Industry committee  Yes, 90%

Industry committee  Yes.

Industry committee  Yes, I can. I wanted to, before I forget, draw your attention to a document that you have in the materials we gave you. This is a briefing paper prepared by Doctors Without Borders--Médecins Sans Frontières--describing their experience of attempting to use the legislation, working with Apotex to get this drug because MSF had identified that they needed it.

Industry committee  And they get a payment stream on sales that they are themselves not making now because their pricing strategy in developing countries is not one that makes it affordable for the vast majority of people who have to pay out of pocket for medicines. So those are unrealized sales for the brand-name companies now.

Industry committee  Sure. Could I just offer a correction, or a clarification?

Industry committee  In the one instance when CAMR was used, it was not the case that the Indian generic manufacturer was offering it at a lower price. The prices were actually matched.

Industry committee  That's right. Well, we only have the one use so far of CAMR, and in that case it was a competitive price. Part of the reason why we've seen the number of people on treatment go up is precisely because the generics have been available. The global fund money, for example, has been able to stretch that much further because you're paying 20¢ per tablet rather than five bucks a tablet.

Industry committee  We don't know.

Industry committee  We know it's going to be more difficult now to get generics from India. It may be impossible. Who knows? But there's certainly a patent barrier that has now gone up in India that will start to take effect.

Industry committee  I will do my best. Let me first of all draw your attention to subsection 37(1) of the Food and Drugs Act, which is not changed by all of this. It is already the case in Canada that any drug that is made in Canada for export is not subject to Health Canada review; it is only in the case of a drug that is produced under CAMR for export that the requirement was made that Health Canada must review it.

Industry committee  It could, and China is one of the countries that has what's called a “state directive” to implement the WTO decision from 2003, which was the basis for the Canadian legislation. China is one of the countries that has this. It's very deficient, not the least because it's quite limited in terms of the diseases for which medications can be produced.

Industry committee  In some it is. MSF tried for 18 months--and it has a presence in various countries--and it ultimately abandoned the effort because it could not get a country to come forward.

Industry committee  Oh, I'm sorry, it's Médecins Sans Frontières, Doctors Without Borders. So in order for Apotex to then move forward to be in a position, legally, to sell it to MSF, they needed to be able to go to the brand name companies in Canada that hold the patents on those three drugs and say to them, “We would like you to voluntarily give us a licence to supply x quantity of this drug to this particular country”.

Industry committee  MSF made the commitment to Apotex that if Apotex developed this drug, this three-in-one fixed-dose combination that they needed in the field, they would seek to purchase it under CAMR from Apotex. Given the way the law is worded, in order for MSF to be able to do that, they needed a country to come forward and notify the WTO of their intention to do this and also of the quantity of the drug that the country expected to need.

Industry committee  Can I be frank?