TEDxZurich 2012
Ellen 't Hoen: Pool medical patents, save lives
Elen 't Hoen (Ellen 't Hoen): Ujedinimo medicinske patente, spasimo živote
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Patentiranje novog leka pomaže finansiranju njegove ogromne cene razvoja, ali taj isti patent može učiniti da napredni tretmani budu van domašaja bolesnim ljudima u zemljama u razvoju, po smrtonosnoj ceni. Elen 't Hoen govori o elegantnom, delotvornom rešenju problema: Zajednički fond patenata za lekove. (Snimljeno na TEDxZurich)
Ellen 't Hoen - Medicine law expert
The founder of the Medicines Patent Pool, Ellen 't Hoen works (and makes change) at the place where profit and health collide: patented drugs. Full bio
The founder of the Medicines Patent Pool, Ellen 't Hoen works (and makes change) at the place where profit and health collide: patented drugs. Full bio
Double-click the English transcript below to play the video.
Godine 2002, grupa aktivista za lečenje
00:17
In 2002, a group of treatment activists met
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sastala se da razgovara
o ranom razvoju aviona.
o ranom razvoju aviona.
00:21
to discuss the early development of the airplane.
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00:25
The Wright Brothers, in the beginning of the last century,
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Braća Rajt su, početkom proteklog veka,
00:30
had for the first time managed
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prvi put postigla
da jedna od tih naprava poleti.
da jedna od tih naprava poleti.
00:32
to make one of those devices fly.
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00:34
They also had taken out numerous patents
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Takođe su iznedrili brojne patente
00:37
on essential parts of the airplane.
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ključnih delova aviona.
00:39
They were not the only ones.
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Nisu bili jedini.
00:41
That was common practice in the industry,
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To je bila uobičajena praksa
u toj industriji,
u toj industriji,
00:44
and those who held patents on airplanes
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a oni koji su posedovali patent
nad avionom žestoko su ih štitili
nad avionom žestoko su ih štitili
00:47
were defending them fiercely
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00:48
and suing competitors left and right.
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i tužili konkurenciju sa svih strana.
00:51
This actually wasn't so great for the development of the aviation industry,
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To zapravo nije bilo tako sjajno
za razvoj vazduhoplovne industrije,
za razvoj vazduhoplovne industrije,
00:56
and this was at a time that in particular the U.S. government
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a to je bilo baš u vreme
kada ja vlada SAD-a
kada ja vlada SAD-a
01:00
was interested in ramping up
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bila zainteresovana da pojača
01:02
the production of military airplanes.
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proizvodnju vojnih aviona.
01:05
So there was a bit of a conflict there.
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Dakle, tu je postojao izvestan konflikt.
01:07
The U.S. government decided to take action,
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Vlada SAD-a je rešila da preduzme mere
01:11
and forced those patent holders
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i primorala nosioce patenta
01:13
to make their patents available to share with others
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da omoguće da njihove patente
drugi mogu da dele
drugi mogu da dele
01:17
to enable the production of airplanes.
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kako bi se omogućila proizvodnja aviona.
01:23
So what has this
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Pa, kakve to veze ima sa ovim?
01:26
got to do with this?
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01:30
In 2002, Nelson Otwoma, a Kenyan social scientist,
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Godine 2002, Nelson Otvoma,
sociolog iz Kenije,
sociolog iz Kenije,
01:35
discovered he had HIV and needed access to treatment.
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otkrio je da ima HIV virus
i bio mu je potreban pristup lečenju.
i bio mu je potreban pristup lečenju.
01:40
He was told that a cure did not exist.
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Rekli su mu da lek ne postoji.
01:44
AIDS, he heard, was lethal,
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Sida je, kako je saznao, smrtonosna,
a lečenje se ne može omogućiti.
a lečenje se ne može omogućiti.
01:47
and treatment was not offered. This was at a time
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To je bilo u vreme kada je to lečenje
postojalo u bogatim zemljama.
postojalo u bogatim zemljama.
