TED演讲是由TED从每年1000人的俱乐部变成了一个每天10万人流量的社区。为了继续扩大网站的影响力,TED还加入了社交网络的功能,以连接一切“有志改变世界的人”。从2006年起,TED演讲的视频被上传到网上。截至2010年4月,TED官方网站上收录的TED演讲视频已达650个,有逾五千万的网民观看了TED演讲的视频。 TED是以下三个英文单词的首字母大写:【T】technology技术;【E】entertainment娱乐;【D】design设计.它是美国的一家私有非盈利机构,该机构以它组织的TED大会著称。TED演讲的主旨是:Ideas worth spreading.
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Patenting a new drug helps finance its immense cost to develop -- but that same patent can put advanced treatments out of reach for sick people in developing nations, at deadly cost. Ellen 't Hoen talks about an elegant, working solution to the problem: the Medicines Patent Pool. (Filmed at TEDxZurich.)
The founder of the Medicines Patent Pool, Ellen 't Hoen works (and makes change) at the place where profit and health collide: patented drugs.
In 2002, a group of treatment activists met to discuss the early development of the airplane. The Wright Brothers, in the beginning of the last century, had for the first time managed to make one of those devices fly. They also had taken out numerous patents on essential parts of the airplane. They were not the only ones. That was common practice in the industry, and those who held patents on airplanes were defending them fiercely and suing competitors left and right.
This actually wasn't so great for the development of the aviation industry, and this was at a time that in particular the U.S. government was interested in ramping up the production of military airplanes. So there was a bit of a conflict there. The U.S. government decided to take action, and forced those patent holders to make their patents available to share with others to enable the production of airplanes.
So what has this got to do with this?
In 2002, Nelson Otwoma, a Kenyan social scientist, discovered he had HIV and needed access to treatment. He was told that a cure did not exist. AIDS, he heard, was lethal, and treatment was not offered. This was at a time that treatment actually existed in rich countries. AIDS had become a chronic disease. People in our countries here in Europe, in North America, were living with HIV, healthy lives. Not so for Nelson. He wasn't rich enough, and not so for his three-year-old son, who he discovered a year later also had HIV.
Nelson decided to become a treatment activist and join up with other groups. In 2002, they were facing a different battle. Prices for ARVs, the drugs needed to treat HIV, cost about 12,000 [dollars] per patient per year. The patents on those drugs were held by a number of Western pharmaceutical companies that were not necessarily willing to make those patents available. When you have a patent, you can exclude anyone else from making, from producing or making low-cost versions, for example, available of those medications. Clearly this led to patent wars breaking out all over the globe.
Luckily, those patents did not exist everywhere. There were countries that did not recognize pharmaceutical product patents, such as India, and Indian pharmaceutical companies started to produce so-called generic versions, low-cost copies of antiretroviral medicines, and make them available in the developing world, and within a year the price had come down from 10,000 dollars per patient per year to 350 dollars per patient per year, and today that same triple pill cocktail is available for 60 dollars per patient per year, and of course that started to have an enormous effect on the number of people who could afford access to those medicines. Treatment programs became possible, funding became available, and the number of people on antiretroviral drugs started to increase very rapidly.
Today, eight million people have access to antiretroviral drugs. Thirty-four million are infected with HIV. Never has this number been so high, but actually this is good news, because what it means is people stop dying. People who have access to these drugs stop dying. And there's something else. They also stop passing on the virus. This is fairly recent science that has shown that. What that means is we have the tools to break the back of this epidemic.
So what's the problem? Well, things have changed. First of all, the rules have changed. Today, all countries are obliged to provide patents for pharmaceuticals that last at least 20 years. This is as a result of the intellectual property rules of the World Trade Organization. So what India did is no longer possible. Second, the practice of patent-holding companies have changed. Here you see the patent practices before the World Trade Organization's rules, before '95, before antiretroviral drugs. This is what you see today, and this is in developing countries, so what that means is, unless we do something deliberate and unless we do something now, we will very soon be faced with another drug price crisis, because new drugs are developed, new drugs go to market, but these medicines are patented in a much wider range of countries. So unless we act, unless we do something today, we will soon be faced [with] what some have termed the treatment time bomb.
It isn't only the number of drugs that are patented. There's something else that can really scare generic manufacturers away. This shows you a patent landscape. This is the landscape of one medicine. So you can imagine that if you are a generic company about to decide whether to invest in the development of this product, unless you know that the licenses to these patents are actually going to be available, you will probably choose to do something else. Again, deliberate action is needed.
