Adonis Diaries

Posts Tagged ‘Doctors Without Borders

 

This story is included with an NYT Opinion subscription.

JERUSALEM —

As Israel bombarded the people in Gaza with extensive airstrikes and followed up with a ground operation in the Gaza Strip and Hamas reacted by launching rockets at Israeli cities, the most immediate cause of this latest war has been ignored: Israel and much of the international community placed a prohibitive set of obstacles in the way of the Palestinian “national consensus” government that was formed in early June.

That government was created largely because of Hamas’s desperation and isolation. The group’s alliance with Syria and Iran was in shambles. Its affiliation with the Muslim Brotherhood in Egypt became a liability after a July 2013 coup replaced an ally, President Mohamed Morsi, with a bitter adversary, Gen. Abdel Fattah el-Sisi.

Hamas’s coffers dried up as General Sisi closed the tunnels that had brought to Gaza the goods and tax revenues on which it depended.

He is a father, and he just lost his son.

Younes Arar's photo.
Younes Arar's photo.
Younes Arar's photo.
A few hours ago, the 4 Palestinian children of Baker family ((Ahed Atef Bakr (10 years), Zakareya  Bakr (10 years), Mohamad Ramez Bakr (11 years) and Esma’il Mohamad Bakr (9 years))
The four killed kids running before the second shell whipped them down 
‎أولادي الذين لم الدْهم. لو انني التقطتهم بيديّ قبل ان يسقطوا.‎

Seeing a region swept by popular protests against leaders who couldn’t provide for their citizens’ basic needs, Hamas opted to give up official control of Gaza rather than risk being overthrown.

Despite having won the last elections in 2006, Hamas decided to transfer formal authority to the Palestinian leadership in Ramallah.

That decision led to a reconciliation agreement between Hamas and the Palestine Liberation Organization, on terms set almost entirely by the P.L.O. chairman and Palestinian Authority president, Mahmoud Abbas.

Israel immediately sought to undermine the reconciliation agreement by preventing Hamas leaders and Gaza residents from obtaining the two most essential benefits of the deal:

1. the payment of salaries to 43,000 civil servants who worked for the Hamas government and continue to administer Gaza under the new one, and

2. the easing of the suffocating border closures imposed by Israel and Egypt that bar most Gazans’ passage to the outside world.

Yet, in many ways, the reconciliation government could have served Israel’s interests:

1. It offered Hamas’s political adversaries a foothold in Gaza;

2. it was formed without a single Hamas member;

3. it retained the same Ramallah-based prime minister, deputy prime ministers, finance minister and foreign minister; and, most important,

4. it pledged to comply with the 3 conditions for (Western colonial powers) aid long demanded by America and its European allies: nonviolence, adherence to past agreements and recognition of Israel.

Israel strongly opposed American recognition of the new government and sought to isolate it internationally, seeing any small step toward Palestinian unity as a threat.

Israel’s security establishment objects to the strengthening of West Bank-Gaza ties, lest Hamas raise its head in the West Bank. And Israelis who oppose a two-state solution understand that a unified Palestinian leadership is a prerequisite for any lasting peace.

Still, despite its opposition to the reconciliation agreement, Israel continued to transfer the tax revenues it collects on the Palestinian Authority’s behalf, and to work closely with the new government, especially on security cooperation. (Not a correct statement)

But the key issues of paying Gaza’s civil servants and opening the border with Egypt were left to fester.

The new government’s ostensible supporters, especially the United States and Europe, could have pushed Egypt to ease border restrictions, thereby demonstrating to Gazans that Hamas rule had been the cause of their isolation and impoverishment. But they did not.

Instead, after Hamas transferred authority to a government of pro-Western technocrats, life in Gaza became worse.

Gaza is a concentration camp.

Gaza is a concentration camp.

Médecins Sans Frontières (Doctors Without Borders), have some scathing, painful things to say about what Israel is doing to Gazans:

[A senior official with the] humanitarian charity has described his organisation’s work among the 1.8 million besieged Palestinian refugees as akin to being “in an open-air prison to patch up prisoners in between their torture sessions”.