01:51
that treatment actually existed in rich countries.
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01:53
AIDS had become a chronic disease.
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Sida je postala hronična bolest.
01:56
People in our countries here in Europe, in North America,
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Ljudi u zemljama u Evropi,
u Severnoj Americi,
u Severnoj Americi,
02:00
were living with HIV, healthy lives.
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vodili su zdrave živote sa HIV virusom.
02:03
Not so for Nelson. He wasn't rich enough,
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To nije bio slučaj sa Nelsonom.
Nije bio dovoljno bogat, a isto je bilo
i sa njegovim sinom starim tri godine,
i sa njegovim sinom starim tri godine,
02:06
and not so for his three-year-old son, who he discovered a year later
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za koga je godinu dana kasnije saznao
da takođe ima HIV virus.
da takođe ima HIV virus.
02:10
also had HIV.
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02:13
Nelson decided to become a treatment activist
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Nelson je rešio da postane
aktivista za lečenje
aktivista za lečenje
02:16
and join up with other groups.
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i priključio se drugim grupama.
02:18
In 2002, they were facing a different battle.
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Godine 2002, naišli su na drugačiju bitku.
02:25
Prices for ARVs, the drugs needed to treat HIV,
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Cena ARV, lekova koji su potrebni
za lečenje HIV-a,
za lečenje HIV-a,
02:30
cost about 12,000 [dollars] per patient per year.
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godišnje iznose
oko 12 000 dolara po pacijentu.
oko 12 000 dolara po pacijentu.
02:34
The patents on those drugs were held
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Pravo na patent nad tim lekovima su čuvale
02:36
by a number of Western pharmaceutical companies
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brojne zapadne farmaceutske kompanije
02:42
that were not necessarily willing
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koje baš i nisu bile voljne
02:45
to make those patents available.
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da učine te patente dostupnim.
02:48
When you have a patent, you can exclude
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Kada imate patent,
možete da zabranite svima ostalima
možete da zabranite svima ostalima
02:51
anyone else from making, from producing or making
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da naprave, proizvode ili, na primer,
02:55
low-cost versions, for example,
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02:58
available of those medications.
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učine dostupnim jeftine vezije tih lekova.
03:02
Clearly this led to patent wars breaking out
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Očito da je to dovelo
do izbijanja ratova oko patenata
do izbijanja ratova oko patenata
03:06
all over the globe.
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širom planete.
03:09
Luckily, those patents did not exist everywhere.
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Srećom, ti patenti nisu svuda postojali.
03:13
There were countries that did not recognize
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Bilo je zemalja koje nisu priznavale
03:15
pharmaceutical product patents, such as India,
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patente na farmaceutske proizvode,
kao što je bila Indija,
kao što je bila Indija,
03:18
and Indian pharmaceutical companies
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a indijske farmaceutske kompanije
03:21
started to produce so-called generic versions,
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počele su da proizvode
tzv. generičke verzije,
tzv. generičke verzije,
03:25
low-cost copies of antiretroviral medicines,
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jeftine kopije antiretroviralnih lekova
03:29
and make them available in the developing world,
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i učinile su ih dostupnim
u zemljama u razvoju,
u zemljama u razvoju,
03:32
and within a year the price had come down
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a za godinu dana je cena pala
03:35
from 10,000 dollars per patient per year
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sa 10 000 dolara godišnje po pacijentu
03:39
to 350 dollars per patient per year,
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na 350 dolara godišnje po pacijentu,
03:41
and today that same triple pill cocktail
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a danas je ta ista kombinacija tri pilule
03:45
is available for 60 dollars per patient per year,
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dostupna za 60 dolara godišnje
po pacijentu,
po pacijentu,
03:48
and of course that started to have an enormous effect
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što je, naravno, počelo da dovodi
do ogromnih posledica
do ogromnih posledica
03:51
on the number of people who could afford access
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za veliki broj ljudi koji su mogli
da priušte da dođu do tih lekova.
da priušte da dođu do tih lekova.
