NHI – what about patent laws and access to affordable medicines….?

Representatives of two major health advocacy groups, Medicins Sans Frontieres (MSF – Doctors without Borders), and Section 27, have expressed almost dismay at the lack of attention paid to medicines accessibility and affordability in the current NHI Bill itself and in current debates and discussions around it.

In an exclusive AxessHealth “AxessPoints” video discussion this past week, both Baone Twala, Section 27 legal researcher, and MSF Access Campaign Advocacy advisor, Candice Sehoma, supported the contention that extensive health reform would have to be put in place before any attempts to implement NHI: “If we don’t reform our health system, under NHI we are going to face the same issues as we are facing in our current health system at the moment,” said Twala.

And none more so, she stressed, than current patent systems making it difficult to access affordable medicines…

“We have to look at compulsory licensing as well as domestic patent law reform which will be critical to NHI in the sense that access to medicine issues that we have at the moment because of our patent laws are going to persist with NHI,” she explained.

“So, as much as NHI is something that is purported to bring about universal health coverage (UHC), we are going to have to deal with, address and correct our patent systems,” Twala added, stressing again that health reform is needed “more than necessarily rebranding the health system!”

Endorsing these sentiments, the MSF’s Sehoma reiterated that the greater part of this in terms of legislative reform was outside of the NHI – “not considered, outside of the discussion” – despite the considerable work that has and is still being done to reform the patent laws.


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To this end, she explained, there is now a coalition of organisations that have been calling for patent law reform, recognising that the current system “is blocking us from accessing affordable medicine”.

The problem, Sehoma went on to acknowledge, was historic, going back in fact to the TRIPS agreement issues back in the mid-1990s. It was also central to a lot of the discussions during the Covid pandemic: “But we still haven’t had any reform with our patent laws to ensure that the patent system safeguards the public and ensures that they get access to affordable medicine and enable us to have these medicines.

“So, it’s not part of the NHI discussion at all – something that is still sidelined, irrespective of all these things we have seen – and have recognised that this has actually fuelled the inability to get access to these as it is not central to the NHI discussion.

“I agree with Baone in as much as although we will have these reforms, we will still have the same problem. We need to have a much broader look at the interaction between departments. The patent system sits with the Department of Trade and Industry which needs to interact with the Department of Health.

“We need to have these conversations in parallel,” Sehoma concluded, acknowledging that many of these interactions must still take place outside the Department of Health: “But we realise that the NHI is part of an ecosystem and need to create that ecosystem for it to work.”

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