A noted political philosopher has described the rules governing the development and distribution of drugs as “morally unacceptable”.

Speaking at the Federation of European Pharmacological Societies Congress in Manchester, UK, Thomas Pogge, professor of philosophy and international affairs at Yale University, said that the current rules on intellectual property “contribute to the fact that millions of poor people avoidably die each year from a lack of effective medicines”. He added that huge mortality and morbidity rates can be dramatically lowered by reforming the way the development of new medical treatments are funded.

Prof Pogge and colleagues have been working for two years on a project, called the Health Impact Fund, which he says is “required as an add-on to the existing system to render it human-rights compliant”. It would be a global agency, underwritten by governments, and would reward the patentee of any new medicine during its first decade or so, with annual payments proportional to the drug’s “demonstrated global health impact”.

He added that registering a medicine with the HIF would be voluntary and require a concession affecting its price. This would give innovators the opportunity to forgo “monopoly rents in favour of an alternative path that would provide ample rewards for the development of new high-impact medicines without excluding the poor from their use”, he added.

Prof Pogge argues that the crucial responsibility lies not with pharmaceutical companies but with how they are regulated and incentivised. He said that “once the HIF complement is known to be an option, we must not perpetuate a system under which the affluent get the medicines they need while the poor are systematically excluded”.

The professor went on to say that the main responsibility for change lies with politicians and citizens “but pharmaceutical companies are also citizens and they play a significant role in the political process of most societies”. He added that “they lobby a lot” and “here I do see fault. They lobby for holding the line on a status quo that is simply morally unacceptable”.

Prof Pogge continued: “They do this because they know the existing rules, can have a profitable business model under them, and are uncertain what alternative rules would be settled upon once the existing rules were found unacceptable”. He stated that “I want to change this conservative attitude. I want to give them an institutional reform that they can endorse and unite behind. I am convinced they would do better, on the whole, with the HIF than without”.

The professor went on to say he wants to show the pharmaceutical firms that “on balance, they have more to gain than to lose by supporting this reform”. He claimed that “it will be harder and harder to hold the line on the existing system, and the HIF reform preserves pretty much everything they like about this system”.

Prof Pogge summed up by saying that “in other words, they have both moral and strategic reasons to support the HIF”.