Dr Simon Reid-Henry is a geographer and Reader at Queen Mary, University of London and Senior Researcher at the Peace Research Institute, Oslo, Norway. 

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Dr Simon Reid-Henry is a geographer and Reader at Queen Mary, University of London and Senior Researcher at the Peace Research Institute, Oslo, Norway. 

We are all internationalists now

Planet Earth

Kevin Gill under a Creative Commons Licence

The New Internationalist was founded in 1973 – a propitious year.

The Bretton Woods system had recently collapsed, opening the door to floating currencies and global financial speculation.

In July of that year, the Trilateral Commission met for the first time in the US to promote a more conservative internationalism than that offered by the Non-Aligned Movement of the so-called ‘third world’ nations.

In October, Egypt’s attack on Israel in the Yom Kippur war set the pretext for a sharp price hike agreed by the oil-producing countries of the Organization of the Petroleum Exporting Countries (OPEC).

Forty years on, 2013 is an equally propitious time to be reflecting on current challenges in each of these three areas – global economics, democratic values and geopolitics.

Global capitalism is in a state of organized disarray. Democratic values are questioned everywhere, from the US Congress to the Security Council Chamber. And wars are fought by powerful nations on the territories of weaker ones both by hook and by crook.

But partly as a result of these crises, there is now a greater recognition that our lives are shaped not just by our local geography but by forces that bind us all together.

In this weaker sense, we are all internationalists today – as Blair would have put it.

Yet there is a stronger and more compelling case for internationalism than the idea that our security is threatened by the insecurity of others.

It stems from the recognition that while we may not have personal responsibility for the lives of distant strangers, we do have political responsibilities towards them – at least to the extent that the choices we make in our lives have consequences for the choices they can make in theirs. To be an internationalist does not require one to be a card-carrying cosmopolitan in outlook, but it does mean recognizing that we share at least that much in common.

This raises moral, political and practical questions – none of which have easy answers. But then being an internationalist is about embracing complexity, not simplifications.

Above all it means a constant state of open-mindedness. Internationalism is a relational disposition: like democracy, it is poorly served by efforts to cast it in the stone of one group’s needs alone.

These are not just questions for the Left but they are of most immediate relevance to it. As Donald Sassoon wrote in his 1998 tome One Hundred Years of Socialism: ‘For the Left to remain national, while capitalism is international, would be like becoming a shadow that has lost its body.’

How right he was. And with its failure to articulate a response to rising inequality in the rich world and its lack of original thinking about a post-Millennium Development Goals agenda for the poor world the organized Left displays well the poverty of thinking at just the national level today.

Rather than shrink from both challenges, the ‘internationalist’ would see that growing inequality in rich countries and the failure of our efforts to address global poverty are connected to one another.

It is clear, for example, that the ideal of equality now hangs in the balance, even in the social democratic heartlands of Europe There are those who take this as proof that universal social protection was always too expensive, too inefficient – even for the wealthiest of countries. But that is far from obvious looking from Norway, where Oslo is Europe’s fastest-growing city because others are voting with their feet and moving there to find work.

But the crisis of social democracy in Europe and the US is not just about economics and responding to it also requires social democrats to think beyond the borders of the nation state.

Which brings us to the issue of global poverty, which is still too often framed, even by those wishing to help, as a problem of others: the poverty of elsewhere.

It is very much a problem of ‘here’ too, however, not least in that European citizens, for one, benefit from the resource transfers that gave their countries greater wealth to redistribute in the first place. Those whose solution to rich world inequality is to turn inwards, the better to save the sinking ship of social democracy at home, commit both a moral and a tactical error in doing so.

Not least, as Richard Wilkinson and Kate Pickett showed in their 2009 book The Spirit Level, more equal rich societies tend not just to be more redistributive within themselves, they also tend to give more to others. But more so, as the United Nations Research Institute for Social Development (UNRISD) has shown, social policy and more open internationalism (which is not the same thing as open markets and free trade) can contribute to greater wellbeing and economic productivity for all. That, after all, was the lesson the Scandinavian countries followed.

