Compulsory Licenses - The Dangers Behind The Current Practice
Compulsory Licenses - The Dangers Behind The Current Practice
Compulsory Licenses - The Dangers Behind The Current Practice
2009
Recommended Citation
Feldman, Jamie (2009) "Compulsory Licenses: The Dangers Behind the Current Practice," Journal of International Business and Law:
Vol. 8: Iss. 1, Article 9.
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Feldman: Compulsory Licenses: The Dangers Behind the Current Practice
COMPULSORY LICENSES:
THE DANGERS BEHIND THE CURRENT PRACTICE
Jamie Feldman*
INTRODUCTION
* J.D. Candidate, 2010, Hofstra University School of Law. I would like to thank the entire senior
staff of the Journal of International Business and Law, particularly Vanessa Tiradentes and Brian
Farrar. I would also like to thank my advisor, Professor Efthimios Parasidis, along with Professor
Eric Bensen, for providing me with invaluable guidance. A special thanks to my parents, Mitchell
and Mauria, and my siblings, Madelyn, Daniel, Billy, Allison, and Jessica, for loving and supporting
me in everything I do. Thank you to my best friends, Jenna and Jen, for always being there for me.
Lastly, I would like to thank Michael for bringing me happiness everyday.
' See Daniel R. Cahoy, Confronting Myths and Myopia on the Road from Doha,42 GA. L. REV.
131, 133 (2008). See also Colleen Chien, Cheap Drugs at What Price to Innovation: Does the
Compulsory Licensing of PharmaceuticalsHurt Innovation?, 18 BERKELEY TECH. L.J. 853, 858
(2003).
2 Chien, supra note 1.
compulsory licenses have all been headlining news. Thailand and Brazil's
actions have created negative connotations, while Rwanda's use has been
widely praised. Part V highlights four main dangers that are likely to arise if
the current laws are not amended. Finally, Part VI lays out several suggestions
on how to reform the provisions which govern compulsory licenses.
A. Background
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grants the patent holder a 20-year exclusive right over his invention, during
which time no one, absent authorization by the patent holder, may make, use, or
sell the patented product. 12 In exchange for this exclusive right, the patent
holder pays his due to society by disclosing the technical information behind
how the invention was created, and at the end of the 20-year 3 period the
protection expires and the creation enters the public domain.'
In the realm of pharmaceuticals, an inescapable tension exists between
the aspiration to provide the sick with access to life-saving drugs, and the need
to maintain incentives for pharmaceutical companies to create new innovations
by ensuring a return on their investments. 14 On one extreme it is argued that
"patent protection should end where saving lives or alleviating suffering begins;
that is, patent law should be subordinate to certain social interests."' 5 At the
opposite end of the spectrum, it is argued that pharmaceuticals should be treated
like all other commodities, thus the price should be determined by the basic
principles of supply and demand.16 The former approach is motivated by socio-
humanitarian objectives because health, wellbeing, and even death are on the
line.17 The latter approach, on the other hand, is driven by the incentive to
innovate. 18 Prospective profits have always been the necessary incentive in
encouraging the inventions of marketable products.1 9 Most opinions on this
issue fall somewhere in the middle of these two extremes, believing that some
governmental regulation is necessary in guarantying access to essential
medicines. However, the question still remains: when does governmental
regulation cross the line from being helpful to becoming destructive?
Intellectual property rights are the fundamental driving forces behind
the pharmaceutical industry.2 ° In light of globalization, transnational
obviousness, and sufficient disclosure to allow others to make and use the invention).
2 Id. at 28.
13 World Trade Organization, Understandingthe WTO: The Agreements 7 (2007),
http://www.wto.org/english/thewto-e/whatis-e/tif-e/utwchap2-e.pdf.
"4 See Robert Bird & Daniel R. Cahoy, The Impact of Compulsory Licensing on Foreign Direct
Investment: A Collective BargainingAppraoch, 45 AM. Bus L.J. 283, 284 (2008).
'5 Amir H. Khoury, The "PublicHealth" of the Conventional InternationalPatent Regime & the
Ethics of "Ethicals:" Access to PatentedMedicines, 26 CARDOZO ARTS & ENT. L.J. 25, 32 (2008).
16Id. (explaining that patentees are in general able to set the price of their invention, which in turn
determines where and to whom the product is sold).
17 Id. (explaining that medicines are unique from other patented products in the sense that they are
capable of easing pain and are even able to pro-long life).
18 Id.
19 Senator Max Baucus, Hearing on International Enforcement of Intellectual Property Rights and
American Competitiveness (July 15, 2008) (transcript available at 2008 WLNR 13295305) (stating
that patents are essential for a competitive market).
20 Jenna Greve, Healthcare in Developing Countries and the Role of Business: A Global
B. Compulsory Licenses
http://www.kommers.se/upload/Analysarkiv/ArbetsomrC3%A5den/WTO/Handel%20och%20sky
dd%20fC3%B6r%20immateriella%20rC3%A4ttigheter%20-
%20TRIPS/Rapport%20TheWTOdecisiononcompulsory-licensing.pdf [hereinafter WTO
DECISION].
27 Cahoy, supra note 1, at 133.
28 id.
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Stricter and more objective laws are needed to govern the practice of
issuing compulsory licenses in order to maintain the delicate balance between
the right of access to life-saving medicines and the right pharmaceutical
companies have to earn a profit from their inventions. Of course, under very
36
limited circumstances, compulsory licenses can be a beneficial tool.