Jonathan Whittall, head of humanitarian analysis at MSF, who worked in Libya during the 2011 war, in Bahrain during the uprising of the same year, in Syria, Afghanistan, Pakistan, South Sudan and Darfur, has bluntly asked his colleagues:

At what point does MSF’s repeated medical action in an unacceptable situation [like Gaza] become complicity with aggression and oppression?”

“An entire population is trapped in what is essentially an open-air prison,” Mr Whittall writes. “They can’t leave and only the most limited supplies – essential for basic survival – are allowed to enter. The population of the prison have elected representatives and organised social services.

“Some of the prisoners have organised into armed groups and resist their indefinite detention by firing rockets over the prison wall. However, the prison guards are the ones who have the capacity to launch large-scale and highly destructive attacks on the open-air prison.”

The current escalation in Gaza is a direct result of the choice by Israel and the West to obstruct the implementation of the April 2014 Palestinian reconciliation agreement. The road out of the crisis is a reversal of that policy.

Emails Show Hillary Clinton Aides Celebrating F-15 Sales to Saudi Arabia: “Good News”

Lee Fang. Feb. 22 2016

The shockingly brutal Saudi air campaign in Yemen has been led by American-made F-15 jet fighters.

The indiscriminate bombing of civilians and rescuers from the air has prompted human rights organizations to claim that some Saudi-led strikes on Yemen may amount to war crimes.

At least 2,800 civilians have been killed in the conflict so far, according to the United Nations — mostly by airstrikes. The strikes have killed journalists and ambulance drivers.

The planes, made by Boeing, have been implicated in the bombing of three facilities supported by Doctors Without Borders (Médicins Sans Frontières).

The U.N. Secretary General has decried “intense airstrikes in residential areas and on civilian buildings in Sanaa, including the chamber of commerce, a wedding hall, and a center for the blind,” and has warned that reports of cluster bombs being used in populated areas “may amount to a war crime due to their indiscriminate nature.”

Bombs dropped by fighter jets are pulverizing Yemen’s architectural history, possibly in violation of international humanitarian law.

A few years earlier, as secretary of state, Hillary Clinton made weapons transfer to the Saudi government a “top priority,” according to her closest military aide.

And now, newly released emails show that her aides kept her well-informed of the approval process for a $29.4 billion sale in 2011 of up to 84 advanced F-15SA fighters, manufactured by Boeing, along with upgrades to the pre-existing Saudi fleet of 70 F-15 aircraft and munitions, spare parts, training, maintenance, and logistics.

The deal was finalized on Christmas Eve 2011. Afterward, Jake Sullivan, then Clinton’s deputy chief of staff and now a senior policy adviser on her presidential campaign, sent her a celebratory email string topped with the chipper message: “FYI — good news.”

The email string was part of a new batch of emails from Clinton’s private server, made public on Friday evening as the result of a Freedom of Information Act lawsuit.

One American official, whose name is redacted in the emails, said he had just received confirmation that Prince Salman, now the king of Saudi Arabia but at the time the senior Saudi liaison approving the weapons deal, had “signed the F-15SA LOA today” and would send scanned documents the following day.

“Not a bad Christmas present,” he added.

Another official, whose name is also redacted, confirmed that a Saudi general who had been working with U.S. officials was “pleased, as are all of us,” and said he would soon contact executives at Boeing.

The congratulatory tone continues through the email chain with other officials, also with redacted names, calling the weapons deal “Great news!”

On December 26, Jeremy Bash, then-chief of staff at the Pentagon, sent the email string, titled “F-15SA Christmas Present,” to Sullivan, who sent it to Clinton with his own note at the top.

David Sirota and Andrew Perez have previously reported for the International Business Times that Clinton’s State Department was heavily involved in approving weapons sales to Saudi Arabia.

