James Elliott is convinced that the statistics describing the prevalence of type 1 diabetes are misleading. “People say that there is little or no type 1 diabetes in poor countries,” he says. “But that is because all of the people who had it are dead.”
When is a decision on a patent application not a decision at all? When it runs counter to the powerful commercial and diplomatic forces that protect massively profitable pharmaceutical monopolies. Or at least that is what many advocates for access to medicines are saying is the reason behind Indian patent officials last month reversing their own 2015 decision that denied United States-based Gilead Sciences a patent on its hepatitis C treatment sofosbuvir, commonly marketed as Sovaldi. The new decision holds that Sovaldi meets the Indian patenting requirements of novelty and inventiveness. But the earlier decision by the same agency came to the opposite conclusion, holding that Gilead’s drug was not a significant improvement over an already available compound.
Mary-Jane Matsolo, wearing tight jeans, gold high-heeled sandals, and a white t-shirt with navy blue block letters reading “HIV Positive,” strides to the front of the Johannesburg conference room. “I’m the one who will make you understand patent laws and intellectual property rights,” she says to the dozen people gathered before her. “It’s what I do, and I do it very well.”
Intellectual property protections for medicines are often overlooked in public discussions of U.S. trade agreements. But they shouldn’t be. Negotiations over such intellectual property can mean the difference between antiretroviral medicine that costs over $10,000 per year—the price originally set in the 1990s by monopoly patent holders—and the eventual grudging concessions that dropped the drug prices to less than a dollar a day. For millions of HIV-positive people in the developing world, that price gap is a matter of life and death. The same dynamic applies to patients in need of medicines to treat cancer, heart disease, and any number of other health conditions.