Until we recognize that the problems confronting us today are not problems of global disorder, as nationalists and other self-styled realists like to claim, but problems of an historically particular way of ordering the world; until we see how our complicity in some of those policies both maintains the status quo ‘here’ and undermines others ‘elsewhere’, we will, in the words of TH Marshal, simply keep ‘abat[ing] the nuisance of poverty without disturbing the pattern of inequality of which poverty [is] the most obvious unpleasant consequence’.

It behoves us all to understand this since we will, in the end, either rise or fall together.

The Internationalists blogging series has been timed to mark NI's 40th anniversary. Read the other blogs exploring perspectives on development and global solidarity.

Novartis vs India: the showdown approaches

The Swiss-based pharmaceutical giant Novartis is taking the state of India to court in a case that has, after rumbling about in the lower courts for six years, wound up as a very public litmus test of the legal framework sustaining India’s generic drugs revolution.

With the case due before the Supreme Court on 28 March, the fate of millions who depend on affordable Indian medicines may soon hang in the balance.

At first glance, the case concerns the fact that Novartis has been denied a patent for one of its blockbuster anti-cancer drugs, Glivec, in what is one of the world’s fastest-growing drug markets.

But at stake is really that part of India’s domestic patent law, known as Section 3d, which was originally used to deny the patent to Novartis. Section 3d specifically prohibits the practice of ‘evergreening’, whereby pharmaceutical companies make small changes in the chemical makeup of a drug in order to secure further patent protection on essentially the same medicine. 

As a result, Section 3d has, since India became fully TRIPS (trade-related aspects of intellectual property rights) compliant in 2005, helped to sustain the growth of India’s generics manufacturers, some of whom currently produce versions of Glivec for less than a tenth of the price. By keeping foreign monopoly interests at bay, Section 3d plays an important role in enabling India to supply life-saving medicines used in poor countries the world over.

All this is reasonably watertight, legally speaking. Yet because of the way that their initial attempt to obtain a patent for Glivec was sent packing by a lower body, the Indian Patent Appellate Board, Novartis have managed to engineer the present, somewhat higher stakes showdown in the Supreme Court.

The Appellate Board decision upheld an earlier ruling by India’s Patent Board stating that, under Section 3d, Novartis had no right to extend its patent on Glivec: that it was simply a case of evergreening. Yet in doing so the Appellate Board made the slip of acknowledging that Glivec was novel in some respects. Specifically, the version of Glivec that Novartis wants to patent in India has greater bioavailability, making it more easily absorbed within the body. But this still wasn’t novel enough, the Appellate Board confirmed, to escape the reach of 3d.

Nonetheless this gave Novartis hope that if it couldn’t get Glivec over the hurdle of Section 3d because the drug itself isn’t novel, it might nonetheless get around Section 3d by loosening the definition of what ‘novel’ is.

The Appellate Board’s decision opens the door to this possibility by no more than the smallest of fractions, since any impartial observer ought in all reasonableness to agree that a novel medicine is one that has a novel clinical effect. Otherwise it’s just packaging and, as patients, we have no reason to be particularly interested in it.

But if what Novartis are arguing is not all that different to saying that if you down a can of Coke rather than drink it slowly the Coke itself is somehow better, the difference in the two earlier verdicts still leaves a chink in the Indian government’s armour. And the danger, both for patients who currently rely upon affordable versions of Glivec in India, and those around the world who rely upon other affordable drugs that Section 3d makes possible, is that woollier arguments than this have been held up in courts before. So we are to hope, therefore, that the Indian government has good lawyers.

Médecins sans Frontières have launched a campaign to stop Novartis

Photo by Harveyben under a CC Licence

Novartis vs India: the court will decide

Photo by Martin Lopatka under a CC Licence

The Indian Supreme Court opens today for the concluding stage of a long-running assault on India’s patent law by drug giant Novartis.

