Last month, a court in India dismissed a contentious and widely followed lawsuit brought against the government by Novartis, which hoped to secure certain patent rights for its Gleevec cancer med. Novartis lost and has since threatened to move operations out of India. Some advocates say patients in poorer countries were big winners. Nature spoke with Jamie Love, director of the nonprofit organization Knowledge Ecology International, who explains the global impact. This is a brief excerpt…

Nature: Nearly half a million people signed a petition, floated by Doctors Without Borders, calling on Novartis to drop this case. Why? What was at stake in the outcome?

Love: India has the most important patent law in the world, in terms of global health. India is also the primary supplier of cheap generic drugs to the rest of the world. If India has tough patent laws and routinely extends patent protection to new uses of old medicines, it will reduce global access to medicines. On the other hand, if India wins the lawsuit, other countries will undoubtedly consider similar changes in their own patent laws.

Nature: What impact will the ruling have in other countries, such as Brazil and Thailand, that have refused to comply with patents on expensive drugs?

Love: There is a lot of confusion about what the WTO rules actually say, and what some countries are doing. Under the WTO rules, only the 50 least developed countries can eliminate patents on pharmaceutical products. Everyone else, including India, Brazil and Thailand, must grant and enforce patents. However, any country can issue a compulsory license on a patent and allow third parties, including generic drug companies, to use the patent in return for the payment of a royalty to the patent owner. Brazil and Thailand issued patents, but also granted compulsory licenses in return for royalty payments.

Compulsory licensing is not limited to public health crises or developing countries. The US has issued at least a half-dozen compulsory licenses on patents in the past 15 months, including on automatic transmissions, software technologies and medical devices. Italy has issued compulsory licenses on three different drugs since 2005.

The Indian Novartis dispute is about a different issue. How much discretion do WTO members have in deciding what constitutes a patentable invention? This is not only an issue in India, it is a question that was also addressed recently in the US Supreme Court.

Unless Novartis drops the suit, the Indian court case may be subject to further appeals. But assuming this decision stands, other developing countries will probably make it more difficult to obtain patents on minor innovations or on new uses for old drugs.

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