However, there is a fine line dividing when the practice of issuing compulsory
37
licenses is proper and when it will cause disastrous results.
There are at least four detrimental consequences that will arise if the
language of the TRIPS Agreement is not amended.38 First and foremost, if
compulsory licenses are too easily obtainable, absent the threat of an acute
health crisis, innovation funding will erode.39 It is the monopoly power
pharmaceutical companies are capable of obtaining over their patented
medicines that induces invention. 40 Therefore, future investment in
pharmaceuticals will be viewed as a risk without this monopoly power.
Secondly, a decline in global health will result because pharmaceutical
companies will be hesitant to introduce new medications into nations with high
rates of disease. Additionally, the nation that will manufacture the generic
version of drug after a compulsory license has been issued will generally have
lower standards of quality than the country that manufactured the named brand
drug. Thirdly, absent strong intellectual property protections foreign investment
will decline, causing devastating effects on developing nations. Lastly, the
American economy will further suffer based on the large, job-producing
pharmaceutical industry in America, which is dependent on strong intellectual
property rights protections.
The practice of issuing compulsory licenses is likely to increase in the
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near future, 4' therefore more stringent laws must be implemented to safeguard
against abusive issuances.42 The current language of the TRIPS Agreement is
not sufficient to protect the world against compulsory license misuse. If more
objective laws are not adopted, the world faces the risk of economic turmoil
coupled with declining world health. Moreover, strong international intellectual
property protections are essential to the continued progress in the field of
pharmaceuticals.
41 See Zolotaryova, supra note 32, at 1109 (explaining that because chronic diseases are now seen
as a severe enough health emergency to implement a compulsory license, the use of compulsory
licenses is likely to increase).
42See Outterson, supra note 37.
43 Zolotaryova, supra note 32, at 1101 (quoting WTO Frequently Asked Questions about TRIPS,
http://www.wto.org/english/tratop-e/trips~e/tripfqe.htm).
" MERGES ET AL., supra note 3, at 2.
45Id. (explaining that "[i]deas do not have this characteristic of excludability" and that more than
one person can use an idea without diminishing the value of the idea).
46 Outterson, supra note 37, at 3. "Tangible goods are rivalrous. They suffer from exhaustion and
congestion. But most intangibles are nonrivalrous, including the biomedical knowledge which
forms the basis of the pharmaceutical industry. Id. Most pharmaceutical knowledge is
nonfivalrous, and this fact enables a transformation from free riding and piracy to fair following."
Id.
47 Khoury, supra note 15, at 39. See also MERGES ET AL., supra note 3, at 13. "Because
intellectual property rights impost social costs on the public, the intellectual property laws can be
justified by the public good argument only to the extent that they do on balance encourage enough
creation and dissemination of new works to offset those costs." Id. See also Baucus, supra note 19
(stating industries that rely on intellectual property protection account for most American exports).
" Khoury, supra note 15, at 37 (explaining that if pharmaceutical companies lost exclusive control
over their patented products they would be robbed of the fruits of their labor and their incentive to
innovate would be offset).
49 See generally MERGES ET AL., supra note 3, at 14 (explaining the economic incentive behind
patents).
50 MERGES ET AL., supra note 3, at 14.
51 See id. at 14; Bird & Cahoy, supra note 14, at 283; Zolotaryova, supranote 32, at 1107.
52 Khoury, supra note 15, at 37. See also Henry J. Kaiser Family Foundation, Cost of New Drug
Development Reaches $897M, Study Says, KAISER DAILY HEALTH POLICY REPORT, May 15, 2003,
http://www.kaisernetwork.org/daily-reports/rep index.cfm?DR-ID= 17747 (explaining that a
pharmaceutical company spent close to $900 million dollars on research and development per drug,
and that there is no guarantee that the drug will be successful).
53 MERGES ET AL., supra note 3, at 2 (describing John Locke's theory of labor).
54 See Khoury, supra note 15 at 37.
55 WTO DECISION, supra note 26, at 15 (explaining one-third of the world's population lacks access
to life-saving drugs).
56 See Khoury, supra note 15, at 37.
57 AIDS stands for Acquired Immune Deficiency Syndrome.
55 WTO DECISION, supra note 26, at 15 (stating the 25 million people have died from AIDS from
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67 Id.
68 TRIPS Agreement, supra note 33, art. 27. "Patents shall be available for any inventions, whether
products or process, in all fields of technology." Id. (explaining the three criteria needed to qualify
for a patent: an invention has to be new (novelty), it must be an inventive step (it must not be
obvious), and it must have industrial applicability (it must be useful)).
51 Zolotaryova, supra note 32, at 1100.
69 Id.
70 World Trade Organization, Fact Sheet: TRIPS and PharmaceuticalPatents,
http://www.wto/english/tratop-e/tripse/factsheet-pram02-e.htm (last visited November 1, 2008)
[hereinafter Fact Sheet].
7' TRIPS Agreement, supra note 33, art. 31(a). See also WTO DECISION, supra note 26, at 7.
72Fact Sheet, supra note 70. See also TRIPS Agreement, supra note 33, art. 31 (h); Cahoy, supra
note 1, at 136. Neither "adequate remuneration" nor "economic value" are defined.
