Team:Wageningen UR/HP/Future.html
Future Perspectives
One of iGEM’s most cherished values is its repository of parts and devices, which can openly and freely be exchanged between scientists. This repository allows for standardization of synthetic biology, which assures that integrating one another’s work is easy, and thus prevent double work. This way, scientists can benefit from each other’s work in the most efficient way possible!
However, it struck us that in the medical field, where our project Mantis fits, an open-source community is very rare. Of course, synthetic biology and health care are two very different things, but these fields overlap more and more; take our, or any diagnostic project as an example!
So we asked ourselves the question: How would our world change if health care would become open source? To answer this question, we interviewed Henk van den Belt. He is a philosopher and an expert in the field of patenting. He also was a judge for iGEM Human Practices at the European-African final in 2011.
The interview
Q: Currently, probably the main incentive for scientific development in the pharmaceutical world is money. On the other hand, developing countries have a lack of funds. How can this dilemma be solved?
A. There is indeed a dilemma here. Making money is an important incentive for pharmaceutical companies and they protect their claim through patenting innovations. This clashes with the iGEM value of sharing intellectual property. At the moment, some health-care is available for a lowered price as it is a good way of creating goodwill for companies. But this is of course not a universal solution. When you take away the money-incentive, no one might be willing to do research anymore. However, free-market prices are often too high for developing countries, and thus patients there do not receive the care they need. Two solutions here exist. Charity organisations can make a deal with parmaceutical companies, where they buy the product at market prices and then provide them for free to those that need them. Alternatively, a pharmaceutical company may find itself pressured by public opinion to offer their products to those in developing countries for much lower prices. This generates goodwill for that company, but does risk cheap medication intended for for for example the African market being sold in Europe, negatively impacting the sales at market prices.
Q. Would an open-source based market benefit healthcare in developing countries, as healthcare prices might drop?
In 1995, the Agreement of Trade-Related Aspects of Intellectual Property Rights (TRIPS) became effective. This agreement made it obligatory for countries to use patents laws, so also in the healthcare market. These patent laws used to be absent in for example India, were generic medicine producers could ‘copy’ newly produced medicine in Europe or the US, and ship them for lower prices to Africa. This way new medicine were made affordable to developing countries. The TRIPS agreement effectively killed this market, which of course greatly benefited big pharmaceutical companies.
This ‘replication’, enabled by a lack of patents, was a positive situation for healthcare in Africa. But it was considered to be more important to protect the intellectua property of pharmaceutical companies. In recent years even in the west, even politicians from political parties that strongly support the free market, have voiced concerns about the ever-increasing cost of medicine and healthcare. But for the coming decade, there seems to be no political support to change the current system.
Q. How can we guarantee production of high-quality products in an open source based market?
A. A big part of the cost in medicine and healthcare in general is due to safety levels and regulation. So even if the R&D costs would drop dramatically in an open-source market, these costs remain. Mostly developing countries will take on regulations from the place of manufacturing, say the US, but this would also change when production is local, which is most likely the case for Mantis.
From a utilitarian point of view one could argue that in case of a severe infectious disease outbreak, lowering the safety standards is ethically defendable. The risk of the disease is far greater than the risks of subpar quality of pharmaceuticals or diagnostics. This also means that people in developing countries, during the time of an infectious disease outbreak, the people receive much less protection than those in the west, purely because of financial incentives. Furthermore, it encourages the use of people in developing countries as guinea pigs, as the severity of diseases outbreaks there also makes it easier to experiment with new pharmaceutical products, which may once found to be reliable and safe be intended for the western markets.
Q. Can DIY-bio be used effectively in developing countries? And will this create more independency of the Western World.
A. For DIY-bio more things are required than just the DNA. A certain level of education and infrastructure is required, which is now mostly missing. For example, this year only two teams from Africa participate in iGEM. However, it can be a small step in increasing the independency of developing countries. As of now, health-care is often set up by Doctors without Borders, or dependent on benefactors like Bill Gates.
Conclusion
While the current patent-based market has its flaws and fails to offer a straightforward market-based way to provide healthcare to the poorest people in the world, it doesn’t seem likely that there will be a major change soon. Money is a major driver of innovation and by using patents, companies can protect their claim. Furthermore it seems unlikely that open source based market could be installed or effectively sustain itself alongside a patent-based market.
