私营部门的查看：Pharma Shift不会帮助最贫穷

British pharmaceutical giant GlaxoSmithKline (GSK) announced last week that it would停止申请专利in the world’s poorest countries, opening the door to manufacturers in the developing world who wish to copy GSK drugs and sell them at lower prices.

The high cost of prescription drugs is a major development challenge. Historically, poor countries have addressed it by purchasinggeneric drugs made in middle-income countries例如巴西和印度，它们可以通过世界贸易组织专利法中的漏洞出售。

Pharmaceutical firms have fought for years to have this loophole closed and their patents enforced globally. Nonprofits such as Médecins Sans Frontières (MSF) have campaigned to reform patent rules that protect drugmakers in the global South. So is GSK’s move a victory for campaigners?

“我们认为这不是一个非常大胆的公告，”政策与分析总监Rohit MalpaniMSF的访问活动， 告诉我。“多年来，我们一直在说[药物的成本]是进入的障碍，制药行业一直在说不是。这是GSK的认可，这是一个问题，但这并不是真正的胜利。”

他说，相反，宣布是对改变政治的回应。从历史上看，富有的政府帮助其国家的制药公司捍卫其国外的专利。但是，对于富裕国家（不仅是贫困国家）的贫困人口而言，毒品成本的上升也有问题，而且对西方医疗保健系统的成本压力不断增加，这引发了人们对医疗专利改革的新兴趣。这包括形成联合国使用药品的面板，以及法国总统弗朗索瓦·奥朗德（FrançoisHollande）的电话include drug access for discussion at G7 and G20 summits。

“多年来，我们一直在说[药物的成本]是进入的障碍，制药行业一直在说不是。这是GSK的认可，这是一个问题，但这并不是真正的胜利。”

Rohit Malpani，无国界医生

马尔帕尼（Malpani）认为，葛兰素史克（GSK）在穷国对专利控制的放松可能是试图领先政治进程，以挫败更重大的改革并维护其核心知识产权利益：发展世界专利。

他指出，GSK提案的细节还有很多不足之处。该政策只会免除最贫穷的国家的专利执行，但这些国家经常lack the capacity to make drugs因此，制药公司在那里申请了很少的专利，如果有的话。因此，目前尚不清楚它会产生什么区别。

马尔帕尼还警告说，GSK的衡量哪些国家“最不发展”依赖于世界银行data关于人均国民生产总值。但是，与大多数经济发展指标一样，该指标并不一定与医疗访问相关，因为它没有考虑到一个国家的健康基础设施的状态或支付毒品的能力。马尔帕尼（Malpani）建议，使用任何单一的开发量度来做出有关药物获取的决策（不仅仅是关于贫困的问题）不太可能成功。

And, indeed, with the long timeframe involved in drug development, it’s unclear whether the countries currently classed as least developed will still qualify whenGSK’s next round of new drugs reach market。

Ultimately, it is governments that must intervene to make real progress on drug access, Malpani says. “The pharmaceutical industry is reliant on government for every stage of its life, from patents to authorising clinical trials,” he says. “Even if they have a lot of power and can dominate the thinking in government,政府have many tools to change the power dynamic and the relationship between the two. And we hope that as the situation [on pricing] becomes more intractable, governments will look to do that.”

Maha Rafi Atalis a PhD candidate at the University of Cambridge, United Kingdom, where she is researching the political effects of multinational firms acting as public service providers in the developing world. She was previously a journalist, including at Forbes, where she covered the intersection of business, development and international affairs. You can contact her on[电子邮件保护]或在Twitter上关注她：@MahaRafiAtal