Germán Velásquez is one of the most well know individuals in the debate on access to medicines due to his criticism on government immobility and the loss of independence and credibility of international agencies. He worked at the World Health Organization (WHO) for more than 20 years, where he was the Director of the Secretary for Public Health, Innovation and Intellectual Property. He is currently a special advisor for South Centre, an organization made up of over 50 developing countries. We talked to him during a meeting organized by the Framamundi-UCM Chair—’Right to Health and drug access’.
You have an extensive track record on access to medicine. From your experience, what has changed in recent years?
The most important and dangerous change is the pharmaceutical industry’s attempt in recent years to change the fixed price model. For 50 or 60 years, the industry argued that research was expensive, so drug prices were high. Today that does not matter, they believe prices should be based on value and not production costs. That value can be of a liver or your life. This is a dangerous change we must combat.
And what about WHO? You spent for than two decades at the agency, but today are one of its biggest critics.
WHO is now run by the private sector. One of the urgent actions is to recuperate public control. Imagine that the Spanish Health Ministry was funded an 85% by private foundations, that would be a catastrophe and no one would accept it. Let’s extend that to the international public agency. Over the next 5 to 10 years, WHO should have 51% of its budget held by the public sector and not in the hands of the pharmaceutical industry and private agencies.
In addition, the WHO needs a new secretary. A couple of years ago it was more active, with all the weight the organization has, it provided technical assistance to countries to advise them on the use of the flexibilities of the TRIPS agreement, including compulsory licensing. However, today the WHO says very little on the topic and it is important that it support the governments studying these possibilities, but are under pressure from the EU and USA.
Do you consider it to still be a necessary organization?
If the WHO were to shut down tomorrow, we would need to open equivalent entities because in the world that we live in today a five hour plane ride can bring us to the other end of the world there needs to be an international regulatory organization.
Do you think we are placing private interests above the health of the population?
We are beginning to unmask the industry’s philosophy, which for years we have believed it was for health service. It’s not. Today it is a financial industry listed on the Stock Exchange and for which the most important thing is not the how many lives are saved, but how much their stock increases on the New York Stock Exchnage. It is a question of prestige and speculation. One can speculate on cars and computers, but not with people’s lives.
The current model of drug research and development is increasingly questioned and there seems to be consensus that it needs to be reformed. What’s next?
Civil society movements are very important because they are clarifying what the problem is, who the actors are and who has to do what. The next step would be to go to the parliaments of the countries, especially the industrialized with more power, to decide national standards and set positions to define how to act at WHO and how to call on WHO.
And lastly, we have to limit the pharmaceutical industry. There is an English author who says, “What does a 400-kilogram gorilla do? Well, whatever it wants.” That is what the pharmaceutical industry, which is more powerful than many states, does. We need to limit that.
You claim that patents are a major obstacle to drug access.
Yes, it is an important obstacle, but not the only one. There is a lot of work to be done. For example, in South Centre, where I currently work, we have a program to assist governments and patent offices. We train, especially patent providers, to introduce public health criteria in their patent examinations. The reality is by being stricter we would have less patented medicines and the problem would decrease.
As a global issue, what do you find feasible at the interstate level?
The launch of a Convention at the WHO, such as the tobacco convention, is important. It is vital to have an international treaty where each country contributes, depending on its wealth, to a common research fund, without the patent obstacle. A few weeks ago, there was an article in The Lancet that said that perhaps the response to antibiotic resistance should come from mandatory mechanism, so I believe it should enter the jurisprudence of health access, so that there are standards that require patients at a national and international level to have access to medicines as a citizen right.
Another star topic is the research agenda.
Yes, that’s also one of the serious issues. Today the agenda is defined according to the market and profits. The States and WHO should exert their influence so that research is done on the real health burdens of the population.
With this outlook, do you think there is room for optimism?
If you look back, of course there is room for optimism. Fifteen years ago, there were 27,000 people being treated with antiretrovirals and today there are 20 million. It’s a sign that we have to keep fighting and be optimistic.