So surely if a patent pool could be established to ramp up the production of military airplanes, we should be able to do something similar to tackle the HIV/AIDS epidemic.
And we did. In 2010, UNITAID established the Medicines Patent Pool for HIV. And this is how it works: Patent holders, inventors that develop new medicines patent those inventions, but make those patents available to the Medicines Patent Pool. The Medicines Patent Pool then license those out to whoever needs access to those patents. That can be generic manufacturers. It can also be not-for-profit drug development agencies, for example. Those manufacturers can then sell those medicines at much lower cost to people who need access to them, to treatment programs that need access to them. They pay royalties over the sales to the patent holders, so they are remunerated for sharing their intellectual property.
There is one key difference with the airplane patent pool. The Medicines Patent Pool is a voluntary mechanism. The airplane patent holders were not left a choice whether they'd license their patents or not. They were forced to do so. That is something that the Medicines Patent Pool cannot do. It relies on the willingness of pharmaceutical companies to license their patents and make them available for others to use.
Today, Nelson Otwoma is healthy. He has access to antiretroviral drugs. His son will soon be 14 years old. Nelson is a member of the expert advisory group of the Medicines Patent Pool, and he told me not so long ago, "Ellen, we rely in Kenya and in many other countries on the Medicines Patent Pool to make sure that new medicines also become available to us, that new medicines, without delay, become available to us."
And this is no longer fantasy. Already, I'll give you an example. In August of this year, the United States drug agency approved a new four-in-one AIDS medication. The company, Gilead, that holds the patents, has licensed the intellectual property to the Medicines Patent Pool. The pool is already working today, two months later, with generic manufacturers to make sure that this product can go to market at low cost where and when it is needed. This is unprecedented. This has never been done before. The rule is about a 10-year delay for a new product to go to market in developing countries, if at all. This has never been seen before. Nelson's expectations are very high, and quite rightly so. He and his son will need access to the next generation of antiretrovirals and the next, throughout their lifetime, so that he and many others in Kenya and other countries can continue to live healthy, active lives.
Now we count on the willingness of drug companies to make that happen. We count on those companies that understand that it is in the interest, not only in the interest of the global good, but also in their own interest, to move from conflict to collaboration, and through the Medicines Patent Pool they can make that happen. They can also choose not to do that, but those that go down that road may end up in a similar situation the Wright brothers ended up with early last century, facing forcible measures by government. So they'd better jump now. Thank you. (Applause)
2002年,一群医疗活动分子相聚在一起 讨论飞机的早期发展问题。 在上个世纪初, 怀特兄弟第一次成为 让飞行器上天的人 他们当然也获得了众多 飞机主要部件的专利 不过他们并不是唯一的专利人 这是工业界的惯例 那些飞机专利的持有者 便极力维护 甚至投诉周围的竞争对手
这一举动对航空工业的发展并没有好处 而且当时正是美国政府 意在扩大 军用飞机生产的时候 所以冲突也就不可避免 美国政府随即采取行动 迫使那些专利持有者们 和他人共享专利 从而保障飞机的生产
那么我说的这件事情 与现在要提到的这个有什么关系呢?