73 Fact Sheet, supra note 70. See also TRIPS Agreement, supranote 33, art. 31 (b). Neither
reasonable commercial terms nor reasonable time period are defined in the TRIPS Agreement.
74 TRIPS Agreement, supra note 33, art. 31(b) (explaining that, under circumstances of national
emergency or extreme urgency, the right holder should be notified of the practice of compulsory
licensing on their product as soon as reasonably practicable). Similarly, when a license is used for
public non-commercial use, the government shall inform the right holder promptly. Id.
Additionally, "national emergency", "circumstances of extreme urgency", or in cases of "public
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states that after a nation is authorized to issue a compulsory license, the use
must be for the supply of the domestic market.75
Article 31(f) was the source of much criticism because medicine
production is concentrated in high-income countries, and many developing
76
countries lack pharmaceutical production capacity all together. This provision
therefore acted like a barrier, preventing countries with insufficient or no
manufacturing capabilities from issuing a compulsory license.77 Article 31 was
essentially
78
useless to the countries that were in need of compulsory licenses the
most.
In response to the backlash on this matter, the Ministerial Conference
of the World Trade Organization met in Doha Qatar, and on November 14,
2001 79 and adopted a Declaration on the TRIPS Agreement and public heath,
commonly known as the Doha Declaration. 80 The Doha Declaration
acknowledged the problem developing countries were facing in issuing
compulsory licenses due to article 31(f) of the TRIPS Agreement. 81 Paragraph
6 of the Declaration stated, "[w]e recognize that WTO members with
insufficient or no manufacturing capacities in the pharmaceutical sector could
face difficulties in making effective use of compulsory licensing under the
TRIPS agreement," and the Declaration called for an expeditious solution to
this problem. 82 The WTO General Council adopted Paragraph 6 of the Doha
Declaration on August 30, 2003.83 The decision was comprised of three
waivers under Article 31. First and foremost, the exporting countries' duty is
waived because a compulsory license is no longer only for the supply of the
domestic market under article 31(f). 8 4 Secondly, the obligation under 31(h) is
waived because only the exporting country, and not the importing country, is
responsible for remuneration to the patent holder. 85 Lastly, re-export of the86
imported pharmaceutical is allowed among members of a regional agreement.
Following the adoption of Paragraph 6 several nations, including the United
States, agreed not to use Paragraph 6 as an importing member.87
Not only did the Declaration move to correct several problems
associated with Article 31, but it also addressed how the TRIPS Agreement as a
whole should be interpreted. The Doha Declaration affirmed that the TRIPS
Agreement should be construed in a manner supportive of WTO Members'
right to protect public health, and the Declaration acknowledged that the TRIPS
Agreement provided intentional flexibilities for this precise purpose. 88
Although Paragraph 1 of the Doha Declaration does not explicitly list what
diseases are eligible for prompting the issuance of a compulsory license, it does
state, "[w]e recognize the gravity of the public health problems afflicting many
developing & least developed countries, especially those resulting from
patented process, of the pharmaceutical sector needed to address the public health problems as
recognized in paragraph I of the Declaration...'eligible importing Member' means any least-
developed country Member, and any other Member that has made a notification to the Council for
TRIPS of its intention to use the system as an importer... 'exporting Member' means a Member
using the system set out in this Decision to produce pharmaceutical products for and export them to,
and eligible importing Member" (quoting the Doha Declaration,supra note 73)).
84 Christina Cotter, The Implications of Rwanda's Paragraph6 Agreement with Canadafor Other
Developing Countries, 5 LoY. U. CHI. INT'L L. REV. 177, 191 (explaining that developing countries
can now import generic drugs from developed countries).
85 Id. (stating that the importing country is no longer burdened with paying the patent holder
adequate remuneration).
86 Id. (noting that now developing countries with small populations can declare a joint emergency).
87 Cahoy, supra note I at 158 n.86 (noting countries agreeing not to use paragraph 6 of Doha
Declaration as importing members: Australia, Austria, Belgium, Canada, Denmark, Finland, France,
Germany, Greece, Iceland, Ireland, Italy, Japan, Luxembourg, Netherlands, New Zealand, Norway,
Portugal, Spain, Sweden, Switzerland, UK, and US, since joining the EU the list also includes
Czech Republic, Cyprus, Estonia, Hungary, Latvia, Lithuania, Malta, Poland, Slovak Republic and
Slovenia). See also Doha Declaration,supra note 73, 1.
88 Abbott, supra note 80, at 322 (noting that the Doha Declaration reaffirmed the TRIPS Agreement
"can & should be interpreted in a manner supportive of WTO members right to protect public health
and in particular, to promote access to medicines for all" (quoting Doha Declaration,supra note 73,
6)); Implementation of Paragraph6, supra note 77 (paragraph 7 of Doha states that the TRIPS
agreement should be interpreted in a way to promote the objective of paragraph 6: "promoting the
transfer of technology and capacity building in the pharmaceutical sector").
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HIV/AIDS, tuberculosis, malaria and other epidemics. '89 Moreover, the Doha
Declaration stated, "each Member has the right to determine what 9°
constitutes a
national emergency or other circumstances of extreme urgency.
