Joff Wild

Indonesia has indicated that it will be implementing a wide-ranging compulsory licensing regime relating to a number of HIV and AIDs treatments. According to reports coming out of the country, the government there has stated that the new orders will cover a range of secondary anti-retroviral treatments such as tenofovir, emtricitabine, and lopinavir/ritonavir. In late 2012, the country won praise from many quarters when it opened the way for the manufacture and distribution of generic versions of seven anti-hepatitis and HIV drugs produced by Merck, GSK, Bristol-Myers Squibb, Abbott and Gilead. This followed an original batch of compulsory licences issued in 2004 for two other drugs that treat the same diseases.

As a developing country with a growing population, Indonesia faces many health problems. There is no doubt that tackling HIV/AIDs is one of these. And, of course, medicines protected by patents often do not come cheap. Government, however, is about choices. While those that run the country will doubtless win plaudits for their latest action, it is worth noting that in September 2012 the same government increased military spending by 6.6% to stand at an annual $8 billion. According to The Economist, defence spending in the country was $2.6 billion in 2006. That’s a 200% plus rise in the space of six years. By contrast, the country’s total healthcare budget is $3.27 billion.

You can’t help wondering how many more medicines and treatments Indonesia might be able to afford, how many more lives might be saved and enhanced, and how much more inward investment the country might be able to attract from life sciences companies if the government decided to put health before armaments. Indonesia is not a rich country, but those who run it still have options. When it comes to compulsory licensing, patents and the unaffordability of medicines, the story is sometimes more nuanced than many might think. And maybe, just maybe, big pharma is not always unequivocally the bad guy.