How to Worsen Africa's Health Crisis

Faced with Africa's devastation by HIV/AIDS, people are looking for scapegoats. Global pressure groups and now the World Health Organization are targeting "Big Pharma." The drug companies do make easy targets but that doesn't make them villains. The life-saving treatments they create remain Africa's best hope. The misguided battle against pharmaceutical companies' patent rights will only make Africa's health crisis worse.

Intellectual property rights for AIDS drugs are "the biggest public health challenge" as they make them too costly for most Africans, Hans Hogerzeil, head of the WHO's Essential Medicines program, recently said. They are "a barrier to access," he previously claimed, but the real barriers are the lack of infrastructure and the diversion of aid money. Fewer than 5% of WHO's 423 Essential Medicines are currently protected by patents—mostly advanced "second-line" anti-AIDS medicines.

More work still needs to be done to improve the availability of HIV/AIDS treatments. But experience has proven that we need not tear up drug patents to achieve this. The twelve-fold increase in those receiving treatment over the last decade came as companies joined public-private partnerships and granted voluntary patent licenses to lower-cost "generics" manufacturers. Those programs were further aided by pharmaceutical companies cutting prices in developing countries. Many of these are drugs still under patent, including the few on the WHO Essential Medicines list.

Still, health activists, such as Michelle Childs, policy director at Doctors Without Borders, argue that more availability requires more "compulsory licences"—government orders that override patents to allow domestic production with minimal royalties to rights-holders. Yet trampling over intellectual property rights removes drug companies' incentives to invest billions of dollars in the development of the next generations of anti-retrovirals. These treatments will be essential when—not if—the AIDS virus mutates and renders the current treatments useless.

Maybe the increasing supply of medicines is why compulsory licenses have only been used a few times over the past decade. The World Trade Organization clause that allows compulsory licences to import minimal-royalties copies when a country lacks domestic manufacturing has been used only once, when Rwanda invoked it briefly to treat 21,000 AIDS patients. Yet the activists' scratched record repeats its refrain.

While this campaign about intellectual property and access to drugs continues, lower-profile diseases, such as respiratory infections and diarrhoea, remain bigger killers in the poorest countries. These two preventable diseases alone claim over four million victims a year according to the WHO, compared to about three million for AIDS. If the activists were right that prices and patents are the main barriers, the treatments for these diseases, which are very cheap and off-patent, should be widely available. But anti-infectives and oral rehydration treatments remain scarce in the world's poorest countries.

The real public health problems on the ground have little to do with intellectual property rights and the cost of drugs. Rather, in the world's poorest countries the sick and the dying are being failed by the lack of investment in domestic health care infrastructure. At July's African Union summit, leaders were confronted with WHO figures showing that only six member countries have met their 2001 pledge to invest 15% of their national output on health care.

The real global public health problem is that for every aid dollar African governments receive for health care they divert up to $1.14 of their own resources to other areas. And aid for health care more than doubled from $8 billion in 1995 to $19 billion in 2006.

The WHO and international activists are diverting attention from this investment crisis with their campaign against intellectual property. The poorest will not be saved by fashionable campaigns against Big Pharma. Killing off patents will kill off innovation and patients.

Mr. van Gelder is project director at the International Policy Network.