Due to the fact that "each Member has the right to grant compulsory
licenses and the freedom to determine the grounds upon which such licenses are
granted," great subjective power rests with developing nations in the
determination of whether to issue a compulsory license. 9 1 The broad text of the
TRIPS Agreement was intended to grant each nation the authority to promote
public health, but the wording is too flexible and lacks objective guidelines,
thereby providing a perfect atmosphere for compulsory license abuse. Misuses
of this strong governmental right will lead to detrimental consequences.
96 Savoie, supra note 90, at 237. See also WTO DECISION, supranote 26, at 34.
97 Savoie, supra note 8, at 237.
98 Id. See also WTO DECISION, supra note 26, at 34.
99 India did not yet have patents on their pharmaceuticals. See Cahoy, supranote 1, at 13
(explaining that developing countries were given a transition period to adopt patents on
pharmaceutical products under the TRIPS Agreement). See also Hestermeyer, supra note 36
(explaining India had until January 1, 2005 to start granting product patent protection for
pharmaceuticals).
1ooSee The World Bank, Country Classifications, http://web.worldbank.org (last visited February 1,
2009) (defining a middle income country as a country having a gross national income per capital
between $936-$3,705).
10' Savoie, supra note 90, at 237. See also WTO DECISION, supra note 26, at 34.
102WTO DECISION, supra note 26, at 34. See also TRIPS Agreement, supra note 33, art. 31(b).
Public non-commercial use is one of the exceptions to the general requirement that efforts to
compromise with the patent holder must have failed before a nation can issue a compulsory license.
Id.
Io3 Savoie, supra note 90, at 237. See also WTO DECISION, supra note 22, at 34.
'04 Savoie, supra note 90, at 237.
105 id.
106 ICTSD, Brazil Grants Compulsory License, NEWS & ANALYSIS, May 2007,
http://ictsd.net/i/news/bridges/11643/ [hereinafter ICTSD, Brazil].
107Andre Picard, No Room for Petty Politicsin Goodwill Program:Canadais the First Country to
Ship Cheap AIDS Drugs to Africa, but a Morass of Red Tape Continues to Threaten Humanitarian
Efforts, GLOBE & MAIL, Sept. 25, 2008, availableat 2008 WLNR 18185326.
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A. Thailand's Use
persists for an extended period of time." Examples include heart disease, stroke, diabetes, cancer
and chronic respiratory disease).
11 See Abbott Laboratories, supra note 110 (explaining that Plavix is a blood-thinning drug for
cardio-vascular disease).
essentially sending the message that they are willing to invoke a compulsory
4
license over any drug available on the market.' 1
Thailand justified their need to issue a compulsory license for the heart
disease medicine under article 13(b)'s 'public non-commercial use' instead of
the 'national emergency' provision. 115 'Public non-commercial use' is not
defined in the TRIPS Agreement, and therefore Thailand's action represents
how the 'public non-commercial use' provision widens the spectrum as to what
health issues are considered severe enough to override a patent.' 16 This is
disheartening because pharmaceutical companies are now under threat of huge
financial losses. The majority of money spent by pharmaceutical companies in
research and development goes to drugs that are marketable in the developed
world." I7 While infectious diseases are more prevalent in developing nations,
chronic diseases are found everywhere in the world. Now that any patented
drug is capable of being overridden by a compulsory license pursuant to the
lenient text of the TRIPS Agreement, pharmaceutical companies are in danger
of not being able to recoup money from the main drugs that drive their industry
- drugs aimed at developed nations' markets.1 8 This new, unlimited scope of
compulsory licenses is likely to cause pharmaceutical companies to decrease
investment in all drugs out of fear that they will not earn their expected profits.
Moreover, Thailand angered Abbott Laboratories, the manufacturers of
Kaletra when it issued a compulsory license over their AIDS medication
because Abbott Laboratories was already selling Kaletra to Thailand at a
substantially discounted rate.' 19 Abbott Laboratories complained that the Thai
government did not engage in proper negotiations with the pharmaceutical
company before issuing the license. However, because Thailand issued the
license on 'public non-commercial use' grounds, the negotiation requirement
120
was lawfully waived under article 31(b).
If the type of compulsory licensing exercised by Thailand continues,
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Thailand along with the rest of the world will suffer damaging consequences.2
For example, Abbott Laboratories reacted to Thailand's actions by stating,
"Thailand has revoked the patent on our medicine, ignoring the patent system.
Under these circumstances we have elected not to introduce new medicines
there."' 22 Abbott then withdrew seven registration applications for new
pharmaceutical products in Thailand. 23 Five of those applications were
targeted at chronic diseases. 124 As a result of Thailand's abuse of compulsory
licenses, Thai citizens will now suffer because they will be deprived of new
drugs created by Abbott Laboratories and other cautious pharmaceutical
companies. 125
Thailand's actions also promoted trade retaliation by the United
126
States. The United States is Thailand's largest trading partner, but due to
Thailand's recent irresponsible issuances, the United States placed Thailand on
its' Priority Watch List. 12 This list highlights which of the United States'
trading partners the US has concerns over the adequacy and effectiveness of
intellectual property right protections.1 28 Lastly, Thailand's recent practice has
caused worldwide disproval. The EU Trade Commission has stated that they
object to Thailand's approach to issuing compulsory licenses. 129 Although the
EU Trade Commission agrees with the overall underlying theory of authorizing
developing nations to issue compulsory licenses, it feels that Thailand's
121 But see Thai Health Ministry Takes "Bold Step" in Breaking Patent,Issuing Compulsory
License for AntiretroviralKaletra , EditorialSays, available at
http://www.thebody.com/content/art39745.html (last visited April 6, 2009) (explaining that health
groups have applauded Bangkok's recent policy because the low drug costs will allow the
government to treat thousands more people).
