0:00:01.266,0:00:05.755 In 2002, a group of treatment activists met 0:00:05.755,0:00:09.785 to discuss the early development of the airplane. 0:00:09.785,0:00:14.486 The Wright Brothers, in the beginning of the last century, 0:00:14.486,0:00:16.188 had for the first time managed 0:00:16.188,0:00:18.760 to make one of those devices fly. 0:00:18.760,0:00:22.023 They also had taken out numerous patents 0:00:22.023,0:00:23.999 on essential parts of the airplane. 0:00:23.999,0:00:25.440 They were not the only ones. 0:00:25.440,0:00:29.024 That was common practice in the industry, 0:00:29.024,0:00:31.316 and those who held patents on airplanes 0:00:31.316,0:00:32.472 were defending them fiercely 0:00:32.472,0:00:35.894 and suing competitors left and right. 0:00:35.894,0:00:40.811 This actually wasn't so great for the development of the aviation industry, 0:00:40.811,0:00:44.117 and this was at a time that in particular the U.S. government 0:00:44.117,0:00:46.674 was interested in ramping up 0:00:46.674,0:00:49.363 the production of military airplanes. 0:00:49.363,0:00:52.074 So there was a bit of a conflict there. 0:00:52.074,0:00:55.313 The U.S. government decided to take action, 0:00:55.313,0:00:57.645 and forced those patent holders 0:00:57.645,0:01:01.806 to make their patents available to share with others 0:01:01.806,0:01:07.315 to enable the production of airplanes. 0:01:07.315,0:01:10.285 So what has this 0:01:10.285,0:01:14.305 got to do with this? 0:01:14.305,0:01:19.368 In 2002, Nelson Otwoma, a Kenyan social scientist, 0:01:19.368,0:01:24.509 discovered he had HIV and needed access to treatment. 0:01:24.509,0:01:28.744 He was told that a cure did not exist. 0:01:28.744,0:01:31.947 AIDS, he heard, was lethal, 0:01:31.947,0:01:35.140 and treatment was not offered. This was at a time 0:01:35.140,0:01:37.908 that treatment actually existed in rich countries. 0:01:37.908,0:01:40.903 AIDS had become a chronic disease. 0:01:40.903,0:01:44.504 People in our countries here in Europe, in North America, 0:01:44.504,0:01:47.449 were living with HIV, healthy lives. 0:01:47.449,0:01:50.284 Not so for Nelson. He wasn't rich enough, 0:01:50.284,0:01:54.256 and not so for his three-year-old son, who he discovered a year later 0:01:54.256,0:01:57.496 also had HIV. 0:01:57.496,0:02:00.916 Nelson decided to become a treatment activist 0:02:00.916,0:02:03.045 and join up with other groups. 0:02:03.045,0:02:09.388 In 2002, they were facing a different battle. 0:02:09.388,0:02:14.103 Prices for ARVs, the drugs needed to treat HIV, 0:02:14.103,0:02:18.500 cost about 12,000 [dollars] per patient per year. 0:02:18.500,0:02:21.025 The patents on those drugs were held 0:02:21.025,0:02:26.796 by a number of Western pharmaceutical companies 0:02:26.796,0:02:29.717 that were not necessarily willing 0:02:29.717,0:02:32.958 to make those patents available. 0:02:32.958,0:02:35.130 When you have a patent, you can exclude 0:02:35.130,0:02:39.859 anyone else from making, from producing or making 0:02:39.859,0:02:42.857 low-cost versions, for example, 0:02:42.857,0:02:46.433 available of those medications. 0:02:46.433,0:02:50.694 Clearly this led to patent wars breaking out 0:02:50.694,0:02:53.652 all over the globe. 0:02:53.652,0:02:57.313 Luckily, those patents did not exist everywhere. 0:02:57.313,0:02:59.705 There were countries that did not recognize 0:02:59.705,0:03:02.624 pharmaceutical product patents, such as India, 0:03:02.624,0:03:05.145 and Indian pharmaceutical companies 0:03:05.145,0:03:09.104 started to produce so-called generic versions, 0:03:09.104,0:03:13.571 low-cost copies of antiretroviral medicines, 0:03:13.571,0:03:16.868 and make them available in the developing world, 0:03:16.868,0:03:19.584 and within a year the price had come down 0:03:19.584,0:03:23.370 from 10,000 dollars per patient per year 0:03:23.370,0:03:25.872 to 350 dollars per patient per year, 0:03:25.872,0:03:29.388 and today that same triple pill cocktail 0:03:29.388,0:03:32.224 is available for 60 dollars per patient per year, 0:03:32.224,0:03:35.588 and of course that started to have an enormous effect 0:03:35.588,0:03:38.677 on the number of people who could afford access 0:03:38.677,0:03:40.167 to those medicines. 