4.5 PANDEMICS
CHARLES GORE Charles Gore has been executive director of the Medicines Patent Pool since 2018. He founded and ran the Hepatitis C Trust in the United Kingdom from 2000 to 2018. He helped create the European Liver Patients’ Association and was its first president in 2004. He was instrumental in launching the World Hepatitis Alliance, and was president from 2007 to 2017. He participates in several advisory bodies, including the World Health Organization Director-General’s Strategic and Technical Advisory Committee for Viral Hepatitis, and in WHO guideline development groups on testing and treating viral hepatitis. X-TWITTER @CharlieGore medicinespatentpool.org
for upper-middle-income countries, 6.9 years for lower-middle-income countries and 8 years for low-income countries. In some cases, it is very much longer. The 2024 Access to Medicines Index shows that 49% of the products analysed were not registered in any of the countries with the highest disease burden. Early licensing could therefore produce an income stream through royalties much earlier – or even where there will be none. A report in 2024 funded by MPP, the Government of Canada and the World Intellectual Property Organization showed that other financial benefits from voluntary licensing for pharmaceutical companies included staff attraction and retention and market opening. The more that the pharmaceutical industry understands that voluntary licensing is not a give-away but rather a commercial opportunity, the more willing companies will be to consider it. PREPARATION IS KEY The Pandemic Agreement frequently references licensing and technology transfer as important mechanisms for addressing the next pandemic equitably. Optional benefits are also proposed in Article 12 on Pathogen Access and Benefit Sharing. Governments commit to including such access instruments in public funding agreements and to encouraging the private sector to do more licensing and technology transfer. Where the pharmaceutical industry cannot be persuaded of the financial benefits of so doing, companies may need to be incentivised. Governments could consider several options, including direct incentives, reimbursement packages that include access and regulatory incentives. But technology transfer cannot happen overnight. For companies in LMICs to be able to receive technology during a pandemic, they need to be capacitated well in advance, and their facilities and staff need to be ‘kept warm’ by continuing to produce products. A good example of how multilateral technology transfer to LMICs can work is the WHO/MPP-led mRNA Technology Transfer Programme, which has set up mRNA capability in 15 LMICs and is currently moving to its second phase to ensure the facilities are indeed ready. However, to believe that the entire onus of technology transfer and licensing should fall on governments or private entities in high-income countries is to perpetuate a dependency culture with its inherent dangers, as evidenced by the dislocations resulting from recent reductions
The more that the pharmaceutical industry understands that voluntary licensing is not a give-away but rather a commercial opportunity, the more willing companies will be to consider it” “
in official aid. The mRNA programme, for example, supports South-South research and development consortia, some involving entities from HICs and some of which do not. LMIC governments need to see licensing and technology transfer as a series of partnerships, including considering incentivising participation in licences and technology transfer, increasing expenditure on health as a proportion of gross domestic product and upskilling national regulatory authorities. In particular, it is important that LMIC governments support these partnerships by buying the products produced. Licensing and technology transfer can provide affordable access, and contribute to health security and economic development. The key is to ensure the participation of all the key stakeholders – high-income governments, low- and middle-income governments, the pharmaceutical industry, the generics industry, and civil society and affected communities – in shaping the solutions. The fact that the different stakeholders have different goals does not mean this cannot be a win for everyone; it merely means that the solutions will require compromises. ▪
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HEALTH - A POLITICAL CHOICE Health: A Political Choice – The Future of Health in a Fractured World
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