REIMAGINING DRUG DEVELOPMENT
When pharmaceutical giant Johnson & Johnson got the tick of approval for its drug bedaquiline on the last day of 2012, a new chapter of tuberculosis treatment began. Bedaquiline was the first antibiotic developed for the bacterial disease in nearly 50 years - a breakthrough millions of people across Asia and Africa had been crying out for.
A decade later, bedaquiline has become a latest flashpoint in the searing debate about affordable access to life-saving medicines. Knowing its main patent for the drug would expire in July 2023, Johnson & Johnson sought to extend its monopoly by enforcing secondary patents for an ever-so-slightly altered version in more than 65 countries.
India took a stand. Its Patent Office rejected the company's application in March 2023, following a four-year global campaign agitating for fair access to the drug. Then, in July 2023, a historic deal permitted non-profit organisation Stop TB Partnership to supply cheaper generic versions of bedaquiline to 44 low- and middle-income countries.
While some countries with the highest burden of tuberculosis aren't covered by the agreement, those that are will be able to buy the drug at half price. The Stop TB Partnership estimates that by the end of 2024, more than 51,000 extra treatments could be purchased with the cost-savings.
The deal is a small concession from a pharmaceutical giant that has reaped the benefits of market exclusivity for a decade, and experts say it's long overdue. “It raises the question, why couldn't this have been done earlier?” asks Diego Silva, a bioethicist at the University of Sydney concerned with infectious diseases. “We didn't need to get to the eleventh hour of a patent expiring for this outcry to happen.”
The story of bedaquiline is just one example of an industry that has long prioritised profit over public health. Companies argue that sky-high prices are necessary to fund research and development (R&D) into new drugs, but the data doesn't back up this claim. Plus, researchers have repeatedly exposed the pharmaceutical industry's profit-driven motives that shape its clinical trials, skew its drug development and inflate drug prices.
But does it have to be this way? What – or where – are the alternatives?
Around the globe, a few initiatives are going against the grain of the for-profit pharmaceutical industry, instead prioritising neglected diseases, refusing to patent their drug discoveries and funding research that puts public health
