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1. Intellectual Property and Public Health: An Overview of the Debate with a Focus on U.S. Policy

Author:
Carsten Fink
Publication Date:
06-2008
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Over the past fifteen years, the United States and other developed countries have employed trade agreements to substantially strengthen the protection of intellectual property rights for pharmaceutical products in the developing world. The associated rules changes have already had an effect on pharmaceutical prices in developing countries, prompting conflicts between developing country governments seeking to promote drug access and Western pharmaceutical companies wishing to protect their exclusive rights. If anything, such conflicts are bound to intensify as more patent protected drugs enter pharmaceutical markets outside rich countries. This paper describes the global shift in intellectual property policies and employs economic analysis to evaluate its consequences for developing countries. It also puts forward several recommendations for policymakers in developing countries and in the United States, seeking to better reconcile innovation incentives and access needs.
Topic:
Economics, Health, and Science and Technology
Political Geography:
United States

2. A Risky Business: Saving Money and Improving Global Health Through Better Demand Forecasts

Publication Date:
05-2007
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Today's global health programs will attain their objectives only if products appropriate to the health problems in low-and middle income countries are developed, manufactured and made available when and where they are needed. Achieving this requires mobilizing public and charitable money for more and better products to diagnose, prevent and treat HIV/AIDS, tuberculosis, malaria, reproductive health problems and childhood killers. But more money is only one part of the story. Weak links in the global health value chain—from research and development (R) through service delivery—are constraining on-the ground access to essential products. The consequences of those weak links are many: supply shortages, inefficient use of scarce funding, reluctance to invest in R for developing country needs and, most important, the loss of life among those who need essential products.
Topic:
Globalization, Health, Political Economy, and Poverty

3. Advance Market Commitments for Vaccines Working Paper and Spread Sheet

Author:
Rachel Glennerster, Heidi Williams, Georg Weizsacker, Ruth Levine, Jean Lee, Michael R. Kremer, and Ernst R. Berndt
Publication Date:
08-2006
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
The G8 is considering committing to purchase vaccines against diseases concentrated in low-income countries (if and when desirable vaccines are developed) as a way to spur research and development on vaccines for these diseases. Under such an “advance market commitment,” one or more sponsors would commit to a minimum price to be paid per person immunized for an eligible product, up to a certain number of individuals immunized. For additional purchases, the price would eventually drop to close to marginal cost. If no suitable product were developed, no payments would be made. We estimate the offer size which would make revenues similar to the revenues realized from investments in typical existing commercial pharmaceutical products, as well as the degree to which various model contracts and assumptions would affect the cost-effectiveness of such a commitment. We make adjustments for lower marketing costs under an advance market commitment and the risk that a developer may have to share the market with subsequent developers. We also show how this second risk could be reduced, and money saved, by introducing a superiority clause to a commitment. Under conservative assumptions, we document that a commitment comparable in value to sales earned by the average of a sample of recently launched commercial products (adjusted for lower marketing costs) would be a highly cost-effective way to address HIV/AIDS, malaria, and tuberculosis. Sensitivity analyses suggest most characteristics of a hypothetical vaccine would have little effect on the cost-effectiveness, but that the duration of protection conferred by a vaccine strongly affects potential cost-effectiveness. Readers can conduct their own sensitivity analyses employing a web-based spreadsheet tool.
Topic:
Development, Economics, Health, and Markets

4. Governance and Corruption in Public Health Care Systems

Author:
Maureen Lewis
Publication Date:
01-2006
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
What factors affect health care delivery in the developing world? Anecdotal evidence of lives cut tragically short and the loss of productivity due to avoidable diseases is an area of salient concern in global health and international development. This working paper looks at factual evidence to describe the main challenges facing health care delivery in developing countries, including absenteeism, corruption, informal payments, and mismanagement. The author concludes that good governance is important in ensuring effective health care delivery, and that returns to investments in health are low where governance issues are not addressed.
Topic:
Corruption, Development, Health, and Human Welfare