As weapons transfers were being approved, both the Kingdom of Saudi Arabia and Boeing made donations to the Clinton Foundation. The Washington Post revealed that a Boeing lobbyist helped with fundraising in the early stages of Hillary Clinton’s current presidential campaign.

Jeremy Bash is now managing partner at Beacon Global Strategies, a consulting firm that provides advice to Clinton on foreign policy while providing paid advice to the military contracting industry.

Related:

Air Attack on MSF’s Kunduz Hospital: An MSF Nurse Recounts from Afghanistan

October 03, 2015

Doctors Without Borders/Médecins Sans Frontières (MSF) nurse Lajos Zoltan Jecs was in Kunduz trauma hospital when the facility was struck by a series of aerial bombing raids in the early hours of Saturday morning.

This was a US strike. And the US is investigating.

Prior to this bombing a US helicopter was shut down and 11 of its crew dead.

He describes his experience:

Noor Khalil shared this link.

“It was absolutely terrifying.

I was sleeping in our safe room in the hospital. At around 2am, I was woken up by the sound of a big explosion nearby. At first I didn’t know what was going on.

Over the past week we’d heard bombings and explosions before, but always further away. This one was different, close and loud.

At first there was confusion, and dust settling. As we were trying to work out what was happening, there was more bombing.

After 20 or 30 minutes, I heard someone calling my name. It was one of the Emergency Room nurses. He staggered in with massive trauma to his arm. He was covered in blood, with wounds all over his body.

At that point my brain just couldn’t understand what was happening. For a second I was just stood still, shocked.

He was calling for help. In the safe room, we have a limited supply of basic medical essentials, but there was no morphine to stop his pain. We did what we could.

I don’t know exactly how long, but it was maybe half an hour afterwards that they stopped bombing. I went out with the project coordinator to see what had happened.

What we saw was the hospital destroyed, burning. I don’t know what I felt, just shock again.

We went to look for survivors. A few had already made it to one of the safe rooms. One by one, people started appearing, wounded, including some of our colleagues and caretakers of patients.

We tried to take a look into one of the burning buildings. I cannot describe what was inside. There are no words for how terrible it was. In the Intensive Care Unit six patients were burning in their beds.

We looked for some staff that were supposed to be in the operating theater. It was awful.

A patient there on the operating table, dead, in the middle of the destruction. We couldn’t find our staff. Thankfully we later found that they had run out from the operating theater and had found a safe place.

Just nearby, we had a look in the inpatient department. Luckily untouched by the bombing. We quickly checked that everyone was OK. And in a safe bunker next door, also everyone inside was OK.

And then back to the office. Full, patients, wounded, crying out, everywhere.

It was crazy. We had to organize a mass casualty plan in the office, seeing which doctors were alive and available to help. We did an urgent surgery for one of our doctors. Unfortunately he died there on the office table. We did our best, but it wasn’t enough.

The whole situation was very hard. We saw our colleagues dying. Our pharmacist…I was just talking to him last night and planning the stocks, and then he died there in our office.

The first moments were just chaos. Enough staff had survived, so we could help all the wounded with treatable wounds. But there were too many that we couldn’t help. Somehow, everything was very clear. We just treated the people that needed treatment, and didn’t make decisions. How could we make decisions in that sort of fear and chaos?

Some of my colleagues were in too much shock, crying and crying. I tried to encourage some of the staff to help, to give them something to concentrate on, to take their minds off the horror. But some were just too shocked to do anything. Seeing adult men, your friends, crying uncontrollably—that is not easy.

I have been working here since May, and I have seen a lot of heavy medical situations. But it is a totally different story when they are your colleagues, your friends.

These are people who had been working hard for months, non-stop for the past week. They had not gone home, they had not seen their families, they had just been working in the hospital to help people… and now they are dead. These people are friends, close friends. I have no words to express this. It is unspeakable.

The hospital, it has been my workplace and home for several months. Yes, it is just a building. But it is so much more than that. It is healthcare for Kunduz. Now it is gone.

