As an insatiable consumer of information empowered by the Internet, I die a little death every time I click on a link and am told that I must pay a fee to access something. It's not that I would deny anyone the right to profit from their "content." My disappointment, paradoxically, is a function of how much information is already freely available. There are so many paths to follow online, so much that can be learned about every aspect of the universe, that every time I hit a roadblock it is a rude awakening. I am unjustifiably annoyed -- spoiled by the cornucopian Internet.
But imagine if life or death did ride on getting the full text of a document, instead of, say, just the abstract? In an editorial in the most recent Bulletin of the World Health Organization, "The Impact of Open Access on Public Health," we are presented with just such an anecdote.
"Arthur Amman, President of Global Strategies for HIV Prevention tells the following story: 'I recently met a physician from southern Africa, engaged in perinatal HIV prevention, whose primary access to information was abstracts posted on the Internet. Based on a single abstract, they had altered their perinatal HIV prevention program from an effective therapy to one with lesser efficacy. Had they read the full text article they would have undoubtedly realized that the study results were based on short-term follow-up, a small pivotal group, incomplete data, and were unlikely to be applicable to their country situation. Their decision to alter treatment based solely on the abstract's conclusions may have resulted in increased perinatal HIV transmision.'"
The reporter in me would like a little more specificity in this anecdote -- some names that could be fact-checked, for example. It sounds almost too good to be true, as if custom-designed for the purposes of the four authors of the article --- who are all employed by the Public Library of Science, a pioneer in publishing peer-reviewed open-access academic papers. But even as a hypothetical, the story would still illustrate a crucial point. When you inject the topic of public health into the domain of intellectual property you immediately fling yourself into an arena where ethical responsibilities and economic interests clash.
Open access to medical information is just one aspect of a much larger, global debate on whether the intellectual property regime that the U.S. and European Union would like to impose upon the entire world serves the interests of poor, sick people in the developing world. Big Pharma says that without strong I.P. rights, there will be no incentive to develop new drugs. In response, the developing world points out that no matter how strong the laws are, there is still little incentive for drug companies to devote R&D to diseases that afflict poor people.
If this question interests you, then hie yourself over to the newly published Bulletin of the World Health Organization. It is a gold mine of essays, editorials, academic reports, and interviews that focus on one of the defining conflicts of today's global economy: the showdown between public health and Big Pharma. Taking as its hook last month's publication of the WHO's "Report of the Commission on Intellectual Property Rights, Innovation and Public Health," the Bulletin punches one hot button after another. Two recommendations: Graham Dutfield's look at the public-health implications of DNA patenting, and Carlos Correa's breakdown of how bilateral "free trade" agreements negotiated by the United States require adherence to intellectual property restrictions that go considerably beyond -- and actually directly undermine -- what has been agreed to in the World Trade Organization's "Trade-Related Aspects of Intellectual Property Rights" agreement.
An additional interview with Correa, director of the Center for Interdisciplinary Studies on Industrial Property and Economics Law at the University of Buenos Aires, is mandatory reading for anyone looking for a stinging, point-by-point summary of why the intellectual property status quo is a mess that needs to be fixed. For a rebuttal, there's a sour distillation of Big Pharma's stance from the International Federation of Pharmaceutical Manufacturers and Associations.
Talk about your Internet cornucopias! There is far more in this WHO Bulletin than can be digested in one morning or even one day. But for those who care about this topic, or those who want to learn the lay of the land, it is the place to start.