| Snakebites, Patents and Medicine Prices | | Minimal Government Thinkers, Inc | | Philippines | Bienvenido Oplas, Jr.(Nonoy)
| Monday, September 22, 2008 | | Improving access to health to as many people as possible is a noble social goal, and there are a few ways to achieve this. One, heavy government intervention by socializing health care, through free or highly-subsidized or price-controlled medicines, diagnostic tests, hospitalization. But health socialization would lead to socialization of the citizens’ income and savings. Health care is first and foremost, a personal and parental responsibility, not “government responsibility, says Nonoy Oplas, summarising the discussions at a symposium on health care at the University of Philippines | The Program in Development Economics (PDE) of the University of the Philippines School of Economics (UPSE), and Minimal Government Thinkers, Inc., jointly sponsored a symposium on “Improving access to health: should government intervene more?” last Wednesday, September 17, 2008, 2pm at Rm 111, UPSE, Diliman, Quezon City main campus. The question, “should government intervene more?” was added by this author to reflect two recent important developments in the health sector, both national and international. First, the passage by Philippine Congress of RA 9502 or the “Affordable medicines law” last June; and second, the release of the World Health Organization’s (WHO) new report, “Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health" in late August this year.  | | Dr Rene Azurin, was the MC, he is Professor at the UP College of Business Administration and a columnist at BusinessWorld newspaper in Manila. |
| | A section of the audience at University of Philippines, in Manila |
The 3 speakers were Mr. Barun Mitra, Director, Liberty Institute, in New Delhi, India; Mr. Alec van Gelder, Network Director, International Policy Network (IPN), London, UK; and Dr. Aleli de la Paz-Kraft, Assistant Professor, UPSE, Philippines. The symposium was open to the public, and about 60 people came, mostly from health NGOs, plus some health professionals, government personnel and students. In his opening remarks, Dr. Ernesto Pernia, PDE Director and UPSE Faculty member (picture below), talked about the PDE and that one of its functions is to hold or host symposia or lectures on selected topics of public interest. He acknowledged the presence of two foreign speakers from Delhi and London.  | | Dr. Ernesto Pernia, PDE Director and UPSE Faculty member. |  | | Mr. Alec van Gelder, Network Director, International Policy Network (IPN), London, UK. |
The Master of Ceremonies (MC) and Open Forum Moderator was Dr. Rene Azurin, a Professor at the UP College of Business Administration and a columnist at BusinessWorld newspaper. Mr. van Gelder spoke first, he talked on the subject, “Free trade and property rights: their role in increasing access to medicines and health care”. It was a good and preliminary overview on some global trends in health, trade, patents, medicine and health care pricing. He argued that a number of poor countries grappling with low access of the general population to quality medicines and health care, are faced with insufficient health care infrastructures more than the issue of patents and intellectual property rights protection or confiscation. Dr. Aleli Kraft spoke next, she presented a powerpoint presentation entitled “Improving access to medicines”. The focus of her talk was on the Philippine case and explained why medicine prices are an important factor in the overall health care situation in the country. The Family income and expenditures survey (FIES) 2003 report showed that on average, two-thirds (67 percent) of all health care expenses by Filipinos were spent on buying medicines. Then she showed more figures, like comparative prices of certain medicines by multinational pharmaceutical companies, Philippines vs. India and Pakistan, showing that prices in the Philippines for the chosen drugs were a lot higher compared to those in India and/or Pakistan. The figures were generated by then President of a Philippine government corporation engaged in parallel importation of selected medicines, 2004 figures. Mr. Barun Mitra spoke the last, and he focused on “Access to health care: the real barriers”. He narrated that certain necessary and prescriptive medicines are available for free, zero cost, to many poor people in India, but up to 70 percent of the Indian population still do not have access to quality health care. He reiterated an earlier point made by Alec that certain health infrastructures – like hospitals and clinics, physicians and nurses, storage facilities for important medicines, roads and electricity for those clinics and medicine storage facilities, and so on – are more important compared to medicine prices and patents. Snakebites kill on average 50,000 people every year in India alone! Barun read this information in one of WHO’s reports. The audience, this writer included, shivered at this fact shared by Barun. Snake venom can be neutralized by certain medicines that are made available for free to many rural villages. Problem is that such medicines need storage at stable, low temperatures, but many villages do not have electricity, or have unstable supply of electricity. Then there are also many instances where “transportation cost” is the biggest component of health care, where patients and their caretakers have to travel many hours, even days, to reach a good clinic or hospital, spend a few days while being diagnosed, then spend many hours, even days, to go back home. 
| Dr. Aleli de la Paz-Kraft, Assistant Professor, UPSE, Philippines. | 
| Mr. Barun Mitra, Director, Liberty Institute, in New Delhi, India. |
For cases like this, Barun (picture above) argued that it is those various health infrastructures, not medicine prices or patents, that constitute real barriers to access by the poor to quality health care. Thus, should governments intervene, they better provide those infrastructures first before intervening in the pricing of medicines, diagnoses and related health care services. The open forum followed. A number of issues were raised from the floor. Program MC, Dr. Azurin reiterated in the symposium his arguments why he is in favour of “parallel importation” scheme to help bring down medicine prices. Another speaker from the audience on the right photo. This writer also briefly argued why “parallel importation” scheme is hypocritical, and argued instead for full free trade – zero tariff and non-tariff barriers – for the entry not only of more quality medicines, but also the innovator pharmaceutical companies. The symposium lasted for nearly 3 hours, including open forum. It was an afternoon of high quality exchange of views, opinions and experiences. Improving access to health to as many people as possible is a noble social goal, and there are a few ways to achieve this. One of which is heavy government intervention by socializing health care, through free or highly-subsidized or price-controlled medicines, diagnostic tests, hospitalization, and so on. But when government gives (or pretend to give) people everything, it will also take everything from them. So health (and other social services) socialization would automatically mean socialization of the citizens’ income and savings. This does not look sustainable nor desirable. Another way is less government intervention, more competition among innovator pharmaceutical companies, among hospitals and clinics, among health and maintenance organizations (HMOs), less taxes, more personal responsibility. Health care is first and foremost, a personal and parental responsibility, not “government responsibility.” People cannot drink every night, heavily smoke everyday, get into frequent fights and injuries, become a drug addict, live in unsanitary places, etc., and when they get serious illness, they blame patents and the multinationals, then demand that they deserve quality health care as a “right”.
| | L to R: Nonoy Oplas, Alec van Gelder, Barun Mitra, Aleli de la Paz-Kraft, and Dr Rene Azurin |
MG Thinkers will conduct more educational activities like this symposium in the future, if only to remind people of the importance of assuming more personal, parental and community responsibilities in running their own lives, their households and their communities. People who take more individual responsibility will appreciate and enjoy more individual liberty.
| | | | This article was published in the Minimal Government Thinkers, Inc on Monday, September 22, 2008. | | Author : Mr Oplas is the head of Minimal Government campaign in Philippines. |
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