What is in my heart since this morning is that this is completely unacceptable. How can this happen? What is the benefit of this? Destroying a hospital and so many lives, for nothing. I cannot find words for this.”

 

Syria: In a besieged hospital

 This impossible luxury of sleeping and resting

Noor Khalil shared this link on FB. March 13, 2015

“Three years of non-stop surgery under tough circumstances – I have maxed out.

I’ve had enough of scenes of misery, but we have no other choice. People here need us.

They are in desperate need of all kinds of medical care, from the most simple to the most complicated.”
Dr. S is a young surgeon who graduated shortly after the outbreak of the crisis in Syria.

 
Dr S. working in a makeshift hospital that received MSF support tells the story of his medical journey.
 An experience that parallels the war in the country.
msf.org

Dr. S is a young surgeon who graduated shortly after the outbreak of the crisis in Syria. He now works in a makeshift hospital in a semi-rural neighbourhood located to the east of Damascus. This is a facility that received dedicated MSF support and supplies throughout the period of siege, support that continues on a regular monthly basis to this day. He tells the story of his medical journey – an experience that parallels the war in the country.

A temporary truce that death could not penetrate

There was a pregnant woman who was trapped during the time we were under full siege. She was due to deliver soon. All negotiation attempts to get her out failed. She needed a caesarean operation, but there was no maternity hospital we could get her to, and I had never done this operation before.

A few days before the expected delivery date, I was trying to get a working internet connection to read up information on doing a C-section. The clock was ticking and my fear and stress started to peak. I wished I could stop time, but the woman’s labour started.

The atmosphere was tense already, with mad shelling hammering the area.

The bombardments had reached a deafening level. We brought the woman into the operating theatre and I did the operation. Joy overwhelmed me when we knew the baby girl was healthy, and her mother too.

In this madness, our work as surgeons is to save as many lives as we can. Sometimes we succeed, and sometimes we fail.

It is as if we repair the damage that the war left. But this operation was not the usual damage repair; it helped bring new life to this earth. It was a magical moment; a temporary truce that death could not penetrate.

I chose a deserted school as my hospital

I graduated as a surgeon shortly after the crisis started in Syria.

In the Summer of 2011, with the acceleration of events and medical needs increasing, I started working in small private hospitals.

A few months later, I was arrested, as were many of my colleagues. At the beginning of 2012 I was out, and I returned to treat people and carry on my general surgery specialization.

I was working in improvised field hospitals, operating in conditions that were largely unsuitable for medical work.

We worked in the east of Damascus and then in the Ghouta area, where the medical need was urgent.

At the end of 2012, a semi-rural neighbourhood located to the east of Damascus witnessed violent clashes. The area was packed with displaced people at the time, without any medical centre to treat wounded people. I went there and decided to set up a field hospital.

Following a search, I chose a deserted school that had previously been hit. The upper floors were damaged, but the ground floor, as well as the basement, were in a good shape.

Despite the daily, continuous shelling on the area, and the constant fear and stress, the medical team with which I worked managed to provide tremendous medical care to those who needed it the most.

The siege

A healthy man walked out, and few moments later, he came back with shards of metal in his body.

One day in July 2013, around 10:00 am, the hospital was hit by a rocket. The massive explosion turned the place upside down and its pressure tore out the wooden walls. Medical tools and people were thrown in all directions. Soon a dust cloud settled over the building and made it impossible to see.

The explosion was like nothing before. I thought that worse could follow and this explosion might be only the beginning of something very bad.

Indeed, shells rained on the area and we could hear the clashes getting worse.

As we were getting over the shock, one of the hospital workers collapsed.

She lived near the hospital. Her young boy was at home and the area was coming under heavy shelling. She could not keep it together and she wanted to save her child. A medic offered to go out and look for the child. I did not like the idea because we did not know what was going on outside.