03:54
to those medicines.
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03:56
Treatment programs became possible,
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Omogućeni su programi lečenja,
03:58
funding became available, and the number of people
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finansiranje je postalo dostižno,
a broj ljudi koji su uzimali
antiretroviralne lekove
antiretroviralne lekove
04:01
on antiretroviral drugs started to increase very rapidly.
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počeo je da raste vrlo ubrzano.
04:08
Today, eight million people
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Danas, osam miliona ljudi
04:11
have access to antiretroviral drugs.
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ima pristup antiretroviralnim lekovima.
04:14
Thirty-four million are infected with HIV.
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HIV-om je zaraženo 34 miliona.
04:18
Never has this number been so high,
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Taj broj nikada nije bio veći,
04:20
but actually this is good news,
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ali to su zapravo dobre vesti,
04:21
because what it means is people stop dying.
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jer to znači da ljudi prestaju da umiru.
04:24
People who have access to these drugs stop dying.
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Ljudi koji imaju pristup ovim lekovima
prestaju da umiru.
prestaju da umiru.
04:26
And there's something else.
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A postoji još nešto.
04:27
They also stop passing on the virus.
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Takođe prestaju da prenose virus.
04:30
This is fairly recent science that has shown that.
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To je relativno skoro pokazala nauka.
04:34
What that means is we have the tools
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To znači da imamo sredstva
04:36
to break the back of this epidemic.
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da stanemo na put ovoj epidemiji.
04:40
So what's the problem?
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U čemu je onda problem?
04:45
Well, things have changed.
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Pa, stvari su se promenile.
04:47
First of all, the rules have changed.
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Pre svega, pravila su se promenila.
04:51
Today, all countries are obliged to provide
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Danas su sve zemlje u obavezi da obezbede
04:57
patents for pharmaceuticals that last at least 20 years.
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patente za farmaceutske proizvode
koji traju bar 20 godina.
koji traju bar 20 godina.
05:02
This is as a result of the intellectual property rules
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To je proizašlo
iz pravila intelektualne svojine
iz pravila intelektualne svojine
05:05
of the World Trade Organization.
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Svetske trgovinske organizacije.
05:07
So what India did is no longer possible.
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Dakle, više nije moguće
ono što je Indija uradila.
ono što je Indija uradila.
05:10
Second, the practice of patent-holding companies have changed.
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Drugo, promenila se praksa kompanija
koje su vlasnici patenata.
koje su vlasnici patenata.
05:15
Here you see the patent practices
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Ovde vidite praktikovanje patenata
05:20
before the World Trade Organization's rules, before '95,
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pre pravila
Svetske trgovinske organizacije,
Svetske trgovinske organizacije,
pre '95. godine,
pre antiretroviralnih lekova.
pre antiretroviralnih lekova.
05:24
before antiretroviral drugs.
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05:26
This is what you see today,
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Ovo je ono što možete videti danas,
05:29
and this is in developing countries, so what that means is,
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a to je u zemljama u razvoju,
tako da to znači da,
tako da to znači da,
05:32
unless we do something deliberate
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ako ne preduzmemo nešto promišljeno
05:34
and unless we do something now,
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i ako ne preduzmemo nešto sada,
05:36
we will very soon be faced with another drug price crisis,
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uskoro ćemo se naći
pred drugom krizom cena lekova,
pred drugom krizom cena lekova,
05:42
because new drugs are developed,
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jer se razvijaju novi lekovi,
05:44
new drugs go to market, but these medicines are patented
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novi lekovi dolaze na tržište,
ali ti lekovi su patentirani
ali ti lekovi su patentirani
05:47
in a much wider range of countries.
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u mnogo širem opsegu zemalja.
05:50
So unless we act, unless we do something today,
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Stoga, ako ne krenemo u akciju,
ako ne učinimo nešto danas,
ako ne učinimo nešto danas,
05:55
we will soon be faced [with] what some have termed
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uskoro ćemo se suočiti
sa onim što neki nazivaju
sa onim što neki nazivaju
tempiranom bombom lečenja.
