Novartis and the Indian patent regime – My view

I went through the good Barbarindian’s blog-post on the Novartis case and I have a few points of agreement and and a few rebuttals.

Let’s go through his points one by one:

        I The ruling stifles innovation

No, it doesn’t.  In fact, I believe, this ruling is neutral as far as innovation is concerned. In one way, it restricts the ability of Big Pharma to extend the life of its patent, thereby reducing incentive to focus on blockbuster drugs.

In another, it forces Big Pharma to cast their nets wider and look for more diseases and conditions to focus on.

 

       II Drug companies rely on Government research

Almost all innovation builds on some primary research done somewhere else. This is a strawman argument, not worth pursuing.

III This ruling will help the poor in the world

Let us assume RoI on health spending can be calculated as a composite of several numerators – no of lives saved/increased life expectancy/decrease inproductive days lost, upon a single denominator – Dollars spent.

  • Preventive efforts to save them from diarrhea, malaria, typhoid and dysentry
  • Neo-natal and obstetric care
  • Prophylactic usage of  preventives/vaccines to control infectious diseases

will provide a far higher RoI, than any amount of research on cancer, IMHO.

IV Novartis was trying to “evergreen” its patent

This is the elephant in the room, and the crux of the argument. What was Novartis exactly trying to do? What was the improved efficacy of the patent being sought? The whole dispute was over improved therapeutic efficacy of the new patent, i.e., enhanced ability to heal the disease. Novartis claimed therapeutic efficacy improvement was due to improved ‘bioavailability’ – i.e., the variant’s capability to be absorbed faster by the human body. The courts have decided against it.

 

We do not really know the additional effort/costs of work done by Novartis done on this new variant.

However, do note that the original patent filed was in ’93, during which Novartis has had 20 years to recoup its original costs. Also note that Indian companies have been restricted since ’03 from producing and distributing generics. It would not be anybody’s case to portray Novartis as a net revenue loser in this case. The fact that they have been distributing the drug to poor patients voluntarily is not germane to this issue either.

Where I really differ with Barbarindian is

a) His assertion that this will be a dis-incentive to drug companies to invest in high-end research in India.

Results of research performed in India can realistically be patented elsewhere under different patent regimes and can be sold at differential costs. Reluctance of drug companies to invest in Indian researchers is similar to reasons why auto companies and aerospace companies are reluctant to invest in India, lack of qualified talent and infrastructure.

b) If there is no incremental improvement, why not continue with the generic and avoid the new drug altogether?

This is not such a simple question. In case of critical conditions like leukemia, doctors (good ones) would face a real ethical dilemma deciding whether to avoid more expensive treatment that would fetch marginal improvements for poor patients, while going ahead with such treatment for richer patients. Can of worms here.

 

In conclusion, I believe the Novartis judgement is neither a blow for social justice nor a regressive judgement to restrict innovation. I, too, agree with barbarindian and realitycheckind that social arguments should not dominate a commercial argument.

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Pi’s Progress

The movie ‘Life of Pi’ seemed like a charming magical realist tale, until this tweet alerted me to the proselytising undercurrent in it. Three of the songs in the soundtrack are – Christ in the Mountains, Thank you Vishnu for Introducing me to Christ and Skinny Vegetarian Boy ref. soundtrack

I thought about it to analyze the movie and found several elements that converted the book, a straightforward exploration of human nature in a magical realist setting, into a Christian allegory.

Let us begin at the beginning.

– The story begins in the French quarter of Pondicherry, an oasis of Western Christian light, starkly contrasted against the darkness of heathen India.

– It is also noteworthy that Hindu epics are introduced through the medium of Amar Chitra Katha illustrations told as a bedtime story, to make it all seem like a charming tale for children.

– The family itself is shown as having taken the first step out of Hindu superstition through an inter-caste marriage

– The Mahavishnu float has a carnival quality, which is broken by the rationalist father, who also introduces Pi to the reality of the world and nature, red in tooth and claw.

– Pi now has his childish Hindu belief rudely interrupted and the stage is set for his introduction to Christ, the redeemer, atop a magical mountain of light.

– After his formal induction into the Christian faith, when he now removed from the home of his childhood

– He now has to navigate the ocean of doubt and superstition.

– He is shipwrecked, wrestles and masters the beast within, symbolized by the tiger.