As soon as the medic was out of the hospital door, he saw a tank with its gun facing towards him. A healthy man walked out, and few moments later, he came back with shards of metal in his body. It was only then that we realized the severity of the situation outside. We decided to evacuate the hospital – two medics per patient to carry them – and we got out of the back door.

It was apocalyptic!

We tried to walk fast towards a small medical centre not far from there. Shelling was hammering the fields around us. I was expecting the worst with every shell we heard. We managed to arrive at our destination unharmed.

It was like a miracle. We had left our equipment in the evacuated hospital, but we did not dare to go back there.

Over the next days, we heard that the fighting was moving away from the area around the hospital.

Under heavy bombardment, we decided to go back and bring our equipment. We had to do that to be able to treat people. Taking turns to do the trip, we managed to retrieve as much as possible after ten days.

From then, we were under siege – impossible to get in and out of there. This was also true for medical supplies.

We received a flow of injured people since the first day of the siege. I often operated on two people at once.

We worked around the clock. Sleeping and resting were an impossible luxury. We managed to stop for few moments before dawn to eat some food and drink some water, before getting back to work.

Most days heavy shelling and raging fighting brought us more injured people, leaving us no chance to rest.

The numbers of injured people were way beyond what we could handle, and that forced us to make painful clinical decisions.

After the siege

We were under siege for eight months, up until February 2014.

Eight months of suffering and stress, followed by a ceasefire, during which many people managed to go back to their homes. It became easier to get hold of supplies, and that helped us to continue providing medical care to people in need. Nevertheless, the humanitarian situation remained bad.

There were still often clashes at the edges of the this area and the shelling was still frequent.

This formal ceasefire did not change the nature of our work, but we finally found enough time to expand the hospital. People returning to the neighbourhood meant an increase in the needs, thus more pressure on us. We setup an obstetrics department and clinics to provide basic medical care and chronic diseases management.

We could start doing bone, internal and urinary surgeries; all operations we could not perform before because we had suffered critical shortages of supplies and we had been prioritizing life-saving operations.

MSF continued to provide us with much of what we needed. We even received laboratory kit, which allowed us to carry out diagnostic tests.

And we received an incubator for the obstetrics unit. Little by little, we could start to respond to all the basic general medical needs for the people in the area.

It has to stop, one day

Three years of non-stop surgery under tough circumstances – I have maxed out. I’ve had enough of scenes of misery.

I was on the phone recently with my surgery professor and he said: “regardless of the operating conditions, your work during these three years matches my whole 30 years’ experience as a doctor. You have reached retirement in just three years.”

And indeed, every moment of every day I feel I have had enough, but we have no other choice.

People here need us. They are in desperate need of all kinds of medical care, from the most simple to the most complicated. We cannot add another reason for the deterioration of this already disastrous situation.

Today, I am almost certain that, when the war is over, I will quit medicine. Any human being would make that decision after living what I have lived through.

I look forward to the end of this war. It has to stop, one day. Then, I can choose what to do. Only then, will we be truly alive again.


Although Médecins Sans Frontières (MSF)/Doctors Without Borders is currently able to run six health facilities in the north of Syria, in most of the country the organization cannot have teams working directly on the ground providing hands-on medical care.

But in order to ensure some continuity of medical provision in the midst of this war, MSF supports over 100 medical centers across Syria where medical help is needed the most, with a focus on besieged communities and active conflict areas where there is little or no other medical support being provided.

Zionist settler kiddies and Israel army using stun grenades to keep Palestinian farmers off their land

Want to meet the victims of hostile acts?

Go to the village of Burin, south of Nablus, because no article can convey the fear, methodicalness, hypocrisy and collaboration of each entity that seeks to make the villagers loathe their lives.

Who will protect Israel’s poor settler kiddies?

While settlers covet a West Bank hill, the army is using stun grenades to keep Palestinian farmers off their land.

 published in Haaretz this Dec. 30, 2013 

Children playing in the Bracha B outpost in December 2013.

