Some health advocates believe that weakening intellectual-property protections and capping prices for the most advanced cancer treatments would expand access in developing countries. But this well-intentioned argument overlooks an inescapable reality: without strong incentives for innovation, such treatments would not exist.
LAGOS—In Nigeria, a cancer diagnosis is often a death sentence. Nearly 130,000 Nigerians receive one each year, and nearly 80,000 die of the disease. An average of 33 women per day in Nigeria are infected with cervical cancer, and 22 women per day die from it. The problem is not that interventions do not exist, but that Nigerians—and developing-economy patients more broadly—lack access to them.
Breakthroughs in cancer treatment, especially immunotherapy, have drastically reduced the disease’s mortality in recent decades. A mere generation ago, the idea that the immune system could be trained to fight cancer sounded like science fiction. Today, it represents the most promising front in cancer research, with more than 30 immunotherapies, treating 25 different forms of cancer, now approved by the US Food and Drug Administration.
The results speak for themselves. Patients with advanced melanoma were once expected to survive a mere 16 weeks. But, thanks to immunotherapy, they now have a one in three chance of living a decade or longer. Likewise, for some lung cancer patients, prognoses that were once measured in months are now measured in years.
But Nigerian patients rarely have access to immunotherapies or other innovative treatments. Even at major hospitals in Lagos and Abuja, doctors routinely find themselves unable to prescribe what they know could help their patients. So, while cancer patients in rich countries live longer than ever, Nigerians—like patients in many developing countries—continue to die.
Some believe that the best way to close this gap is to weaken intellectual-property protections for medical innovations and force drugmakers to give away their treatments at little or no cost. They argue that patent rules and high prices create unfair barriers to health care. But this well-intentioned argument overlooks an inescapable reality: without strong incentives for innovation, advanced treatments like immunotherapy would not exist at all.
The development of new cancer therapies requires immense investment and carries staggering risk. Since most new prospective drugs never succeed, the few that do must make up for the costs of the failures. Nigeria, like many developing countries, does not yet have the economic or scientific infrastructure required to develop its own cancer breakthroughs at scale, so it remains dependent on discoveries made in countries like the United States. If we dismantle the system that rewards their innovative activities in the name of faster access, progress will slow, and future patients in rich and poor countries alike will suffer as a result.
Patents expire, and when they do, low-cost generic versions emerge. In the meantime, several pharmaceutical companies and NGOs have launched initiatives designed to expand access to medicines in developing countries. The system might not be perfect, but at least it allows the breakthroughs to keep coming.
In any case, the biggest barriers to access to accurate cancer diagnosis and effective treatment in developing countries are not patents at all, but regulatory delays, weak health-care infrastructure, and poverty. Instead of attempting to dismantle incentives for innovation, governments should work on reducing bureaucratic red tape, speeding up approvals for imported medicines, and expanding health-care infrastructure and capacity, which is in particularly short supply in rural areas.
Policymakers should also take action to improve overall living standards. Expanding trade and liberalizing markets are among the most effective ways for developing countries to boost economic growth and dynamism. Faster growth, in turn, would enable higher investment in infrastructure and health care, while creating job opportunities that increase household incomes.
When lifesaving medicines are out of reach, calls for quick solutions are understandable. But a short-sighted approach risks turning today’s tragedy into tomorrow’s catastrophe. Weakening the incentives that underpin medical innovation will slow the pace of progress. And it is progress that is essential to prevent a cancer diagnosis from becoming a death sentence.