– At this point, he finally is forced to drop his childish belief in the sacredness of all life, and there is some not-so-subtle ridicule of the Hindu custom of worshipping animals, when he sobs and apologizes to the fish he is forced to slaughter for food

– The carnivorous island, which gives food and shelter to all creatures, only to snuff their lives out at night, is again clearly in the shape of a sleeping Mahavishnu, thereby symbolically proclaiming the cruel and futile nature of the Hindu faith.

– At the end of his journey upon the ocean of doubt, he is led to the Promised Land, again presumably a Christian island of hope and light, when he is finally freed of his animal nature and moves to a state of grace.

 

The message is subtle but clear. The hope for Indians is to jettison their Hindu faith and ignorant customs in favor of Christ, which you arrive at by means of rationalism. I am very impressed by the use of Indian motifs, Indian music, Indian  locales and actors to further a missionary message. Clearly the Joshua project is finding new ways of passing on The Good News.

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About Om or Aum

This is a slightly different post here. I am doing the job of digital scribe for Shri V. Sundararajan, a neighbour of mine, who is aged more than 90.

He is a scholar of various topics, spiritual, religious and has devoted the last few years of his life to committing his knowledge down to writing.

This is the first of many posts I will be adding here

Om – phonetically it is ‘Aum’ and we shall henceforth refer to it as such.

Aum

– Symbolises the eternal universe

– Is the trigger behind the ‘Big Bang’

– Revealed itself to the ancient rishis as the one in which they stand enveloped all the time

As our rishis have discovered, and then passed on to us, It is vocalised in the form of 3 basic lip movements and the supporting tongue

– Starting with ‘A’ or ‘अ’, the first alphabet of all written languages in the world, which is produced by holding both lips wide open

– The first letter of Rig Vedham, as it starts with the word ‘अग्नि’

– The first letter of the Thirukkural

– The first letter of the Old Testament

– ‘U’ – Holding both the lips circularly open, as if, to kindle the fire of a yajna

– ‘M’ – Closing both the lips together tightly and releasing a sound form the throat through the nostrils. The Rig Veda ends with this sound.

Remarkably, all languages of the world are known to incorporate these 3 sounds.

Variations are found in the prayers of other religions also – such as Amin/Ameen/Amen/A’ekohm

Scientific basis

Scientifically speaking, no sound, being vibration, ever dies, but only gets progressively weaker over time. Efforts are underway to record the Sreemad Bhagavatam as it was rendered in the battlefield of Kurukshetra, 5000 years ago,

The ancient rishis, in their meditation, became cognizant of this primordial sound. They could feel the effects of this sound, which was an elavating inner quietitude.

Various places where one can hear this primordial sound

– A prayer conch

– A metallic prayer bell form Nepal, which produces this sound when the wooden stick is rotated around the metal bottom of the bell.

– Has even been produced by a metallurgist rotating his finger on a tulip glass containing brandy from a freshly uncorked bottle!

Notes

1) Some decades ago, there was a newspaper from South Africa, of a visiting India Swami, who was said to have directed his ‘Aum’ chanting towards a 3’X1’1X3′ wall. 2 metres form his, and cracked it by 15-20 minutes of said chanting

2) In the 1950, Swami Shivananda Saraswathi of Rishikesh, on a visit to Poona, demonstrated the ‘Aum’ chant thrice, to be heard across a vast, crowded auditorium, without enhancement, to create an appropriate atmosphere for his address.

3) Every weekly Bhajan congregation of the Sathya Sai Organization ends with group chanting of ‘Aum’ 21 times, which produces a salutory effect.

4) The logo – ॐ – is said to depict the sacred face of Lord Shiva with the moon and star (chandra-bindhu combination) as his head jewel. This head-jewel of a star and crescent is also a very famous religious symbol

5) Agni, which is the commencing word of the Rig Vaedham, is in the middle of the 5 elements – पृथ्वी (Earth), आपः  (Water), अग्नि (Fire), वायु (Wind), आकाश (Space)

6) The Zoroastrian religion places fire at the center of worship and thus, fire is placed for worship in fire temples

7) Semitic religions have a plethora of concepts whose names begin with ‘A’ – Allah, Adam, Abraham

8) St. John’s Gospel in the New Testament of The Holy Bible has it that

‘In the beginning was the Word

And the Word was with God

And the Word was God’

As the Word is not specified anywhere. could we assume it to be ॐ?

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The analogue anti-Hindu

There is a certain type of Indian, who wakes from their torpor-inducing desk job at the end of the day, grabs an alcoholic drink, and spends an evening ridiculing ____________ (fill up with Indian custom or belief of your choice).

