Yesterday, I had the privilege to attend a talk by Priti Radhakrishnan and Tahir Amin, co-founders and directors of I-MAK (the NYC-based Initiative for Medicines, Access and Knowledge). They promote innovation in biomedical research and increase access to life-saving medicines in developing countries (in particular for HIV/AIDS patients).

The problem (in brief)

Novel drugs are expensive because pharmaceutical companies who patent a new medicine earn the exclusive right to manufacture it for a given time. Once the patent expires, the drug belongs to the public domain, and other companies are allowed to make cheaper versions.

Patents were initially created to encourage innovation by protecting the rights of inventors. Yet, “innovation is on the decline and patents don’t work for the communities whom they were supposed to benefit in the first place,” Radhakrishnan says. (This is true not only in biomedicine, but also in other fields of research and development, such as agriculture and software.) Abolishing patents is not a solution – we need adapted incentives for private companies to invest in research.

I am honestly clueless about the subtleties of international Intellectual Property (IP) rights – so at first sight, I-MAK’s premise sounds like yet another daunting David-and-Goliath tale – a handful of idealists against nasty big pharma and “the system”...? But Radhakrishnan and Amin are experienced lawyers specialised in IP. Their approach is sensible (and has earned them a flurry of prestigious awards): a careful, evidence-based challenging of unlawful patents. “We usually intervene when bad patents are being used to keep prices artificially high for the public... Challenging invalid patents is a way to expose system failures while increasing access to specific medicines.”

When I asked Amin what kept them going, he smiled that he relished every small victory: “We’re not trying to bring down the whole wall at once. We do it brick by brick.” Contrary to the US, in Europe, anybody can challenge a patent before it is filed. The same happens in India (a hotspot for generic medicines’ production); I-MAK’s successful cases there are more than comforting.

The solution?

I-MAK suggests a middle road: a new trade system that offers a tailored approach to patenting (vs. the current “one-size-fits-all”) and supports the communities who are voicing their resistance against such aberrations. The rise of patients’ movements (see for instance the International Treatment Preparedness Coalition) for bottom-up policy-making has led to constructive disputes.

More specifically, Radhakrishnan calls for big pharma to make their databases of under-researched compounds available, so that other researchers can investigate molecules that would otherwise gather dust on the shelves of private labs. Also, she wants to raise the bar on innovation and crack down on frivolous patenting. Pharmaceutical companies are often happy to tweak an existing drug (turn a pill into a syrup or a patch, for instance) and get the new version patented to extend their protection. “Often easier than creating new medicines, companies use patent laws around the world to harden their monopolies and protect their sales,” the I-MAK founders write. Hence, they believe patents should be awarded to drugs that are not only safe and effective, but also BETTER than existing drugs.

In the flesh, Radhakrishnan and Amin are so charming, articulate and convincing that everything seems possible. They accept donations here.