05:59
the treatment time bomb.
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06:02
It isn't only the number of drugs that are patented.
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Nije samo stvar u broju lekova
koji su patentirani.
koji su patentirani.
06:07
There's something else that can really scare
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Postoji još nešto što zaista plaši
proizvođače generičkih lekova.
proizvođače generičkih lekova.
06:10
generic manufacturers away.
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06:11
This shows you a patent landscape.
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Ovo vam daje prikaz
stanja stvari kod patenata.
stanja stvari kod patenata.
06:15
This is the landscape of one medicine.
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Ovo je prikaz kretanja jednog leka.
06:19
So you can imagine that if you are a generic company
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Možete zamisliti,
ako ste generička kompanija
koja treba da odluči da li da uloži
koja treba da odluči da li da uloži
06:22
about to decide whether to invest
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06:24
in the development of this product, unless you know
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u razvoj ovog proizvoda,
osim ako znate
da će dozvole za ove patente
da će dozvole za ove patente
06:27
that the licenses to these patents
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06:29
are actually going to be available,
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zaista biti dostupne,
06:32
you will probably choose to do something else.
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verovatno ćete odlučiti
da uradite nešto drugo.
da uradite nešto drugo.
06:35
Again, deliberate action is needed.
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Još jednom, potrebna je
promišljena akcija.
promišljena akcija.
06:39
So surely
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Svakako,
06:41
if a patent pool could be established
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ako se udruživanje patenata
može uspostaviti
može uspostaviti
06:45
to ramp up the production of military airplanes,
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da bi se povećala proizvodnja
vojnih aviona,
vojnih aviona,
06:49
we should be able to do something similar
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trebalo bi da možemo
da uradimo nešto slično
da uradimo nešto slično
06:53
to tackle the HIV/AIDS epidemic.
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da bismo se pozabavili
epidemijom HIV virusa.
epidemijom HIV virusa.
06:56
And we did.
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To i jesmo uradili.
06:58
In 2010, UNITAID established the Medicines Patent Pool
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Godine 2010, UNITAID je uspostavio
udružene patente na lekove za HIV.
udružene patente na lekove za HIV.
07:04
for HIV.
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Ovako to funkcioniše.
07:07
And this is how it works:
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07:09
Patent holders, inventors
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Vlasnici patenta,
pronalazači koji razvijaju nove lekove
07:13
that develop new medicines
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07:16
patent those inventions,
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patentiraju te izume,
ali učine te patente dostupnim
07:19
but make those patents available
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07:21
to the Medicines Patent Pool. The Medicines Patent Pool
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Zajedničkom fondu patenata na lekove.
Zatim Zajednički fond
07:24
then license those out to whoever needs access to those patents.
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daje dozvolu onome kome je potreban
pristup tim patentima,
pristup tim patentima,
a to mogu biti generički proizvođači.
07:28
That can be generic manufacturers.
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07:29
It can also be not-for-profit drug development agencies,
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To takođe mogu biti
neprofitne agencije za razvoj,
neprofitne agencije za razvoj,
07:33
for example.
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na primer.
07:35
Those manufacturers can then sell those medicines
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Ti proizvođači
mogu zatim prodati te lekove
mogu zatim prodati te lekove
07:37
at much lower cost to people who need access to them,
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po mnogo nižoj ceni
ljudima kojima su potrebni,
ljudima kojima su potrebni,
07:42
to treatment programs that need access to them.
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programima za lečenje
kojima je potreban pristup njima.
kojima je potreban pristup njima.
07:45
They pay royalties over the sales to the patent holders,
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Isplaćuju autorsku naknadu
razlike od prodaje vlasnicima patenta,
razlike od prodaje vlasnicima patenta,
07:49
so they are remunerated for sharing their intellectual property.
