Today’s system of medical innovation does not work. Monopolies awarded to pharmaceutical companies—via patents and copyright—keep drug prices artificially high and stunt competition and innovation. The high prices of medicines are often entirely divorced from what it costs to research, develop and manufacture them, and most companies actually spend more on marketing than they do on research.
This has consequences for all of us, not just those unable to afford the medicines they need to survive. A healthy population is far more productive economically. Higher instances of disease require greater public expenditure, and can strain already struggling healthcare systems. In some parts of the world, a lack of access to vital medicines contributes towards continued instability, and the humanitarian and security effects are felt around the world.
This patent-driven system also favors the development of certain drugs over others, typically favoring chronic diseases prevalent in wealthy people over acute infections in poorer people. This means that many critical drugs we urgently need, such as those for neglected and emerging infectious diseases, are not being developed.
The competitive nature of this system also produces sub-optimal results. It’s perhaps easier to think of this in terms of a school exam. At school, exams test individual performance. It’s a competition. Only one person can win. This is why cheating isn’t allowed and most exams don’t involve group work.
But competitions like this aren’t capable of finding the best answer overall, only the best within a particular group. Because collaboration isn’t allowed in these settings, there is no opportunity to improve overall performance by combining aspects of each participant’s work. For this reason, competition rarely produces new or innovative solutions, merely a perfection of known processes.
For health, we aren’t interested in what’s good enough. We want the best. We don’t want the quality of the solution to rely on people having a go at problems one at a time. We want everyone who is researching medicine to have all information available so they can bounce off one another. For this we need a new system that encourages collaboration and allows for competition in the production, not design, of drugs.
To achieve this, Art / Earth / Tech are working on iMed (Innovating Medical Entrepreneurship and Delivery). Generously supported by the Rockefeller Foundation, we want to understand if there is a better way to fund the research and manufacture of the medicines we all rely on. How can we reward individual contributions yet allow for collaboration so we can discover the best solutions while still encouraging the best execution once we know what the solution is? Innovation, competitive manufacture and equitable benefits are not mutually exclusive goals, and our aim is to develop a better, more sustainable system for healthcare innovation that benefits everyone.