0:03:40.167,0:03:42.745 Treatment programs became possible, 0:03:42.745,0:03:45.859 funding became available, and the number of people 0:03:45.859,0:03:52.620 on antiretroviral drugs started to increase very rapidly. 0:03:52.620,0:03:55.333 Today, eight million people 0:03:55.333,0:03:58.449 have access to antiretroviral drugs. 0:03:58.449,0:04:02.431 Thirty-four million are infected with HIV. 0:04:02.431,0:04:04.430 Never has this number been so high, 0:04:04.430,0:04:05.672 but actually this is good news, 0:04:05.672,0:04:08.305 because what it means is people stop dying. 0:04:08.305,0:04:10.625 People who have access to these drugs stop dying. 0:04:10.625,0:04:11.961 And there's something else. 0:04:11.961,0:04:14.745 They also stop passing on the virus. 0:04:14.745,0:04:18.407 This is fairly recent science that has shown that. 0:04:18.407,0:04:21.063 What that means is we have the tools 0:04:21.063,0:04:24.820 to break the back of this epidemic. 0:04:24.820,0:04:30.089 So what's the problem? 0:04:30.089,0:04:31.955 Well, things have changed. 0:04:31.955,0:04:35.783 First of all, the rules have changed. 0:04:35.783,0:04:41.714 Today, all countries are obliged to provide 0:04:41.714,0:04:46.236 patents for pharmaceuticals that last at least 20 years. 0:04:46.236,0:04:49.172 This is as a result of the intellectual property rules 0:04:49.172,0:04:51.520 of the World Trade Organization. 0:04:51.520,0:04:54.699 So what India did is no longer possible. 0:04:54.699,0:05:00.036 Second, the practice of patent-holding companies have changed. 0:05:00.036,0:05:04.420 Here you see the patent practices 0:05:04.420,0:05:08.509 before the World Trade Organization's rules, before '95, 0:05:08.509,0:05:10.894 before antiretroviral drugs. 0:05:10.894,0:05:13.594 This is what you see today, 0:05:13.594,0:05:16.282 and this is in developing countries, so what that means is, 0:05:16.282,0:05:18.705 unless we do something deliberate 0:05:18.705,0:05:21.088 and unless we do something now, 0:05:21.088,0:05:26.204 we will very soon be faced with another drug price crisis, 0:05:26.204,0:05:28.424 because new drugs are developed, 0:05:28.424,0:05:31.786 new drugs go to market, but these medicines are patented 0:05:31.786,0:05:34.855 in a much wider range of countries. 0:05:34.855,0:05:39.492 So unless we act, unless we do something today, 0:05:39.492,0:05:43.424 we will soon be faced [with] what some have termed 0:05:43.424,0:05:46.468 the treatment time bomb. 0:05:46.468,0:05:51.327 It isn't only the number of drugs that are patented. 0:05:51.327,0:05:54.110 There's something else that can really scare 0:05:54.110,0:05:55.951 generic manufacturers away. 0:05:55.951,0:05:59.952 This shows you a patent landscape. 0:05:59.952,0:06:03.636 This is the landscape of one medicine. 0:06:03.636,0:06:06.237 So you can imagine that if you are a generic company 0:06:06.237,0:06:08.230 about to decide whether to invest 0:06:08.230,0:06:11.366 in the development of this product, unless you know 0:06:11.366,0:06:13.869 that the licenses to these patents 0:06:13.869,0:06:16.367 are actually going to be available, 0:06:16.367,0:06:19.419 you will probably choose to do something else. 0:06:19.419,0:06:23.352 Again, deliberate action is needed. 0:06:23.352,0:06:25.749 So surely 0:06:25.749,0:06:29.676 if a patent pool could be established 0:06:29.676,0:06:33.737 to ramp up the production of military airplanes, 0:06:33.737,0:06:37.271 we should be able to do something similar 0:06:37.271,0:06:40.978 to tackle the HIV/AIDS epidemic. 0:06:40.978,0:06:43.041 And we did. 0:06:43.041,0:06:48.430 In 2010, UNITAID established the Medicines Patent Pool 0:06:48.430,0:06:51.913 for HIV. 0:06:51.913,0:06:53.542 And this is how it works: 0:06:53.542,0:06:57.213 Patent holders, inventors 0:06:57.213,0:07:01.058 that develop new medicines 0:07:01.058,0:07:03.624 patent those inventions, 0:07:03.624,0:07:05.375 but make those patents available 0:07:05.375,0:07:08.348 to the Medicines Patent Pool. The Medicines Patent Pool 0:07:08.348,0:07:12.163 then license those out to whoever needs access to those patents. 