Children playing in the Bracha B outpost in December 2013. Photo by Olivier Fitoussi

If the settlers from Yitzhar and its outposts take a rest from their sacred harassment of these villagers, there are still the Bracha B outpost and the mini-outpost Givat Ronen to show these goyim just who the chosen people are.

And let’s not deprive the army and the Border Police, who work day and night to carry out their supreme mission of protecting Israeli citizens, even when those citizens are shooting at Palestinians, throwing stones at them, setting trees and cars on fire, keeping Palestinians from harvesting their olive groves despite pre-coordination with the army, rolling burning tires onto fields, or expelling people from their land.

Burin’s eastern neighborhood is a special target of attack, 500 to 800 meters away from a hilltop claimed by Bracha B and Givat Ronen.

Daringly, young Palestinian couples are building their homes in the neighborhood, as Israelis come down the hill and try to stop the construction. Heroically, they raise their children, who sometimes see psychologists from Doctors Without Borders to help them cope with their fear and powerlessness.

Here is a partial list of some of the latest attacks, taken from a letter sent by human rights group Yesh Din to Maj. Gen. Nitzan Alon, the general in charge of the army’s Central Command:

* October 31: Israelis go down the hill from Bracha B to Burin. The Israel Defense Forces arrives at the village’s eastern neighborhood and fires tear gas at village Palestinian residents.

* November 9: Israelis go down the hill from Bracha B to eastern Burin and throw stones. IDF soldiers are present but don’t intervene. Village residents throw stones back at the Israeli assailants. The army fires tear gas, stun grenades and rubber-coated metal bullets – at the Palestinians, of course.

* November 10: Same as the day before.

* November 13: Same as November 9 and 10.

* November 14: Same thing, but with a few light injuries and three arrests, including that of a 13-year-old boy. Injuries and arrests among the Palestinians, what else?

* November 25: Anonymous assailants throw two firebombs at the Omran family home at night. Since then, the youngest child has been having nightmares and is frightened by noises. Playing outside the house is dangerous, because at any moment “the neighbors” could come down the hill and spread fear.

Let there be no doubt: The settlers are coveting the hill on whose slope the eastern neighborhood of Burin is built.

After all, there are dozens of dunams of pastoral landscape and air as pure as in the Alps. The settlers have already evicted the owners of the one house that’s already there, glory be to God. As for a road, they halted that project a decade ago. Now olives are harvested there, but only in the presence of a rescue team from Rabbis for Human Rights.

‘Two leftists and two locals’

The IDF and Border Police don’t sit idly by.

They do some expulsions of their own. Last Monday, about 10 minutes after this reporter, a photographer and two Burin residents reached the top of the hill, three Border Police officers approached us. One of them, Saher Ghanem, put the stun grenade he had been holding in his hand back in his pocket only when he was about 10 meters from us. “This is a closed military zone,” he announced.

“Show us the order,” I challenged. He didn’t produce it. The other Border Police officer, Niran Yadin, called in the situation.

“There’s two leftists and two locals,” he reported.

Above us, at the edges of Bracha B, soldiers gathered and came down toward us. Sgt. Liran Fuchs acted friendly and extended a hand to one of the Burin residents. He had no order to show us either. Of course, when only the locals are around, who needs an order if you have stun grenades and tear gas?

Now take a look at what the IDF Spokesman’s Office wrote to Haaretz:

* “The Palestinians’ presence in the area under discussion does not constitute a violation of the law, and it is indeed Area B” (which is under Palestinian civil control and joint Israeli and Palestinian security control).

What generosity. We, the Settler Defense Forces, allow Palestinians to step foot (for now) on the land they have been cultivating since before Theodor Herzl was born.

* “Nonetheless, the site is a known locus of conflict between the populations of the area.”

Yes, after all, everything in life is symmetrical, isn’t it? Between those on the hilltop and those in the valley, between shepherds and farmers, between boys from Mars and girls from Venus.

* “During disturbances of the peace, the way we deal with the disorderly is identical and is determined in accordance with a situation assessment on the ground.”