122Abbott Laboratories, supra note 110 (quoting Dirk Van Eeden, Public Affairs Director of Abbott
International).
123Savoie, supra note 90, at 14.
124 Id.
125See Zolotaryova, supra note 32.
126Khoury, supranote 15, at 33.
127Ed Silverman, US Trade Rep: Thailand On Watch List, PHARMALOT, Apr. 30, 2007,
http://www.pharmalot.com/2007/04/us-trade-rep-hailand-on-watch/ (explaining that Thailand has
not violated any world trade rules, but that the Priority Watch List is "reserved for countries that
don't 'provide an adequate level of intellectual property rights protection or enforcement"'). See
also OFFICE OF THE U.S. TRADE REPRESENTATIVE, 2008 SPECIAL 301 REPORT 37 (2008),
http://www.ustr.gov/assets/Document-Library/Reports-Publications/2008/2008-Special-30I -Repo
rt/asset uploadfile553_14869.pdf (stating that "Thailand will remain on the Priority Watch List in
2008 due to a broad range of concerns surrounding IPR protection and enforcement") [hereinafter
SPECIAL 301 REPORT].
128Savoie, supra note 90, at 245.
129Ed Silverman, EU Trade Commish Scolds Thailand, Again, PHARMALOT, May 28, 2008,
http://www.pharmalot.com/2008/05/eu-trade-commish-scolds-thailand-again/.
B. Brazil's Use
130 Id.
131 id.
132Zolotaryova, supra note 32, at 1099.
1-3Id. at 1105. See also TRIPS Agreement, supra note 33, art. 31(b).
1.4 Zolotaryova, supra note 32, at 1104.
'3' Id. at 1107.
136 id.
137 ICTSD, Brazil, supra note 106. See also Merck & Co., Inc., Merck & Co., Inc. Statement on
Brazilian Government's Decision to Issue Compulsory Licensefor STROCRIN, Corporate News,
May 4, 2007, http://www.merck.comnewsroom/press-releases/corporate/20O70504.html
[hereinafter Merck].
38 ICTSD, Brazil, supra note 106.
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money and that are hit harder with the epidemic.1 39 The second reason Merck
condemns Brazil's practice is because future foreign investment will be
discouraged, which will ultimately result in less drugs being introduced into
Brazil. 14° This issuance of a compulsory license has had a negative impact on
Brazil's reputation as an industrialized country seeking to attract foreign
investment. 141
Both Thailand and Brazil's recent actions exemplify a new trend in
issuing compulsory licenses, likely to have dangerous effects not only on the
imprudent nations which practice these methods, but also on the rest of the
world. If there were more stringent laws governing the issuance of compulsory
licenses Thailand and Brazil most likely would not have been authorized to
issue these compulsory licenses.
C. Rwanda's use
139 id.
140 Zolotaryova, supra note 32, at 1107.
141 Id.
142 Savoie, supra note 90, at 237.
143 Zolotaryova, supra note 32, at 1102 (citing Naomi A. Bass, Implications of the TRIPS
Agreement for Developing Countries PharmaceuticalPatent Laws in Brazil and South Africa in the
21" Century, 34 GEO. WASH. INT'L L. REV. 191, 209-10 (2002)) (explaining that Merck lowered the
price for the HIV/AIDS medicine Stocrin, and Roche agreed to lower the price on the AIDS drug
Viracept). Roche is a Swiss pharmaceutical company.
144Hestermeyer, supranote 36 (explaining TriAvir is a combination of three HIV/AIDS drugs:
zidovudine, lamivudine, nevirapone).
145 Cotter, supranote 84, at 177.
notified the WTO on October 4, 2007 that it had authorized the production of a
generic version of the patented antiviral drug for export to Rwanda. 1' The
Canadian company Apotex was the pharmaceutical company responsible 147
for
manufacturing Apo-TriAvir, which is a drug that has nine related patents.
Rwanda has a population of 9.3 million people, of those citizens,
200,000 are infected with either HIV or AIDS. 148 Less than one-forth of the
HIV/AIDS infected people living in Rwanda were receiving anti-viral
treatment. 149 On September 24, 2008 the generic AIDS medication left Toronto
for Kigali. 50 The shipment contained 7 million doses of Apo-TriAvir. From
this shipment, 21,000 Rwandans will be treated for a full year.' 51 Apotex will
export Apo-TriAvir at a cost of approximately $0.20 per tablet, compared 152
to the
three brand name components which would run around $6.00 per dose.
Although Rwanda illustrates a success story, the process laid out in
Paragraph 6 of the Doha Declaration has been criticized for being too time-
consuming. Rwanda did not receive their shipment of the generic drugs from
Canada, for over an entire year after they notified the WTO of their intention to
import the drug. 153 Moreover, if Apotex agreed to export this generic version of
AIDS medication to another developing country, Apotex would have to go
through the entire time-consuming process again. 54 Not only was the process
impractical because it took so long, but it also cost the exporting nation a lot of
money.1 55 Until the process becomes more efficient, developed countries will
be deterred from agreeing to manufacture generic drugs for exportation to
developing countries in need.
146 ld.
