For many poor citizens of the South the access to essential medicines is often a question of life or death while in the European Union and in the US the present cost of medical drugs is meaning a growing financial crunch for both many individuals already struggling to makes ends meet and for state health systems already burdened with large deficits that are being worsened by enormous pharmaceutical expenditures. It is evident that the question of access to medicine is of global concern.

Access to medicine is about: opening up market access for competitively priced generic products, the de-linking of research and development costs from drug prices, finding new ways of rewarding innovation in order to fight neglected diseases in the South, pooling medical patents for responding to health emergencies like AIDS, applying the flexibilities of TRIPs for poorer countries´ health programmes in fighting major diseases, convincing the EU and the US to stop imposing on the South draconian IP enforcement conditions in free trade agreements, allowing the sharing of drug data information and taking the necessary anti-trust measures to guaranee a fair playing field for affordable medicines.

Access to medicine is also about establishing new pro-active economic and institutional structures, both nationally and multilaterally, that promote sustainable responses to important illnesses far beyond the current efforts of charity or international aide. It means showing that new product innovation costs, including research and development of drugs, can shared differently among public and private actors to allow a fairer market reality to emerge.

Above all, access to medicine is about justice and democracy. Monopolies over medical knowledge do not favour fair prices nor product innovation where it is really needed in the field of essential medicines. More often than not EU and US institutions promote patent laws and enforcement measures that do not promote the pubic interest of knowledge sharing, social redistribution and fair competition in the world´s medical product market.

Powerful industrial lobbies asfixiate our democratic institutions, drowning out the voices of consumers and ordinary citizens who are requesting more equitable health care on a global scale. In the end it is a question of choice: it is not at all easy to satisfy the narrow interests a few giant companies while progessing toward universal access to the best possible medical care. Unfortunately, we are not before the win-win situation as many of our politicians and lobbyists like to repeat.

The same forces that are depriving the world´s poor of affordable products for curable illnesses are also working against lower priced medicines and economically sustainable health care in Europe and the United States. For example, over the past year worrisome official studies have been published both in the US and the EU about the manipulation of the market by Big Pharmaceutical firms that seek to prevent or postpone the market entry of generic medicines. In the official EU inquiry carried out by the Directorate General for Competition over two-hundred cases were documented where “pay to delay” agreements or “patent thicket” schemes were employed to extend the intellectual property monopoly over medical products far beyond the legal requirement.

The present patent system, the agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), is the global incentive framework for the development of new medicines. This method of drug innovation has a certain degree of efficiency when a profitable market exists but fails to adequately meet health needs or develop medicines with suitable therapeutic value where lucrative markets do not exist. Furthermore, as a recent Health Action International/Oxfam report states: “Patents for medicines delay competition by prohibiting low-cost copies (generic medicines). This results in higher prices neither developing country governments nor poor people can pay without sacrificing other basic necessities, and has disastrous consequences for millions of poor people.”

The time has come to consider new models of medical innovation that lie outside the current patent system and that could better serve the creation of socially useful medicines for the world´s population.