0:07:12.163,0:07:13.839 That can be generic manufacturers. 0:07:13.839,0:07:17.652 It can also be not-for-profit drug development agencies, 0:07:17.652,0:07:19.129 for example. 0:07:19.129,0:07:21.643 Those manufacturers can then sell those medicines 0:07:21.643,0:07:26.692 at much lower cost to people who need access to them, 0:07:26.692,0:07:29.264 to treatment programs that need access to them. 0:07:29.264,0:07:33.440 They pay royalties over the sales to the patent holders, 0:07:33.440,0:07:43.769 so they are remunerated for sharing their intellectual property. 0:07:43.769,0:07:47.827 There is one key difference 0:07:47.827,0:07:51.187 with the airplane patent pool. 0:07:51.187,0:07:56.104 The Medicines Patent Pool is a voluntary mechanism. 0:07:56.104,0:07:59.536 The airplane patent holders were not left a choice 0:07:59.536,0:08:01.176 whether they'd license their patents or not. 0:08:01.176,0:08:03.380 They were forced to do so. 0:08:03.380,0:08:07.302 That is something that the Medicines Patent Pool cannot do. 0:08:07.302,0:08:10.654 It relies on the willingness of pharmaceutical companies 0:08:10.654,0:08:14.224 to license their patents and make them available 0:08:14.224,0:08:18.764 for others to use. 0:08:18.764,0:08:23.929 Today, Nelson Otwoma is healthy. 0:08:23.929,0:08:27.911 He has access to antiretroviral drugs. 0:08:27.911,0:08:31.688 His son will soon be 14 years old. 0:08:31.688,0:08:34.258 Nelson is a member of the expert advisory group 0:08:34.258,0:08:36.717 of the Medicines Patent Pool, 0:08:36.717,0:08:38.818 and he told me not so long ago, 0:08:38.818,0:08:44.359 "Ellen, we rely in Kenya and in many other countries 0:08:44.359,0:08:47.758 on the Medicines Patent Pool to make sure 0:08:47.758,0:08:53.270 that new medicines also become available to us, 0:08:53.270,0:08:58.659 that new medicines, without delay, become available to us." 0:08:58.659,0:09:02.018 And this is no longer fantasy. 0:09:02.018,0:09:06.497 Already, I'll give you an example. 0:09:06.497,0:09:09.955 In August of this year, the United States drug agency 0:09:09.955,0:09:13.904 approved a new four-in-one AIDS medication. 0:09:13.904,0:09:16.609 The company, Gilead, that holds the patents, 0:09:16.609,0:09:20.845 has licensed the intellectual property to the Medicines Patent Pool. 0:09:20.845,0:09:24.772 The pool is already working today, two months later, 0:09:24.772,0:09:27.877 with generic manufacturers to make sure that this product 0:09:27.877,0:09:31.026 can go to market at low cost 0:09:31.026,0:09:34.436 where and when it is needed. This is unprecedented. 0:09:34.436,0:09:36.376 This has never been done before. 0:09:36.376,0:09:40.095 The rule is about a 10-year delay for a new product 0:09:40.095,0:09:43.066 to go to market in developing countries, if at all. 0:09:43.066,0:09:47.099 This has never been seen before. 0:09:47.099,0:09:50.603 Nelson's expectations are very high, 0:09:50.603,0:09:54.872 and quite rightly so. He and his son will need access 0:09:54.872,0:09:57.961 to the next generation of antiretrovirals 0:09:57.961,0:10:01.068 and the next, throughout their lifetime, 0:10:01.068,0:10:05.746 so that he and many others in Kenya and other countries 0:10:05.746,0:10:10.178 can continue to live healthy, active lives. 0:10:10.178,0:10:13.398 Now we count on the willingness of drug companies 0:10:13.398,0:10:16.020 to make that happen. We count on those companies 0:10:16.020,0:10:19.440 that understand that it is in the interest, not only in the interest 0:10:19.440,0:10:22.624 of the global good, but also in their own interest, 0:10:22.624,0:10:28.338 to move from conflict to collaboration, 0:10:28.338,0:10:31.219 and through the Medicines Patent Pool they can make that happen. 0:10:31.219,0:10:34.615 They can also choose not to do that, 0:10:34.615,0:10:40.826 but those that go down that road may end up 0:10:40.826,0:10:43.750 in a similar situation the Wright brothers ended up with 0:10:43.750,0:10:47.584 early last century, facing forcible measures 0:10:47.584,0:10:52.766 by government. So they'd better jump now. 0:10:52.766,0:10:56.103 Thank you. (Applause)