在2002年,一位叫尼尔森.奥特沃玛的肯尼亚社会学家 发现自己携带艾滋病病毒并需要治疗。 但被告知这种病不可医治。 他听说艾滋病是致命的,也是无药可救的。 但当时的事实是 在发达国家,疗法是存在的。 艾滋病被视为慢性疾病。 像在欧洲、北美的国家 艾滋病毒携带者同样可以健康地生活。 但对尼尔森来说却不行,因为他不够富有, 他3岁的儿子在一年后也被诊断携带艾滋病病毒, 同样得不到医治。
尼尔森就此决定成为医疗活动分子 并加入此类组织。 他们在2002年遇到了不同的困境 用于治疗艾滋病毒的抗逆转录病毒ARV的价格 约为每个患者每年一万两千美元。 持有这种药品专利的 若干西方医药公司 却并不愿意 分享其专利。 持有专利的公司,便可以把其它的任何公司 排除在以低廉价格 生产和制作 这类的药品的范围之外 当然这也就导致专利大战 在全球展开。
幸运的是,此类专利并不是到处都有 很多国家并不认可 制药产品专利,拿印度来说, 印度的制药公司 已开始生产所谓的通用(非专利)配方, 也就是廉价的抗逆转录病毒药品的复制品 以供发展中国家使用 在一年之内,该药品的价格从 每个患者每年一万美元 降到了350美元每个患者每年 直至今天,同样的三联疗法 售价仅为每个患者每年60美元 这当然对于众多 可以买得起此类药品的人 意义深重。 治疗方案从此得以实施 基金到位,使用抗逆转录病毒药品的人数 也迅速增加
今天,已有八百万人 可以使用抗逆转录病毒药物 现有三十四万人感染艾滋病病毒 这一数据史无前例 不过这也是好消息 因为它表明患者的死亡率下降了 买得起这类药品的人不再被判处死刑 更好的是 他们可以杜绝病毒的传播 这是最新的科学研究显示的 这意味着我们掌握了 防止这种传染性疾病的方法
那还有哪些问题存在呢? 今非昔比啊 首先,规定改变了 各个国家都有责任向制药公司提供 至少20年的专利使用权 这是世界贸易组织对知识产权规则 改变的结果 因此印度的做法也就不再成为可能 其次,专利持有公司的惯例也得到改变 在这里你可以看到在世界贸易组织知识产权规则之前 95年之前 抗逆转录病毒药品出现之前的数据 这是今天的数据 这是发展中国家的数据,也就是说 除非我们刻意去做 除非我们现在就改变 我们不久就会面临又一个药品价格危机 因为新药得以研发 投入市场,而药品的专利 在更广泛的国家范围得以注册 如果我们当下不采取措施 我们将很快面临人们所说的 医疗定时炸弹
我说的不仅是专利药品的数量 还有很多因素会使 通用(非专利)药品制造商望而却步 这是一个专利的分布图 它仅代表一种药品 假想你是一个通用药品制造商 要决定是否投资 开发该药品 除非你有把握 得到其专利许可证 你可能会三思而后行 所以我强调,我们需要行动
所以假如 我们真的可以建立一个专利库 来扩大军用飞机的生产 我们同样可以 解决艾滋病病毒/艾滋病的传播
而且我们做到了 2010年,国际药品采购机制成立了艾滋病病毒 医药专利库 它是这样运作的: 专利持有者,发明者 对其发明的新药 申请专利保护 但将这些药品专利 与药品专利库共享 再把许可证发放给需要使用该专利的人 比如通用药品制造商 也可以是非营利性药品开发代理商 等等 这些制造商则将这些药品或治疗方案 以更加低廉的价格 出售给任何需要的患者 他们给专利持有者支付专利使用费 作为共享知识产权的报酬
这件事与飞机专利库的 关键区别在于 药品专利库是自发机制 飞机专利持有者没有权利选择 是否提供专利许可证 他们的行为是被迫的 这在药品专利库则不能实行的 我们需要依赖制药公司的自发性 为他人提供并分享 他们的专利使用权
今天,尼尔森恢复了健康 他可以买到抗逆转录病毒药物 他的儿子也很快年满14岁 尼尔森成为了一个药品专利库 专家咨询小组的成员 不久前他告诉我 “艾伦,在肯尼亚和其他很多国家 我们依赖药品专利库, 保障我们也能得到新的药品 而且能在第一时间得到新的药品”
这已不再是幻想 我这就给你举个例子吧 今年的八月,美国药品代理商 通过了一种新的四合一的艾滋病药物 持有该专利的吉利德公司 就把知识产权共享给了药品专利库 专利库已经开始工作,两个月后, 就会有仿制药品制作商保证 将该产品以低价 及时并准确地推向需求市场 这是前所未有的。 通常情况下,一种新药在发展中国家要等10年 才成为可能并最终上市 这是前所未有的。 尼尔森的期望很高 这理所应当 他和儿子需要下一代的抗逆转录病毒药物 再下一代,甚至一生 所以他和众多肯尼亚和其他国家的人 可以继续过健康积极的生活
我们当下需要依靠药品公司的自发行为 实现这一愿望 我们期望这些公司意识到这不仅符合 全球福利的需要,也符合他们自己的利益 通过药品专利库 化冲突为合作 当然他们也可以拒绝 不过拒绝的结果可能会导致类似 怀特兄弟在上个世纪所面临的处境 那就是政府的强迫政策 所以我提议现在就加入吧 谢谢(鼓掌)