Are you offended by this stereotype? Suck it up, then, for there’s more coming.

I’ll call this type of Indian the analogue anti-Hindu, since they claim themselves to be the exact opposite of the Internet Hindu.
This bunch has internalized their self-hate so thoroughly that one of them decided to secede from the Indian Union. One particularly uncouth specimen wrote a few hundred words wondering if she really was her parent’s child.  Children have been slapped and asked to wash out their mouth for far less.
They share a few characteritics, these desi faux-liberals. They dislike India, desi engineers and Hindu beliefs, in that order.
Some people drink. Some people don’t. Some people are vegetarian. Many aren’t. But nobody makes such a fetish of their drinking or of their meat-eating as the upper-caste Indian liberal.

There was a certain type in your high-school and college, the type that considered itself posh and let off secret snickers at the ‘dehati’s – people from small-town or lower-middle-class backgrounds. Their loudest snickers were reserved for when the dehatis actually tried to use English in conversation or tried something different in clothes. I disliked the buggers then and I dislike them now.

How can you spot these people:
– They’ll be the ones loudly complaining about paan-chewing and waxing eloquent about the virtues of cigars in the same breath
– They’re the folks that order steaks only when white people are at the table, with an expression of guilt, like the guy who farts in a closed room.
– They’ll be the folks making private jokes about other people’s English

I had meant to make this a longer post, but then I figured I’d never have the sting that Malcolm X did, God bless his soul!

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What is to be done?

What are we, the middle-class citizens of this our Republic of India to do? What can we do about corruption?

Here are a few random thoughts and prescriptions, totally unsolicited by anybody, of course:

  • Find out who your ward councillor, local station sub-inspector, MLA and MP are.
  • Get in touch with them to let them know who you are.
  • Give up your assumption that they are greedy sociopaths. They just might be regular people, cutting corners to make their way through a world not of their making. Give them benefit of that doubt.
  • If you have a problem with traffic, uncollected garbage, parks not maintained and so on, talk to your councillor. Get a few of your neighbours together to help him/her work a solution out , if you can.
  • If you have a problem with upcoming legislation in your state, or with problems that your councillor cannot help you with, get in touch with your MLA.
  • Keep abreast of legislation, proposed, upcoming, past. Have an opinion on them. Let your MP know of your opinion. Write to him/her, call, e-mail.
  • You see anything unlawful happening in your neighbourhood? Let your SI know. Ask him/her how you can help. Give evidence when needed and let all of the ward councillor, MLA, MP etc. know if you do.
  • Talk to all these people coolly and calmly.
  • Don’t get excited, frightened, intimidated, irritated, aggressive or preachy.
  • Don’t give them BS about how things work at your office, or worse still, how the USA handles such stuff. That’s of no use to anybody.
  • You wouldn’t like to be told how you do your job. Don’t assume others do.
  • If you have a problem with aforesaid individuals, try to work around them.

That’s the straightforward stuff. Here are some more ambiguous ones

  • Try and identify a political party that mirrors your values and aspirations. You will find out if you try to find out more about them from themselves.
  • Fund them with your legal earnings.
  • A very few of us will actually end up running for office. Find out what they’re running for. Support them if they match your values.
  • Change of the nature we expect will take a few generations. May not happen in our children’s time, maybe in our grandchildren’s. Accept that.

Remember, corruption can be practiced upon a subject populace. The engagement of an informed citizenry is essential to the practice of democracy.

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What If – why don’t we complete?

This article from Madras historian Muthiah set my thinking going – http://www.thehindu.com/news/cities/chennai/article3640377.ece

What if Clive had been defeated?

Muthiah says –

“you would find this column being written in French.

Not only that: you’d probably be entitled to a handsome allowance from the French government in case you are retired; your children would be getting a chance to study in France; you would be having access to some of the best wines in the world; you would be making annual trips to Paris — residents of Pondicherry who opted for French citizenship should be able to brief you better about the benefits.”

Let us think about the bigger picture had Clive lost….

– The French Revolution may never have happened. With colonies to plunder, the peasants would probably have found themselves rich pickings as colonial occupiers. No peasant discontent, no revolution.

– No Napolean! Only the French Revolution and its turmoil offered him a chance to establish himself. With his Corsican heritage, he would probably have been an able general and administrator in India, fighting Gurkhas, Sikhs and Burmese. He would have probably risen to high rank.

– No Napolean – decades of turmoil in Europe would have been avoided.

