Gross inequities in disease burden between developed and developing countries are now the subject of intense global attention. Public and private donors have marshaled resources and created organizational structures to accelerate the development of new health products and to procure and distribute drugs and vaccines for the poor. Despite these encouraging efforts directed primarily from and funded by industrialized countries, sufficiency and sustainability remain enormous challenges because of the sheer magnitude of the problem. Here we highlight a complementary and increasingly important means to improve health equity: the growing ability of some developing countries to undertake health innovation.

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Health innovation networks to help developing countries address neglected diseases.

This paper highlights the growing capacity for innovation in some developing countries. To maximize the potential of this phenomenon for global health, countries and donors need to link two disparate schools of thought: (1) a search for technological solutions exemplified by global public-private product development partnerships, and (2) a focus on systemic solutions exemplified by health policy and systems research. A strong capacity for both technological and social innovation in developing countries represents the only truly sustainable means of improving the effectiveness of health systems. Local public-private research and development partnerships, implementation research, and individual leadership are needed to achieve this goal.

Technological And Social Innovation: A Unifying New Paradigm For Global Health

This study has the objective to: 1) examine the extend to which the flexibilities contained in the WTO agreement on TRIPS have been incorporated into the legislation of developing countries and the extent of the actual use for public health purposes; 2) review the stated trade policies of major industrialized countries, particularly the US and the EU and3) examine the practical effect and implications of recently concluded bilateral and regional FTAs for public health protection in developing countries.

The use of flexibilities in trips by developing countries: can they promote access to medicines?

This article examines the relationship between intellectual property (IP) and public health, with a focus on the extension of AIDS treatment in the developing world While most of the literature on IP and health examines the conditions affecting poor countries’ capacities to acquire essential medicines, I show the distinct—and more complicated—political economy of production and supply IP regulations alter the structure of generic pharmaceutical sectors in the countries capable of supplying essential medicines, and changes in market structure affect actors’ economic and political interests and capacities These new constellations of interests and capacities have profound implications for the creation and maintenance of political coalitions in support of on-going drug supply The result is that the global AIDS treatment campaign becomes marked by mismatches of interests and capacities: those actors capable of taking the economic, legal, and political steps necessary to increase the supply and availability of essential drugs have diminished interest in doing so, and those actors with an interest in expanding treatment may lack the capacities to address the problem of undersupply By focusing centrally on actors’ interests in and capacities for economic and political action, the article restores political economy to analysis of an issue-area that has been dominated by attention to international law And by examining the fragility of the coalitions supporting the production and supply of generic drugs, the article points to the limits of transnational activist networks as enduring agents of change

The political economy of AIDS treatment: intellectual property and the transformation of generic supply

The past thirty years have witnessed the spread of rankings, ratings and league tables as governance technologies which aim to regulate the provision of public goods by means of market pressures. This paper examines the process of company analysis underlying the production of a ranking known as the Access to Medicine Index. We conceptualize the Index as a “regulatory ranking” with the explicit mission of addressing a perceived regulatory gap and market failure: the lack of access to medicine in the Global South. The Index, which ranks the world's largest pharmaceutical companies with regards to their access to medicine policies and practices, aspires to help address the problem of access to medicine through stakeholder consultation, transparency and competition. This study unbundles the epistemic work underlying the performance measurement process leading to the creation of the Index. We trace how the goal of stakeholder consensus, the need to project objectivity and the aspiration to govern through competition shape analysts' epistemic work. We discuss how through notions such as “the good distribution” and “aspirational indicators”, performance measurement and ranking become entangled in a “politics of variability” whereby company data need to be variably interpreted in order to optimise the possibilities of intervening in companies through competitive pressures, while at the same time complying with the imperatives to remain in the space of perceived stakeholder consensus and to provide a faithful representation of companies performance to inform public debates. We reflect on the challenges posed by these analysis processes for the regulatory aspirations of the ranking.

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Robert Lewis-Lettington

Papers

The Effect of Changing Intellectual Property on Pharmaceutical Industry Prospects in India and China