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tako da oni dobijaju obeštećenje
za to što dele
svoje intelektualno vlasništvo.
svoje intelektualno vlasništvo.
07:59
There is one key difference
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Postoji jedna ključna razlika
08:03
with the airplane patent pool.
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kod udruženih avionskih patenata.
08:07
The Medicines Patent Pool is a voluntary mechanism.
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Zajednički fond patenata na lekove
predstavlja dobrovoljni mehanizam.
predstavlja dobrovoljni mehanizam.
08:12
The airplane patent holders were not left a choice
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Vlasnici avionskih patenata
nisu imali izbor
nisu imali izbor
da li će dozvoliti
korišćenje svog patenta ili ne.
korišćenje svog patenta ili ne.
08:15
whether they'd license their patents or not.
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08:17
They were forced to do so.
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Bili su primorani na to.
08:19
That is something that the Medicines Patent Pool cannot do.
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To Zajednički fond
patenata na lekove ne može.
patenata na lekove ne može.
08:23
It relies on the willingness of pharmaceutical companies
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Oslanjaju se samo na dobru volju
farmaceutskih kompanija
farmaceutskih kompanija
08:26
to license their patents and make them available
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da dozvole korišćenje svojih patenata
i učine ih dostupnim za druge.
08:30
for others to use.
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08:34
Today, Nelson Otwoma is healthy.
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Danas je Nelson Otvoma zdrav.
08:39
He has access to antiretroviral drugs.
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Ima pristup antiretroviralnim lekovima.
08:43
His son will soon be 14 years old.
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Njegov sin će uskoro imati 14 godina.
08:47
Nelson is a member of the expert advisory group
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Nelson je član savetodavne grupe eksperata
08:50
of the Medicines Patent Pool,
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Zajedničkog fonda patenata na lekove
08:52
and he told me not so long ago,
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i rekao mi je nedavno:
08:54
"Ellen, we rely in Kenya and in many other countries
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„Elen, mi u Keniji
i mnogim drugim zemljama se pouzdamo
u Zajednički fond patenata na lekove
u Zajednički fond patenata na lekove
09:00
on the Medicines Patent Pool to make sure
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da bismo obezbedili da novi lekovi
postanu dostupni i nama,
postanu dostupni i nama,
09:03
that new medicines also become available to us,
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09:09
that new medicines, without delay, become available to us."
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da nam novi lekovi
neodložno postanu dostupni.“
neodložno postanu dostupni.“
09:14
And this is no longer fantasy.
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To više nije samo fantazija.
09:17
Already, I'll give you an example.
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Daću vam primer.
09:22
In August of this year, the United States drug agency
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Avgusta ove godine,
agencija za lekove iz SAD-a
agencija za lekove iz SAD-a
09:25
approved a new four-in-one AIDS medication.
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odobila je novi lek za sidu
„četiri u jednom“.
„četiri u jednom“.
09:29
The company, Gilead, that holds the patents,
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Kompanija Gilijad,
koja je nosilac patenata,
koja je nosilac patenata,
09:32
has licensed the intellectual property to the Medicines Patent Pool.
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dala je dozvolu
na intelektualno vlasništvo
na intelektualno vlasništvo
Zajedničkom fondu patenata na lekove.
09:36
The pool is already working today, two months later,
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Fond radi već danas, dva meseca kasnije,
09:40
with generic manufacturers to make sure that this product
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sa proizvođačima generičkih lekova
da bi se postarali da ovaj proizvod
da bi se postarali da ovaj proizvod
09:43
can go to market at low cost
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može da bude pušten na tržište
po niskoj ceni kada i gde je to potrebno.
po niskoj ceni kada i gde je to potrebno.
09:46
where and when it is needed. This is unprecedented.
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Ovome nema presedana.
09:50
This has never been done before.
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To se nije radilo nikada ranije.
09:52
The rule is about a 10-year delay for a new product
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Po pravilu, novom prozvodu
treba oko deset godina čekanja
treba oko deset godina čekanja
09:55
to go to market in developing countries, if at all.