147 Hestermeyer, supra note 36 (explaining that of the nine patents associated with the HIV drug,
four of them are owned by the Glaxo company, two of them are owned by the Wellcome
Foundation, two by Shire Biochem, and lastly, one is owned by Boehringer Ingelheim and Dr.
Thomae).
148 Cotter, supra note 84, at 178.
149 id.
150 Picard, supra note 107 (explaining under Canada's Access to Medicines Regime they remain the
only country in the world which can legally produce low cost generic medicines and deliver them to
the developing world).
151 Id.
152See ICTSD, Rwanda Should Receive Cut-Price HIV / Aids Drugs In September, Five Years
After 30 August Decision, BRIDGES WKLY. TRADE NEWS DIG., May 14, 2008,
http://ictsd.net/i/news/bridgesweekly/11081/. See alsoApotex Awarded ApoTriAvir Tender From
Rwanda Government, World Generic Markets, May 21, 2008, availableat 2008 WLNR 9588676.
153See Picard, supra note 107.
154 id.
155 id.
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There are four main dangers likely to arise from the ambiguous
language of Article 31 of the TRIPS Agreement. More stringent laws must be
in place in order to avoid these dangers. The first of these problems is based on
the utilitarian theory. 156 It is well understood that "[p]atents provide incentives
to individuals by offering them recognition for their creativity and material
award for their marketable inventions." 157 Compulsory licenses, nevertheless,
diminish the incentive to undertake research and development in the
pharmaceutical industry because the issuance of a compulsory license causes
the patent holder to lose his expected earnings. Human life is continuously
advanced because innovation is encouraged by incentives. 118 Without
incentive, advances in the pharmaceutical industry will quickly subside.
The high price of medicine stems from the costly research and
development process, which is necessary to produce safe and effective
pharmaceutical products.' 59 In 2001, funding for global research and 6°
development was over $100 billion in the pharmaceutical sector. 6 1
Approximately 56% of this funding was provided by the private sector.'
Moreover, most pharmaceutical research does not conclude in a patented
medicine, therefore pharmaceutical companies must secure earnings that not
only cover their research and development costs and their running costs, but
also the costs of unsuccessful research. 62 The monopoly power created by a
patent is essential for pharmaceutical companies to earn enough money to stay
in business and to finance subsequent research and development projects.' 63 A
decrease in research will certainly
64
reduce the rate of medical progress and
innovation across the globe.'
When a government issues a compulsory license the pharmaceutical
company's incentive to continue to invest their private funds into research and
development for new medicines for that nation quickly fades away. A major
United States drug company, Merck & Co., illustrated this logic when it stated,
"[t]his expropriation of intellectual property sends a chilling signal to research-
based companies about the attractiveness165of undertaking risky research on
diseases that affect the developing world."'
A compulsory license is retroactive in nature, meaning that the product
is already patented and the patent holder only loses his exclusive right over the
patented product after a compulsory license is issued. The private funds have
already been invested into the product, so once a compulsory license is issued
the investment cannot be taken away.166 However, once a compulsory license is
issued, the incentive to invest in the future will be reduced. "You can compel a
private company once [with a CL]. After that they will probably leave your
boarders, and you lose the opportunity to get the access and technology in the
167
future."'
The second foreseeable danger is that global health will actually suffer
due to the subjective language of Article 31, despite the fact that the TRIPS
Agreement was implemented and is interpreted to promote public health. The
unfortunate decline in global health stems from the utilitarian argument. In
light of Article 31, each WTO Member has the authority to issue a compulsory
license.' 68 As previously discussed, this practice will reduce the incentive of
pharmaceutical companies to invest their private funds into discovering new
medicines. Generally, developing nations have weaker intellectual property
protections and are therefore more likely to issue compulsory licenses on
patented pharmaceutical products than are developed countries. 169 Thus
pharmaceutical companies, out of fear of not recouping the cost of research and
development, will stop devoting their time and money into discovering cures for
diseases which primarily plague the developing world. 170 Instead, the
pharmaceutical industry will allocate their resources to innovating medicines
that are likely to have a successful commercial market in developed
countries. 17 1 Based on the effect compulsory licenses have on pharmaceutical
165 Merck, supra note 137 (noting Merck's reaction to Brazil's decision to issue a compulsory
license for Stocrin, an HIV drug).
166 Bird & Cahoy, supra note 14, at 290.
167 Id.
168 WTO DECISION, supra note 26, at 7.
169 See SPECIAL 301 REPORT, supra 127, at 2. The Special 301 Report is a tool used to pinpoint
problems in intellectual property rights protection in countries which are engaged in trade with the
United States. Id. Most of the countries on the Watch List are developing nations. Id.
170See Baucus, supra note 19.
171 See Tim Atkinson, Lifestyle Drug Market Booming, 8 NATURE MED. 909 (2002), available
at
http://www.nature.com/nm/joumalv8/n9/full/nmO9O2-909.html (explaining that lifestyle drugs treat
conditions such as weight loss, anti-smoking, impotence, and hair loss and that the market for these
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Feldman: Compulsory Licenses: The Dangers Behind the Current Practice
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companies' profits, the pharmaceutical industry will turn their backs on very
problematic illnesses found predominately in developing countries.
Unfortunately, many developing nations do not have domestic, progressive
pharmaceutical manufacturers. 172 If safeguards are not placed on the right to
issue compulsory licenses, ill stricken people living in developing countries will
be left with little relief in sight.
