Thread by @nsaikia

There's much to be desired when it comes to healthcare accessibility in India.

We've talked about the compulsory licensing of patents. We've talked of revocations & waivers. Some of us have even thought of not just a #TRIPSwaiver but of the #TRIPSend.

It may be inadequate. 🧵

These are some of the legal options available:

🔹 under the Patents Act:

Compulsory licensing:
Usually, possible under s 84 but, now, s 92 could come into play if the govt issues a notification which would enable it to bypass some of 84's stringency.

Revocation:
Usually (with great difficulty) under s 64 of the Patents Act.

However, now, it may be possible to revoke certain pharma patents under s 66 in public interest on account of their being prejudicial to the public.

There are also provisions in the Patents Act to facilitate government use in ss 47, 100, 102 which, to erase all nuance, allow for pharma distribution in government facilities, extremely limited manufacture in some cases, and the government acquisition of patents.

Patent law is AN obstacle to equitable healthcare but it is far from THE ONLY obstacle. It may well be tempting to invoke provisions that derogate from the rights of patent holders domestically but that won't always cut them out of the pic: you'll likely still need their tech.

🔹 That brings us to the #TRIPSwaiver which India has, quite rightly, been pushing for along with many other countries.

The waiver is not limited to patents alone and it is important...

A thread here on why waiving patents alone is nowhere near enough:

https://twitter.com/nsaikia/status/1387680085826625536?s=19

🔹 So, assuming we do manage to cross IP and tech hurdles, what happens to actual access to pharma products by people who need them?

Firstly, we need to be able to scale manufacturing. That's not an IP issue per se but becomes easier to achieve minus IP roadblocks.

Legally, under Section 26B of the Drugs and Cosmetics Act, the Central Government has powers to regulate or restrict the manufacture, sale or distribution of drugs in public interest during an emergency arising due to epidemic or natural calamity if it is necessary or expedient.

The The National Pharmaceutical Pricing Authority also has significant powers to control the prices of drugs through Drug Price Control Orders.

🔹 However, although legal tools to work towards equitable healthcare exist, none of them can independently actually achieve equity.

Healthcare that's not equally accessible to all is not an IP problem alone. It is not a legal problem alone. And it is certainly not a logistics problem alone. Focusing on any one of those factors without considering the others will not lead to a solution.

We need a multi-pronged and collaborative approach which addresses all the hurdles we're facing simultaneously. There's isn't the slightest chance that it'll be easy but it is important that we do whatever we can so that we (hopefully) ultimately achieve equitable healthcare.

There's much we could do within India to enhance healthcare access but it's also important to remember: the state of healthcare in India is not entirely up to Indians.

TRIPS came with the implicit understanding of necessary tech transfers.

BUT… that's not how it's working out.

The infographic in the previous tweet updated till April 28, 2021 shows just who's in favour of the #TRIPSwaiver, and who isn't, & who's undecided. It's v MSF (msf.org/countries-obst…) which, of course, has nothing to do with the text of this thread.

The image speaks for itself.