For six years Novartis has been trying to get Indians to pay market price for one of its patented drugs, Glivec – a life-saving anti-cancer medicine. Like other Big Pharma, Novartis believes that middle-income countries such as India and Brazil are no longer dirt poor and should now be paying their way for medicines. It argues that India should button up and follow the 40 other countries that already recognize the patent on Glivec.

But this is rather like saying it thinks India should jump under a bus on the grounds that others have been coaxed into doing so, and it sidesteps what is really at stake in today’s case. Because while India is a lucrative market and Glivec a blockbuster drug – with a price tag of around 10 times the generic equivalent – the tenacity with which Novartis has clawed its way through the Indian legal system to bring its case before the Supreme Court belies a far more significant pay off.

India now exports as much as 50 per cent of its $15 billion generics industry to other countries and supplies many of the medicines used in global health treatment programmes around the world

By challenging not only the rejection of its own patent, but the constitutional legality of a key part of India’s patent law, Novartis has in effect teed up an important litmus test of the sorts of flexibilities that emerging economies can draw upon to protect their own domestic industries under governing WTO TRIPS (trade-related aspects of intellectual property rights) legislation.

This means that if Novartis ultimately win the case, they not only open up the potentially lucrative Indian market for their own drugs, they will also force all Indian pharmaceutical producers to think twice about the sorts of drugs they make cheap versions of in future. And by further pegging India to rich-country levels of patent protection, the ultimate consequence may be to undermine the country’s entire generics revolution.

An Indian lifeline

The implications of this reach far beyond India’s borders. For while it is well known that India produces cheap generic drugs, it is less well known that India now exports as much as 50 per cent of its $15 billion generics industry to other countries, or that Indian generics supply many of the medicines used in global health treatment programmes around the world. The medical group Médicins Sans Frontières (MSF) source 80 per cent of the HIV drugs that they use across the developing world from India, for example. Which makes India, as MSF spokesperson Leena Menghaney puts it, ‘literally the lifeline of patients in the developing world’.

But that lifeline itself is protected by the very part of India’s patent law that Novartis seeks to challenge. Section 3d, as it is known, was a public health safeguard that India adopted when it became officially TRIPS compliant in 2005. It is specifically intended to prevent what Novartis have for years been trying to do with Glivec: namely to extend the life of an older patent through clinically insignificant modifications, a practice known as ‘ever-greening’.

This case will – by luck or by design – undermine the legal room for maneouvre that India’s generics revolution relies upon

Novartis strongly reject this. They say that activist groups like MSF, ‘are confusing the issue’ by claiming that the case will affect generic medicines produced in India for the developing world. It is hard to feel all that sympathetic for Novartis, here. India has only become the pharmacy of the developing world because until now it has been so easy for them to undercut Big Pharma’s preference for a vastly overpriced market. And proven unwilling to compete on price, Novartis’ current actions now further paint them in the well-slippered guise of the monopoly capitalist, banging their fists on the table and crying foul play while doing all they can at the same time to rewrite the rules in their favour: they must surely know that by cranking up the risks for Indian generic producers this case will – by luck or by design – undermine the legal room for maneouvre that India’s generics revolution relies upon.

Regardless of the outcome, the world should follow what happens in New Delhi from today with interest. Novartis’ backdoor attempt to lob the hand grenade of Western monopoly rights into India’s well-functioning generics laboratories is likely to be just one of many coming salvos in the battle to meet, and to profit from, the health needs of those parts of the developing world with a dollar or two in their back pocket. Expect the EU-India Free Trade Agreement to be the next to try. And expect many people’s health to suffer if either attempt is successful.

Simon Reid-Henry is a lecturer in geography at Queen Mary, University of London and the founding director of the Centre for the Study of Global Security and Development. His most recent book is The Cuban Cure: Reason and Resistance in Global Science. He is currently based in Oslo.

Further New Internationalist coverage on related issues:

Mari Marcel Thekaekara on India's drug lifeline under threat

Dinyar Godrej: Eight things you should know about patents

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