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Why We Desperately Need Publicly Funded and Controlled Pharmaeutical Production: An Interview With Tim Joye

In this interview, Tim Joye discusses the importance of shifting from private pharmaceutical production to public ownership, emphasizing the need to regain control over medicines’ development and production, while also boosting the need for local production. Highlighting examples and challenges, it underscores the necessity for public alternatives to address pricing, shortages, and innovation in crucial health domains. For post-socialist countries facing greater financial strain on social budgets, exploring public pharma offers a path to independence from multinational corporations and ensuring access to affordable medicines.

Sopiko Japaridze (SJ): Tell us the reasoning behind the “Public Pharma for Europe” conference?

Tim Joye (TJ): During and after Covid, many people realized that we are too dependent on pharmaceutical multinationals. There’s a growing sentiment that we need to regain control over the development and production of our medicines. A significant number of progressive individuals throughout Europe are considering public alternatives to regain control. The conference focused on public pharma in Europe, highlighting how its development and production could help resolve the current challenges we are facing.

SJ: How do you envision this shift from private pharmaceutical production to public ownership? Are there any precedents we can draw upon?

TJ:  The current system isn’t functioning properly. During the conference, we discussed some experiences in public pharma. We began the two days with a talk by Els Torreele, an economist and pharmaceutical innovation researcher who said that most people recognize that the current model isn’t working: Prices are too high, putting pressure on our social security systems. This is one problem. Another is the growing shortage of lifesaving medicines, caused by the current production model taking too many risks. Torreele also highlighted the third problem, the lack of innovation in crucial public health domains, such as antimicrobial resistance. In many cases, innovation in big pharma is really just innovation of making profits over public health. We need to explore public alternatives to address pricing, shortages, and innovation.

Valentin Veron Toma from Romania explained that vaccines in his country were once produced by public institutions, as was the case in many European countries. However, privatization occurred over the last 30 years of neoliberalism. There are also examples from other parts of the world. A guest from Brazil shared how some medicines are currently produced by public pharma laboratories. Additionally, a representative from the University of Barcelona discussed the development of new cancer cell therapy in their public pharmacy. They face challenges in keeping their knowledge public and preventing privatization by multinational corporations (MNCs) seeking to patent it. Cancer cell therapy serves as an inspiring example from the conference. The issue of patents was extensively discussed; while parents are intended to stimulate innovation in theory, they often hinder innovation in practice.

SJ: Some might not grasp what is at stake here with regard to patents. Let’s revisit how companies develop drugs and what patents entail. What’s the current model, and why can patents be detrimental?

TJ: Most new medicines that we can find in Europe are protected by patents. Patents are something you can ask for as a company or a researcher, if you have a product or a technology that is new, that gives an added value to what already exists, it gives the protection of up to twenty years that other companies are not allowed to sell your product. The idea is to give protection to private companies to invest in new research knowing they have a monopoly to sell for twenty years. A lot of innovation is done by public money in universities. The problem is when you have a new scientific discovery, you need a lot of money for the trials in order to bring it to the market. You need a lot of money for clinical trials and studies with patients. The current model is that researchers turn to big pharmaceuticals to invest in their product, patent it so their clinical trials can be done, so that means they get the patent and they get the monopoly to determine the price until the patent is finished for 20 years. It’s a system where innovation is done by public funding, but the result is privatized and in the hands of 10-12 big pharmaceutical MNCs who are not interested in our health. They are trying to make the most profit possible. 

SJ: Give us an example of a patent on a new drug that could be harmful. 

TJ: New medication for cystic fibrosis,Trikafta, an American MNC Vertex, it’s a disease, a genetic disease. Those with this disease need a lung transplant before the age of 30. There is a new medication that solves the genetic problem at the base of the disease, which gives fantastic results. This scientific discovery was made by charity funding from patients associations in the US. But today, all the knowledge, technology and monopoly to sell it on the market is owned by the American MNC vertex who sells it to different countries. They sell it for 200,000 euros per year. 