The health concerns associated with compulsory licensing are not only
that pharmaceutical companies will stop manufacturing drugs directed at
illnesses plaguing developing nations, but also that the generic drugs that will
either be domestically manufactured or imported into developing countries will
be of lower quality than the drugs created by the transnational pharmaceutical
companies. 1 3 Both India and China have become major international suppliers
of generic drugs.174 As the manufacturing is allocated to these countries, "the
risk to human health is growing exponentially."' 175 The concern about low
quality drugs arises from the fact that quality-control inspections are rarely
conducted by the Food and Drug Administration in India or China.176 In 2005
alone, the FDA conducted 1,222 quality inspections in the United States, but
within the past 7 years the FDA only conducted only 200 inspections in China
and in India combined. 177 Of the 200 inspections conducted, few of them 178
measure up to the thorough inspections carried out in the United States.
Unlike the surprise visits routinely practiced in the United States, the
inspections in India and China were scheduled in advance which gave the
manufacturing plants time to prepare. 179
Private investigations have been conducted to uncover the poor
conditions in foreign operated plants. 180 These investigations have exposed that
some plants have open walls which invite pests and dust into the production
drugs is driven by the Western market where people are willing to pay high prices to improve their
image and mental agility).
172 WTO DECISION, supra note 26, at 7 (explaining many countries have no production capacity in
facility, other plants had different chemical equipment so congested that cross-
contamination is inevitable, and one study even discovered a hornet's nest on
top of a drug making vat.'18 Based on the increase in importation from
developing nations, combined with the low levels of quality inspections in
exporting nations, the chance that consumers will receive impure or ineffective
generic drugs has greatly multiplied.' 82 Unfortunately, it is virtually impossible
to determine whether the low quality drugs imported from these lightly
regulated plants have caused patients to get more ill or remain ill because the
83
medicines are not effective. 1
The Doha Declaration clarifies that developing nations unable to
domestically manufacture drugs are authorized to import generic drugs from
nations with manufacturing capabilities. 184 Thus, developing countries
suffering from the most severe epidemics are likely to be importing drugs from
these lightly regulated Asian plants. These generic drugs have the potential to
be both unsafe and ineffective. This is a very serious danger because once a
contaminated or ineffective drug hits the market, injuries and deaths are likely
to occur before the source of the problem is tracked down.1 85 Therefore, the
overall health of theses importing nations is at risk if the rules that govern
compulsory licensing are not amended.
The third potential danger arising from the use of compulsory licenses
under the TRIPS Agreement is the reduction in the amount of money that will
be invested into developing nations. In developing countries a substantial
amount of investment comes from outside the country, which stimulates the
growth of local industry. 86 While strong intellectual property protection results
in increased investment, likewise, weak intellectual property rights leads to a
decrease in investment.' 87 When a pharmaceutical company discovers that the
security of their property rights are vulnerable in a given nation, they are likely
to avoid engaging in foreign direct investment with that nation. 188 This comes
at a heavy price for developing nations because foreign direct investment is a
major source of economic growth. 189 When a nation exercises their right to
issue a compulsory license that nation is viewed by the rest of the world as
181 Id. (explaining these private investigators were hired by U.S. companies).
182Id. (quoting Brent Zell the past chairman of the Bulk Pharmaceuticals Task Force).
183Id. (explaining that it is unlikely that doctors suspect poorly manufactured drugs are the
causation of the problem).
184Implementation of Paragraph6, supra note 33.
185 Kaufman, supra note 174 (quoting William Hubbard, a former FDA Associate Commissioner).
186Bird & Cahoy supra note 14, at 284.
187 id.
188Id.
189 Id.
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199Id.
200 Id.
20' Id. at 7 (explaining that these "employees invent, produce, and provide medicines that save and
improve lives.").
202 id.
203Id. at 5 (quoting Senator Marcus Baucus).
204 Id. (quoting Jeffery Kindler, CEO of Pfizer).
205
Doha Declaration, supra note 73, 5(c).
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Feldman: Compulsory Licenses: The Dangers Behind the Current Practice
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for the WTO to set out an enumerated list classifying which diseases do and
which diseases do not constitute a severe enough emergency to justify the
issuance of a compulsory license. Not only do new diseases occasionally
surface, but each nation also faces different conditions, and therefore an illness
in one country could be a serious national emergency, while that same illness in
another country could be nothing more than an inconvenience.
While it is clear that it would be idealistic to explicitly define when it
is appropriate for a nation to issue a compulsory license, it ought to be required
that each nation demonstrate: (1) they are suffering from 'a national
emergency', (2) they are suffering from 'a circumstance of extreme urgency',
and (3) the nation will be using the patented medicine for 'public non-
commercial use'. These three factors are already set forth in the TRIPS
Agreement, but for a different purpose. In article 31(b) the requirement of
reasonable negotiations with the patent holder is suspended under the
circumstances of a 'national emergency', 'other extreme circumstances of
extreme urgency', or a 'public non-commercial use'. 2 ° 6 These three familiar
terms to the TRIPS Agreement should be barrowed from article 31(b), and
transformed into a conjunctive requirement that each nation must fulfill before
having the option of overriding a patent.