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da stigne na tržište
zemalja u razvoju, ako uopšte stigne.
zemalja u razvoju, ako uopšte stigne.
09:58
This has never been seen before.
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Ovo nikada nije ranije viđeno.
10:02
Nelson's expectations are very high,
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Nelsonova očekivanja su velika,
i to sa pravom.
i to sa pravom.
10:06
and quite rightly so. He and his son will need access
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Njemu i njegovom sinu
će biti potreban pristup
će biti potreban pristup
10:10
to the next generation of antiretrovirals
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sledećoj generaciji
antiretroviralnih lekova
antiretroviralnih lekova
10:13
and the next, throughout their lifetime,
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i sledećoj, kroz njihov životni vek,
10:16
so that he and many others in Kenya and other countries
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tako da on i mnogi drugi
u Keniji i drugim zemljama
u Keniji i drugim zemljama
10:21
can continue to live healthy, active lives.
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mogu da nastave
da vode zdrav, aktivan život.
da vode zdrav, aktivan život.
10:26
Now we count on the willingness of drug companies
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Računamo na dobru volju
kompanija lekova da se to ostvari.
kompanija lekova da se to ostvari.
10:29
to make that happen. We count on those companies
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Računamo na te kompanije da razumeju
10:31
that understand that it is in the interest, not only in the interest
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da ovo nije samo u interesu
globalnog dobra,
globalnog dobra,
10:35
of the global good, but also in their own interest,
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već i u njihovom interesu,
10:38
to move from conflict to collaboration,
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da bismo se odmakli
sa konflikta ka saradnji,
sa konflikta ka saradnji,
10:44
and through the Medicines Patent Pool they can make that happen.
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a one to mogu ostvariti
kroz Zajednički fond patenata za lekove.
kroz Zajednički fond patenata za lekove.
10:47
They can also choose not to do that,
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Takođe mogu odlučiti da to ne urade,
10:50
but those that go down that road may end up
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ali one koje krenu tim putem mogu završiti
10:56
in a similar situation the Wright brothers ended up with
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u sličnoj situaciji kao i braća Rajt
početkom prošlog veka,
početkom prošlog veka,
10:59
early last century, facing forcible measures
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kada su se suočili
sa prinudnim merama vlade,
sa prinudnim merama vlade,
11:03
by government. So they'd better jump now.
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tako da bi im bilo bolje da priskoče sada.
11:08
Thank you. (Applause)
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Hvala.
(Aplauz)
ABOUT THE SPEAKER
Ellen 't Hoen - Medicine law expertThe founder of the Medicines Patent Pool, Ellen 't Hoen works (and makes change) at the place where profit and health collide: patented drugs.
Why you should listen
Ellen ’t Hoen is an independent medicines law and policy consultant. In 2009, she founded the Medicines Patent Pool at WHO/UNITAID, to accelerate the availability of low-cost HIV treatments, especially antiretroviral medicines, in developing countries through patent licensing. In June 2012 she stepped down from the MPP, but remains involved in supporting it.
She is a research fellow at the IS HIV/AIDS Academy of the University of Amsterdam and authored the book The Global Politics of Pharmaceutical Monopoly Power. Drug patents, access, innovation and the application of the WTO Doha Declaration on TRIPS and Public Health. It's available as a free download .
Before founding MPP, from 1999 until 2009 she was the Director of Policy and Advocacy at Médecins sans Frontières’ (MSF) Campaign for Access to Essential Medicines. She won several awards for her work on the effects of exposure to the drug (DES) in the 1980s and 1990s, including the prestigious Harriet Freezerring award in 1989. She is a member of the World Health Organization’s Expert Advisory Panel on Drug Policies and Management and a member of the advisory board of Universities Allied for Essential Medicines (UAEM).
More about this speaker
Website: http://www.medicinespatentpool.org/
Twitter: @ellenthoen, @medspatentpool
Ellen 't Hoen | Speaker | TED.com