April 2011 - Centre for Civil Society - University of KwaZulu-Natal

discount.
The pilot AMC of $1.5 billion, funded by the Gates Foundation and G7
countries, for pneumococcal diseases, which kills almost a million children
annually, pays $3.50 per dose to the companies in the mechanism
(GlaxoSmithKline and Pfizer-Wyeth, among others). Recipient countries
make a small co-payment. However, instead of developing new vaccines,
the AMC brought in vaccines already developed by big pharma, for which
costs had been recovered substantially from sales in western markets.
Donald W Light, a distinguished academic and visiting professor at Stanford
University, was part of the AMC process, but found himself out of it when
his views crossed that of big pharma. Light often dubs it the "advance
procurement commitment" for its overwhelming bias towards big pharma
and profits. "GAVI is basically setting the markets for big pharma," says
Leena Menghaney, campaign co-ordinator (India), Medecins Sans Frontieres
(MSF), a medical humanitarian organisation that won the Nobel Peace
Prize in 1999.
The GAVI Alliance is already in a deep funding crisis. It is expected to
scour for $4.1 billion this year, primarily because of action skewed in
favour of big pharma. "Leaders of donor nations and GAVI board members
should sit with the chairman of Pfizer and GSK to negotiate a new price
near $2," says Light. "In the longer run, they should negotiate licensing,
technology transfer and other ways to foster price-competition from other
low-cost producers."
The suggestion is indeed relevant for the AMC, which disregards the
immense potential of small pharma companies in developing countries to
bring cheaper vaccines to the world. The Pune-based Serum Institute of
India participates in the AMC, but when it requested funding support
during its R&D process for a vaccine, it was turned down. Light is in favour
of companies in the Serum Institute mould.
Institutional Influence
The Gates influence and stranglehold on global institutions and
mechanisms in healthcare are quite evident. It doesn't stop here.
Numerous proposals for a 'Medical R&D Treaty' as a more egalitarian
alternative to the existing one, which links R&D costs to product prices,
has been systematically snuffed out.
The treaty seeks to place global, and country-specific obligations, on
funding medical R&D. Each country is expected to extend support on the
basis of its national income. "It's regrettable that the Gates Foundation
opposes discussions at the WHO on a possible treaty on medical R&D," says
James Love. "An initiative that can create new global sustainability
standards, promote access to knowledge, and usher much-needed
transparency and ethical norms." At a press conference in New Delhi on
Wednesday, Gates said: "I don't know about this treaty. I don't have a
position on this."
Interestingly, while large organisations such as the WHO bare a tendency
to capitulate easily to pressure, smaller, newer outfits show more spunk.
The Drugs for Neglected Diseases Initiative (DNDi), a product development
partnership, which also seeks funds from the Gates Foundation, has clear
firewalls in place.
"We limit funds from a single donor to not more than 25% of our total
requirement," says Bernard Pecoul, executive director, DNDi, which is
seeking to raise euro 274 million by 2014. The Gates Foundation has