents on retroviruses shows that juridicial issues over patents are keeping even Canadas Supreme Court busy.

IF one would assume that a non-negligible share of the medical costs could be due to questions about intellectual property rights then this could make such property right trials look very very ugly. The juridicial matter would look even more ugly, if these fights would impair the medical progress (like it seems to do in the case of the mpeg standard).

It was maybe for these reasons that the TRIPS agreement on Trade-Related Aspects of Intellectual Property Rights of the World Trade Union contains the passus (Section 5, Article 27, Patentable Subject Matter):

2. Members may exclude from patentability inventions, the prevention within their territory of the commercial exploitation of which is necessary to protect ordre public or morality, including to protect human, animal or plant life or health or to avoid serious prejudice to the environment, provided that such exclusion is not made merely because the exploitation is prohibited by their law.

3. Members may also exclude from patentability:

(a) diagnostic, therapeutic and surgical methods for the treatment of humans or animals;

In view of all this and looking at the UN Goals I have trouble to understand the following passus in the Political Declaration on HIV/AIDS of 15 June 2006
60/262, of UNAIDS:

47. Encourage bilateral, regional and international efforts to promote bulk procurement, price negotiations and licensing to lower prices for HIV prevention products, diagnostics, medicines and treatment commodities, while recognizing that intellectual property protection is important for the development of new medicines and recognizing the concerns about its effects on prices;

Why is “intellectual property protection important for the development of new medicines” ?

But back to the Bali conference. What does the above discussion have to do with the Bali conference?

At the Bali conference the socalled adaption fund will be discussed. The adaption fund shall provide means to balance the costs, which are due to climate change and climate change prevention. Part of these costs will be health costs.

->Here a Impacts of Climate Change on health chart in death/million of the United Nations Development program.

Last but not least devices like this instrument that simultaneously detect five bacterial and fungal pathogens for rapid diagnostics for use in disasters can provide a fast medical response in case of hurricans/Tsunamis (whereas by the way the HIV testing still needs 3-6 months!). But of course not only testing for bacterias, but also the treatment of injuries, disaster epidemics etc. fall into this category.

Concluding – when looking at the costs of diseases – and especially those which are and will be due to climate change it may be sensible to rediscuss the true value of patents and similar intellectual property issues.

Moreover this discussion is of course not limited to health technologies. May be I will give some more examples later. For now just a citation from the newspaper India Economic Times in the article What should be Indias stand at Bali climate meet:


In addition, the Adaptation Fund (needed after cyclones and tsunamis) must be operationalised in Bali. Can we also get Mr Al Gore to persuade western MNCs to relax intellectual property rights on clean technologies to make them accessible to us? Recall Bill Clinton’s efforts on medicines for AIDS for Africa.

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