Madam, - A report headed "Oxfam criticises drug firms for price and patent policies" (Health Supplement, November 27th) included claims by Oxfam that pharmaceutical companies are "guilty of denying medicines to millions of poor people".
The truth is quite different. As noted by former UN secretary general Kofi Annan, poverty and a lack of basic healthcare infrastructure to distribute medicines are the greatest barriers to obtaining medicines in the developing world. Other factors, such as armed conflict, corruption, bureaucracy and the lack of such basics as food, decent housing, clean water, condoms and mosquito nets unfortunately mean that poor health is endemic for the world's poorest people.
The IPHA disputes Oxfam's rather cursory dismissal of industry donation and other programmes. These are eradicating major diseases, strengthening healthcare systems and supporting research into neglected diseases - steps which are "beyond philanthropy".
Oxfam and the IPHA both believe that industry, along with governments in developed and developing countries, intergovernmental bodies and NGOs, has a role to play in addressing these issues. However, we do have some differences with Oxfam as regards the way industry can best contribute.
Oxfam calls for greater use of differential pricing. It notes that companies have increased their use of this tool, but complains that it is essentially restricted to "high-profile" diseases, notably HIV/Aids and malaria. This is a fair comment, but only scratches the surface. A number of factors come together to make differential pricing work in these areas. HIV/Aids and malaria are resistant to older treatments, so there is a greater need for relatively expensive new medicines. These diseases' high profile has led to the establishment of large-scale funding mechanisms.
Conditions such as pneumonia and diarrhoea are also major killers, especially of young children. The medicines needed to combat these are mostly off-patent and should be widely available in generic form. But virtually no money is being put into these disease areas by OECD governments. And without donor funding, even generics are largely unaffordable in poor countries.
There is a role for differential pricing, but it makes sense only if there is broader donor funding, if differential pricing is implemented by generic manufacturers and if developing countries lower tariffs and other barriers to essential medicines. - Yours, etc,
RONAN COLLINS,
Communications Manager,
Irish Pharmaceutical
Healthcare Association,
Dublin 4.