Identical?

Is that why when settlers attack Palestinians, the army expels the Palestinians from their land? Is that why the army broke into the Omrans’ home three weeks after assailants firebombed it?

* “Due to a misunderstanding, at the beginning it was indeed said that the area had been designated a closed military zone, but the matter was then clarified and no action was taken to disperse those present in the area. Directives on the matter will be clarified to the forces.”

Sure. Let’s talk the next time the Palestinian residents are forcibly dispersed.

The outposts are illegal, even according to the Israeli laws of plunder. But the IDF and Border Police must protect Israeli criminals as long as they’re settlers in occupied territory.

The toddlers of the Bracha B outpost, with large knitted kippot and long sidelocks, who last week were still playing soccer with what was left of the snow, are indeed entitled to any protection there is. But no one is protecting them from the malignant disease of a master race.

India Drug Patents: Threat on Merck, Bristol-Myers?

Pharmaceutical companies from Merck & Co. (MRK:US) to Bristol-Myers Squibb Co. (BMY:USface fresh threats to protecting their patents in India as a government-appointed panel prepares to evaluate more drugs for local makers to copy.

Ketaki Gokhale on Bloomberg News this Jan. 21, 2014

Merck to Bristol-Myers Face More Threats on India Drug Patents

The panel is looking beyond the cancer treatments it studied last year to areas such as HIV and diabetes, according to two people with knowledge of the matter, who asked not to be identified because the discussions are private.

It plans to study more than 20 drugs and recommend the government assign about three so-called compulsory licenses to allow local firms to make low-priced copies in India, they said.

The heightened scrutiny illustrates how emerging markets are becoming harder to navigate for global drugmakers including Pfizer Inc. (PFE:US) and Novartis AG (NOVN), which have struggled to defend their rights on blockbuster therapies in India.

The drugmakers are facing a rising threat to their patents as India’s government seeks to make treatments cheaper locally, said Ajit Mahadevan, leader of the life sciences consulting group at Ernst & Young in Mumbai.

“Moves by policymakers like compulsory licensing result in the feeling that you’re not very comfortable investing,” Mahadevan said. “You can’t build predictability, and big pharma doesn’t like that.”

Compulsory licensing occurs when a government allows someone else to produce a patented product without the consent of the patent owner, who still owns the rights and receives payment for its use, according to the World Trade Organization.

Such licenses can therefore put pressure on brand-name manufacturers to cut prices in response to cheaper generics.

R.K. Jain, additional secretary at the Ministry of Health and Family Welfare, didn’t immediately respond to a call and an e-mail seeking comment on compulsory licenses.

Wider Scrutiny

Among the therapies the committee is preparing to study or had an early look at are two diabetes drugs, Merck’s sitagliptin medication, Januvia, and Bristol-Myers’ saxagliptin drug called Onglyza.

Merck’s HIV drug raltegravir, sold under the brand name Isentress; and Bristol-Myers’ arthritis drug abatacept, sold as Orencia, according to the people.

The panel is also considering other drugs and it still isn’t clear which ones will be shortlisted, the people said.

Patents provide Merck with the incentive to assume the risks associated with drug discovery, the Whitehouse Station, New Jersey-based company said in an e-mailed response to questions. “We encourage the government of India to reassure investors that India respects and values innovation and the protection of intellectual property.”

Bristol-Myers in an e-mailed statement said it is “deeply concerned with the deteriorating protections for patented innovative medicines in India” and will continue to act to protect its intellectual property rights.

Any recommendations will still need the government’s approval. The panel’s proposals will be submitted to the Department of Industrial Policy and Promotion, which will make a decision on whether compulsory licenses can be awarded.

India’s Controller General of Patents, Designs and Trademarks will then need to sign off on the compulsory licenses. Following that, a generic drugmaker could require the patent holder to grant it a license to make a copy in India.

Medical Needs

Besides boosting the domestic generic drug industry, cheaper copies of blockbuster medicines would help India meet the needs of low-income citizens.