Secondly, The TRIPS Agreement furthered by the Doha Declaration
leave the door wide open for abuses by allowing WTO Members absolute
subjective power in determining whether to issue a compulsory license. As the
TRIPS Agreement reads now, each WTO Member has the authority to
determine when their own nation is suffering from a national emergency or
circumstance of extreme urgency. This subjective approach is easily
manipulated. For example, Brazil abused the system when the nation issued a
compulsory license over Efavirenz. Despite the fact that Efavirenz is
manufactured to fight the HIV/AIDS epidemic, which is predominantly viewed
as a national emergency, Brazil's use was opposed by many nations. The
controversy arose because Brazil is a relatively wealthy nation and compared to
other nations did not have an extremely serious HIV/AIDS problem.2 °7
Controversies such as this would be avoided if a nation, other than the issuing
nation, were the determinate of whether circumstances are severe enough to
warrant the issuance of a compulsory license.
The decision of whether a nation is suffering from a national
emergency or circumstance of extreme urgency should be left to the WTO as a
whole. There should be a vote conducted before any nation is authorized to
2
06TRIPS Agreement, supra note 33, art. 31(b).
207
See ICTSD, Brazil, supra note 106. See also Merck & Co., Inc. Statement on Brazilian
Government's Decision to Issue Compulsory License for STROCRIN, supra note 137.
20
TRIPS Agreement, supra note 33, art. 31 (b).
2
mId. (uses the word 'and' instead of 'or').
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Feldman: Compulsory Licenses: The Dangers Behind the Current Practice
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prior negotiations with the patent holder before any compulsory license is
issued. Under this approach the patent holder would always be given a
reasonable amount of time, consisting of at least a set number of weeks, to
come to a compromise over the price of their pharmaceutical product. This
requirement would lessen the tension between pharmaceutical companies and
developing nations because pharmaceutical companies would be guaranteed at
least the option of lowering the price of their medicine before their exclusive
right was stripped away from them. It is conceivable that under very
extraordinary circumstances, a severe emergency could plague a nation to the
extent that it would not be plausible to negotiate prices with a pharmaceutical
company. This would only occur when there is the possibility that large
amounts of people are likely to be infected with a disease with in the amount of
time it would take to negotiate the price.210 Under this intense situation, while
the WTO representatives were voting as to whether a nation is entitled to a
compulsory license, the WTO Members would also have the authority to waive
this prior negotiation requirement, if the emergency seemed severe enough.
The TRIPS Agreement would be furthered improved if all of the terms
within the agreement were fully defined, resulting in the governing laws of
compulsory licenses being less ambiguous. There are several undefined terms
throughout the TRIPS Agreement. In order to make the Agreement less
ambiguous these terms must be defined. For example, article 31(h) requires the
right holder to be paid 'adequate remuneration' while taking into account the
'economic value' of the authorization. 1 Neither of the terms 'adequate
remuneration' nor 'economic value' are defined in the TRIPS Agreement or in
the Doha Declaration. Additionally, article 31(b) requires prior negotiation
with the right holder on 'reasonable commercial terms and conditions ,'2 2
Again 'reasonable commercial terms' is not defined in the TRIPS Agreement or
in the Doha Declaration. Essentially, this could allow a nation seeking a license
to give the pharmaceutical company an unreasonable ultimatum of either
delivering the medicine for the fraction of the market price or having a
compulsory license issued on their product. The asking price of the nation
requesting the license should be in relation to the economic wealth of that
nation along with factoring in the amount of drugs the nation needs to import.
In order to safeguard the world against potential abuse of the TRIPS
Agreement, more definite language should be implemented. Words and phrases
that are fundamental to issuing compulsory licenses should be clear and
21
°This time should only be a few weeks, to strike a fair balance between the developing country's
need and the pharmaceutical company's need.
21
'TRIPS Agreement, supra note 33, art. 3 1(h).
2 12
id"
2 13
General Agreement on Tariffs and Trade 1994, April 15, 1994, Marrakesh Agreement
Establishing the World Trade Organization, Annex IA, 1867 U.N.T.S. 187; 33 I.L.M. 1153 (1994),
art. XXIII, available at
http://www.wto.org/english/res_efbooksp-e/analytic7index-e/gattl994_08_e.htm#article23. See
also World Trade Organization, TRIPS: 'Non-Violation' Complaints (Article 64.2) - Background
and the Current Situation,
http://www.wto.org/english/tratop-e/TRIPS-e/nonviolation -background e.htm (last visited March
21, 2009) [hereinafter TRIPS: 'Non-Violation' Complaints].
2 14
TRIPS: 'Non-Violation' Complaints, supra note 213. See also TRIPS Agreement, supra note 33,
art. 64.2.
21
5TRIPS Agreement, supra note 33, art. 31(b).
216/d"
21
'House Democrats Endorse USTR Pressureon Thai Compulsory License, August 15, available at
2008 WLNR 15320070.
21
8TRIPS Agreement, supra note 33, art. 64.2.
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'creative legislative activity' that would allow them to get around their TRIPS
' 21 9
commitment.
Lastly, and most importantly strong international intellectual property
rights must be maintained worldwide. Strong intellectual property protections
are fundamental to ensuring stability of the world's economy and the health of
the world's citizens. It is each individual nation's responsibility to implement
strong intellectual property protections, and strict punishment for violations of
these protections.
CONCLUSION
219
TRIPS: 'Non- Violation' Complaints, supra note 213.
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