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What role should pharmaceutical companies play in improving global health?

A recent editorial by the Lancet asserts that pharmaceutical companies have the responsibility to improve access to health, and that “companies must be better held to public account in relation to those responsibilities.” These comments stem from a recent UN human rights report on pharmaceutical company GlaxoSmithKline’s (GSK) policies concerning the right to health.

UN Special Rapporteur Paul Hunt visited GSK in 2008 to assess its current practices with regards to its responsibility in improving access to medicines. Hunt was invited to complete his assessment by GSK, which is one of the largest research-based pharmaceutical companies in the world. It has been both lauded and criticized for its attitude and actions towards developing nations and the poor’s access to medicine. In 2008, it was ranked first out of 20 pharmaceutical companies in enhancing access to medicines by an independent foundation. It is one of the few pharmaceutical companies to promote research on diseases primarily affecting developing countries, such as malaria and tuberculosis. However, it was also involved in the now infamous lawsuit filed by over 30 pharmaceutical companies in 1998 against the South African government challenging their Medicines and Related Substance Act. This Act allowed compulsory licensing and parallel importation, and was intended to reduce the high cost of HIV/AIDS drugs in South Africa. The companies eventually dropped their lawsuit in response to significant international criticism.

Paul Hunt’s report noted that, while making strides towards enhancing access to medicines, GSK has not done enough to fulfill its right-to-health responsibility by “tak[ing] all reasonable steps to enhance access to medicines.” His recommendations to GSK included increasing its use of voluntary licensing, which allows for production of cheaper generic drugs, and no longer lobbying against flexibilities in intellectual property laws. He also found that GSK rarely used its accountability mechanisms to assess its progress in right-to-health responsibilities. Hunt called on all pharmaceutical companies to give a much higher priority than they do currently to research and development on diseases of the developing world.

GSK’s response to this report emphasized its contributions to improving healthcare in developing countries, but refused to acknowledge that its work on improving health was “in any way required by international legal norms.” It concluded by stating that the company will review the UN’s report and recommendations “with interest.”

Although GSK believes that the right to health is “not well defined”, numerous international conventions have constructed and clarified the meaning of this right. Lisa Forman recently argued in a Health and Human Rights article that the right to health has “transformative potential with regard to essential medicines,” using the South African case as an example. As the Lancet noted last year, the right to health has been transformed into a “legal instrument” that can be used to hold both individual states and the international community accountable for providing the highest attainable standard of health. For example, in 2008, the UN created guidelines for pharmaceutical companies in fulfilling their responsibility to fulfilling the right to health. These recommendations noted that many of the obstacles that states face in providing the right to health were created by pharmaceutical companies. It also defined the actions that pharmaceutical companies must take to realize their responsibilities in terms of human rights. The responsibility of pharmaceutical companies to improve access to health has additionally been affirmed in the Millennium Development Goals produced by the UN: a target in developing global partnerships involves working with pharmaceutical companies to “provide access to affordable essential drugs in developing countries.”

It seems, then, that the responsibilities of pharmaceutical companies in terms of a right to health have become well-defined. These obligations need to be internationally enforced to ensure that companies fulfill their responsibility to improve health globally.

For more information:

Pharmaceutical Actually Listens to U.N.?

Poor availability and high prices are barriers to access to essential drugs in developing countries

Fact Sheet for MGD 8 on developing global partnerships

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