We know from a health economist who analyzed the annual financial reports of Vertex, it only costs 3% of this price to make the product. The price is excessively high. Why? How can they do this? They have a monopoly protected by the patent. On the one hand, in Europe, the medications available have a huge impact on our social security. It takes millions and millions to buy for all patients with cystic fibrosis. On the other hand, in Africa, Latin America and Asia, they can’t afford to pay for the drugs. It’s not available in India, not South Africa, not in Brazil. There is an international campaign to put pressure on Vertex right now. This is a good example of why the current system is not working. We need to find ways to produce drugs in the future. So governments and societies won’t be dependent on MNCs in the future. 

SJ: Can you explain to us the whole process of how medicine is made?

TJ: In the case of Vertex, most money came from patient groups. In other cases, it’s mostly state money, university money. So I will give you an example of ZOLGENSMA, from Novartis which was until recently the most expensive drug in the world. One injection costs 1.9 million euros. It’s  for a rare genetic disease, spinal muscular atrophy (SMA).  It’s a lethal disease. This injection cures this disease, it’s fantastic. We can give children a future. The price Novartis is asking is too high. It  was discovered in a public research center in Paris that ZOLOGENSMA got money from the French government and patient associations. They also got money from crowdfunding. The whole innovation was done by public research, patients and crowdfunding. It takes a lot of money to pay for the clinical trials as I have stated earlier, so you have to test it on people before you can bring it on the market, make it and follow the patients 2-3 years. The research center made a private spinoff, so that capitalists from financial markets could invest. They pay for clinical trials for 4-5 years to see if the medication is promising.  Novartis, the MNC, they bought the spinoff, not sure, for 1 or 2 billion Euros, and bought the patent, and the technology. They bought the monopoly to bring it to the market. They control everything. They have the protection of the market for 8 more years. Governments are powerless. The original scientific innovation was made by a public research center with public money. This goes for almost all new medications. 

SJ: Let’s go back to the conference. How did you choose who came to speak? What do you hope this would be a step toward? 

TJ: The introduction was by Els Torreele who reiterated the three main problems: 1) pricing, 2) shortages 3) lack of innovation. We need a new model to put the people first. We had Massimo Florio, an Italian economist, who already wrote a report for the European Parliament two years ago about what public medical facilities in Europe could look like. There is already a plan created by this economist. So he gave an introduction about the report and the current discussions in the EU parliament about public pharma. So it gave the conference a political context for discussion. 

Then we had a panel with five speakers,  who had developed a vision of public pharma. I was there from Belgium, Joost Smiers from the Netherlands, Valentin-Veron Toma from Romania, Keir Milburn from the UK and Beat Ringger from Switzerland. It’s crazy to see four people from four countries–without knowing each other–take the initiative to write about public pharma in Europe. It shows how more and more people are thinking about it. It shows the diversity in the ideas. Jost’s vision is research without patents, UK was focused on public production. These four visions were complimentary. We should also talk about research, development and production. There was a proposal for a European Salk institute for regional coordination. While the proposition (from Switzerland) was local, and started to build the network from the bottom. These two approaches were complimentary. To fight at the European level and fight at the base, these could reinforce each other. 

For the rest of the conference we had two workshops. We asked: How should a public institute make its knowledge and results of their research available for everyone? What is the alternative vision on patents? Second was how to fund it? Is it economically sustainable? We had propositions from Dana Brown, an activist in the US. Brown made it clear that public pharma is not impossible, it might seem out of the box now, but it is perfectly possible to have a more open and transparent policy and to fund such institutes. It is economically sustainable: it’s a question of political will. Do we want to leave it to the market or take control of it? How to move on? How to go from here. We sensed that a lot of people present were eager to move forward and keep meeting. To put this on the political agenda. We will create a public coalition of public pharma in Europe which can develop further what it could be. At the same time, we want to organize webinars and lunch sessions in every country. It’s important to say, it’s not just a question of NGOs, we want to reach out to healthcare staff, workers in pharma, pharmacists, and patient associations. We want to reach out to thousands of researchers who are doing research for new medication, but are stuck in the system where their research depends on big pharma. All these people are victims of the current system and we want to reach out and ask them to join us. 

SJ: How can people reach out to you to get involved?

TJ: We have a website for the conference where you can find further information. Get in contact with us, if you want to organize something in their countries. Join us at the next digital meeting. 

Tim Joye is vice-president of the Belgian health organisation ‘Medics for the People’ (MPLP). MPLP  developed the vision of a European Salk Institute for the development and production of medicines. Together with the People’s Health Movement, they took the initiative to organize this conference for public pharma.