Diabetes afflicts 65 million Indians, according to the International Diabetes Federation. The country has an estimated 2.1 million people living with HIV, according to the Joint United Nations Programme on HIV/AIDS.

The committee recommended compulsory licensing for dasatinib, a Bristol-Myers therapy for chronic myeloid leukemia sold under the brand Sprycel, last year, the people said.

Any award of compulsory licenses will take time because the process is fraught with bureaucracy, said Leena Menghaney, a patient advocate at Doctors Without Borders in New Delhi. India also is worried about its international image, she said.

The U.S. International Trade Commission said in August that it would investigate “Indian policies that discriminate against U.S. trade and investment” at the request of the House Committee on Ways and Means and the Senate Committee on Finance.

Trade Relationship

“What the Indian government is really worried about is the court cases that will follow from drug companies,” Menghaney said. “It’s worried about the international criticism it will face from developed country governments who back their pharmaceutical companies, and the impact it will have on the India-U.S. relationship.”

Roche decided not to pursue Indian patents for its breast cancer medicine Herceptin because of the Indian intellectual property environment, the company said in an e-mailed statement in August. It introduced a lower-cost Herceptin packaged by a local drug company for the Indian market in 2012.

Under India’s patent laws, compulsory licenses can be awarded for some products still under patent if the original isn’t available locally at a reasonable price.

Natco Pharma Ltd. (NTCPH) applied directly to India’s patents office and was awarded the nation’s first compulsory license in March 2012 to make a copy of Bayer’s Nexavar cancer drug at a 97% discount to the original product.

In March last year, Bayer lost its bid to stop Natco from making the generic drug and is appealing the decision at the Mumbai High Court.

Bayer Chief Executive Officer Marijn Dekkers called the compulsory license “essentially theft.”

“We did not develop this medicine for Indians,” Dekkers said Dec. 3. “We developed it for western patients who can afford it.”

To contact the reporter on this story: Ketaki Gokhale in Mumbai at kgokhale@bloomberg.net

To contact the editor responsible for this story: Anjali Cordeiro at acordeiro2@bloomberg.net

Bayer Pharmaceutical CEO: Cancer drug only ‘for western patients who can afford it’

Scott Kaufman posted this January 26, 2014
bayer ceo
In an interview with Bloomberg Businessweek, Bayer CEO Marijn Dekkers said that his company’s new cancer drug, Nexavar, isn’t “for Indians,” but “for western patients who can afford it.”

The drug, which is particularly effective on late-stage kidney and liver cancer, costs approximately $69,000 per year in India, so in March 2012 an Indian court granted a license to an Indian company to produce to the drug at a 97 percent discount.

Bayer sued Natco Pharma Ltd., but in March of last year, the High Court in Mumbai denied its appeal.

Bayer CEO called the compulsory license issued by the Indian court “essentially theft,” then said “[w]e did not develop this medicine for Indians…[w]e developed it for western patients who can afford it.”

Nexavar costs approximately $96,000 per year in the United States, but Bayer assures “western patients” that they can have access to the drug for a $100 copay.

The United States International Trade Commission said that it will investigate “Indian policies that discriminate against U.S. trade and investment,” and despite the High Court’s decision, many in the Indian government are worried about the effect it will have on U.S.-India relations.

In an e-mail to Bloomberg Businessweek, Bristol-Meyers Squibb said that it is “deeply concerned with the deteriorating protections for patented innovative medicines in India.” The court cases that could ensue could tie up the Indian legal system in a manner that makes it impossible for doctors in the country to acquire any version of the drugs at any cost.

[Image of Bayer CEO Dekkers via 2010 Annual Report]

Scott Kaufman
Scott Kaufman
Scott Eric Kaufman is the proprietor of the AV Club’s Internet Film School and, in addition to Raw Story, also writes for Lawyers, Guns & Money.
He earned a Ph.D. in English Literature from the University of California, Irvine in 2008.

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