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‘Western countries call India a pirate, a rogue state’

Dylan Mohan Gray took on Big Pharma and exposed its predatory patent practices in his documentary Fire In The Blood, now out on DVD. He tells Nishat Bari that the worst is yet to come.

Nishat Bari  7th Jun 2014

A still from Fire in the Blood

. What about this story made you turn it into a documentary film?

A. There is a whole pattern of policy-making being taken over by corporate interests, to the point where Western governments were going to bat on behalf of the pharmaceutical companies. There were no qualms about killing millions of people who could easily have been saved very cheaply. The story illustrates this very strongly. For me the HIV/AIDS angle was not even the interesting thing. It was really the incredible cynicism, the degree to which corporate interests take supremacy over everything else. It didn't matter that 10-12 million people had to die for this. The other thing that motivated me very strongly was that the story had not been told, ever, in any comprehensive way. That was quite shocking, that the record didn't exist and was beginning to be lost. And it was very clear that the groundwork was being laid for something similar, or even much worse, to happen in the future. That's why the film also became very important. At least nobody could have the excuse of saying they didn't know what happened earlier.

Q. At what point in the narrative did you find this story?

A. By the time generic drugs started coming to Africa and the developing world and mass treatment with ARVs had begun in 2003, Africa had two-thirds of the world's HIV cases. The story was already turning into a good news story by the time I started digging into it. But the flip side is you realise this incredible crime had taken place, mass genocide, a holocaust, as many people have called it. It was already clear at that point that nobody was going to be called to account for this; nobody was going to be punished; no names were going to be named. I initially set out to name the people responsible. When I started talking to the people in the film, who are the heroes, they all kept saying the same thing: we are all responsible for this. That's why it caused me to change my approach to the film to making sure this never happens again.

Q. How high is the possibility of something like this happening again?

A. I would say, in terms of scale of loss of life, at least 95% possible. The trade laws being pushed by Western countries and the Japanese — countries that have big and powerful pharmaceutical giants — will ensure patent laws are tightened so that India can no longer supply the world with affordable drugs. There is immense pressure on every single country in the world to adopt these very strict intellectual property provisions. People in low-income countries will never be able to afford the medication if they are under patent. In South Africa, the market for the big pharma companies is the top 5% of the population, which includes people who will sell their house and do anything to pay for medication. They don't care about the 95%. In India that number might be 0.75%. Luckily, right now in India we have generic drugs, which means almost everybody in the country can afford basic essential medicines. In Pakistan, that's not the case; drugs cost 10 times than they do in India and most people do without.

India is the only major country that has a correct patent system, operating in the spirit in which the patent system was created internationally: to serve the public interest. — Dylan Mohan Gray

Q. In the film you say pharma companies barely invest in R&D, instead using government-funded research. Then why is the profit margin so high?

A. They were able to get the rules changed under President Reagan. Most of the research takes place in universities and small biotech firms, not in government facilities. It should belong to the taxpayers, but the universities own the rights to the research and they license it to drug companies, which in turn put them through clinical trials. But clinical trials are not very expensive compared to the revenue they generate. Every year just one organisation of the US government, the National Institute of Health, funds about $35 billion in basic research into medication. Because of this monopoly, drug prices in the US are double that of any other country, because every other country has price control on drugs.

Q. Why are Indian patent laws unique?

A. India is the only major country that has a correct patent system, operating in the spirit in which the patent system was created internationally: to serve the public interest. India has had the temerity to say that if you want a patent from us, you have to prove you actually invented something. Another great thing is that we have something called pre-grant opposition, which allows the public, generic drug makers and groups to question the patent before it is given. Western countries are now attacking India, calling it a pirate and rogue state.

Q. How likely are they to succeed in changing Indian laws?

A. The drug companies are immensely powerful, but it all comes down to whether the Indian government holds its ground. This is a very bad time for US-India relations, but the US pharma industry was so powerful that they pushed the Obama administration to threaten India with sanctions. However, as we point out at the end of the film, the thing with HIV drugs is that you can't stay on the same regimen forever, and a lot of the newer drugs that these people will need are under patents. India can no longer produce them due to TRIPS. Many of the people in our film will die because they will not get the medication they will need, so they are desperately hoping that they can stay on the first-line medications long enough till the patents expire on the new drugs. But that is a very risky game.

Q. As the film mentions, half the American population finds healthcare unaffordable. Where is this going?

A. In the US and Europe, most people do not realise the price of medication because of government healthcare. So if a drug costs $1000 a month, they may pay $20 a month. They are paying with their taxes but they don't get the sticker shock when buying the drug that people in India, where over 90% of medicine purchases are out of pocket, will get. So even though drugs might seem affordable to the end user, they are bankrupting the healthcare system in a lot of these countries. There is a breaking point coming, and I feel cautiously optimistic here in India because here, we all know the incredible power of pocket issues, whether it be oil or onions. People are very sensitive to price. If basic medication becomes very expensive, people will notice and they will be very unhappy about it. I don't think the Indian government in the long term can tolerate that. The new drugs are incredibly expensive. Except for one, every new cancer drug that has come in the market in the last four years costs in excess of $100,000 per year per patient. The numbers are staggering. Nobody can afford to pay that.

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