Industry committee  That's worldwide.

Industry committee  Africa is the most heavily affected continent, so the bulk of those deaths are happening in Africa, but it's not only Africa.

Industry committee  Yes.

Industry committee  Yes. These are figures that come from UNAIDS.

Industry committee  This legislation is not doing that as it stands because, as we were saying, there's been only one use of it, and that has been for an AIDS drug to one country. So we can't say this legislation is doing anything. This legislation could do something, because the legislation, as it stands now, is not limited to only AIDS drugs.

Industry committee  Yes, 90%

Industry committee  The Global Fund is around... It depends on each country's contribution.

Industry committee  Thank you. That's an excellent question. Because India now grants patents on pharmaceutical products--where it did not before 2005--in order to produce and export a generic version of a drug, you would need a mechanism like CAMR. In 2005, when India made the changes to its Patents Act to introduce patents on products, it also included one paragraph in the Indian Patents Act, section 92A, that is basically supposed to be the equivalent of CAMR under Indian law.

Industry committee  It would depend on the country, but most of the drugs, most of the generics, for example, that are being used to treat people are being WHO pre-qualified. That's why WHO set up that mechanism, and most developing countries that are purchasing medicines are requiring that there be that WHO pre-qualification for any medicines they purchase.

Industry committee  I would just add that if we have all of that infrastructure in place, but that infrastructure can't actually purchase medicines at an affordable price, what is it giving to patients? The two actually are not mutually exclusive; they need to go hand in hand. So this is about dealing with the pricing issue, and then we need complementary action to build up the infrastructure where it doesn't exist.

Industry committee  There's the on-the-ground part and then there's the legal part about CAMR. Maybe we could split it up.

Industry committee  I would differ slightly with Dr. Kilby about the perhaps overly rosy picture regarding access here to medicines being perfect. In the U.S. there are barriers to access, but not necessarily the patent barriers. I did want to specifically speak to the legal aspect of preventing this kind of diversion from happening.

Industry committee  I can, and I actually think there are two experts who have also made a written submission to the committee, addressing some of these very specific points, two economists who have studied the pharmaceutical sector quite intensively. One thing to say in response to this claim that there's no evidence that changing CAMR would actually make a difference is I think it's fair enough to say that we won't know until we try.

Industry committee  Thank you. I think it's important to remember that in the one instance when, despite the flaws in CAMR, it was actually made possible to get a medicine out the door, the price the generic manufacturer offered Rwanda was competitive. It was 19.5¢ per tablet, which was the same price on offer from the Indian generic manufacturers.

Industry committee  But it is not a static situation. It is dynamic.