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