– No Louisiana purchase. The French were de-stabilized due to the slave revolt in Haiti, which meant loss of revenue from slavery and hence were forced to sell Louisiana to the US.  With a wealth yielding colony like India, the French would never have faced such a fiscal difficulty.

– No Loiusana purchase = completely French US and Canada. We might have had a quaint North American region called New England where the inhabitants spoke English!

– We would all drive on the left-hand side of the road.

– Australia would have been French. The Fench reached Australia at about the same time as English, and at the same Botany Bay.

Of course, the outcome would not have been very different for indigenous peoples – American, Australian, African or Indian.

American and Australian Natives would have been exterminated anyway.

Africans would have been enslaved anyway

Indians would have been colonized and starved to death in famines anyway.

Some good would have come of it though – We’d be spared the British Royal wedding. Prince Charles would probably fetch his weekend groceries on a bicycle, like other North European royals.

Not sure if I want to see the residents of Chennai in berets though.

 

And to think it was all because of an opium-addled, womanizing Shropshire lad……..

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Guwahati and our society

I started this blog almost 2 years back.

I have been inactive till now. The Guwahati incident actually roused to post something.

I’d like to analyze this against two angles:

– The absolutely atrocious behavior of our national press and the local Asom press.

– How this exposes our failings as a society

Local Press

The nature of the incident seems to have been nothing more than a bar-room brawl, to start with.  It has then grown into something of a public lynching of the victim, an under-age girl.

The reporters who filmed the incident should have first tried to stop what was happening and should have alerted the police. Their claims that they filmed the incident only when they failed to stop it ring hollow. There are unconfirmed reports that the reporter/photographer actually had a drink with the attackers.

Next, the national media just picked the incident up and made a cause celebre out of it. There was no analysis of the nuance and clear reportage.

As a sample, I present this DNA article:

http://www.dnaindia.com/india/report_guwahati-molestation-what-really-happened_1714657

Some examples of truly sloppy reporting in this article:

“The 17-year-old girl, who is pursuing studies in fashion designing in the national capital, was attacked when she was returning home after celebrating the birthday of her friend, a teenaged girl, at a bar. ”

May we know why a couple of underage children were served drinks at a bar?

“Three young persons had accompanied the two girls on that fateful night. ”

Who were these young men and what were their names?

“The birthday girl had lost her ATM card and couldn’t settle the bills. So, they were evicted by the bar employees. But soon, she picked up a quarrel with the young men who accompanied her and started beating them up. ”

Who picked up a quarrel? With whom? Who hit whom?

Without this information, the public cannot really understand who was at fault. How did a mob build up? Where did the other 9 assailants come from and why did they beat up the girl?

This looks more and more like a stage managed incident, especially considering how all national channels picked it up for outrage, as if on cue.

Our Society

A few inconvenient questions:

  • How were underage children served drinks at a bar?
  • When a brawl broke out outside the pub, where was the police?
  • Why did the reporters continue filming the incident?
  • How can TV channels just run these videos, without protecting the identity of the victim?
  • And finally, the CM of the state just gives instructions to police to ‘conduct raids as necessary’. How will this prevent such incidents in the future?

Have we setup the institutional safeguards against such occurences?

Have the police been trained in standard operating procedure, which is to:

  1. Regularly visit establishments where liquor is being served, without any fuss and without disturbing legitimate patrons.
  2. Identify anyone who looks underage
  3. Politely ask them for proof of age.
  4. If age is not satisfactorily proven, inform the parents/guardian of the underage drinker
  5. Wait until parent comes to pick up the individual or escort the person home.
  6. Notify authorities in child welfare of afore-said underage individual.
  7. Start proceedings to cancel the alcohol service license first and undertake legal action against the proprietor of the establishment.

In the event of a violent altercation breaking out, our duty as citizens would be to:

  1. Notify the police first.
  2. Try and prevent whoever is being violent.
The press would do well to protect the identity of the victim. Instead, the local Asomese news channel has repeatedly run unedited footage of the incident, without protecting the identity of the victim. The editor of the channel has actually supplied us with this nugget of wisdom on Twitter https://twitter.com/atanubhuyan/statuses/222744909722042369
He has also claimed this – “The girl who was molested in Ghy had lied that she was a teenager. She is in fact a married woman and even has a daughter a local tv claimed”
So what? How does that change anything?
I have seen any rational debate on understanding why such basic and simple procedures are ignored in our media, only shrill rhetoric.

 

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