Does for-profit drug development harm people in poor countries?

Ronald Bailey argues against calls for an "essential research obligation" mandate that would require drug companies to reinvest a percentage of pharmaceutical sales into R&D for neglected diseases that effect poor countries, either directly or through public R&D programs and a global treaty on R&D for neglected diseases that could provide a framework for such mandates and help make drugs for neglected diseases global public goods. Citing a policy paper by the International Policy Network, he argues that the problem leading to excess death from disease in poor countries is not the lack of development of new drugs for diseases that most affect their populations (mainly tropical diseases), but rather the lack of access to these medications. This lack is not just to due to lack of money but to bad fiscal policy, including the high tariffs and taxes some governments impose on pharmaceuticals and points out that poor countries benefit from drugs designed for richer countries. The provocative conclusion: That the best way to address these public health needs is through the profit motive.

Although I tend to agree with the conclusion that "the health problems faced by the world's poorest populations are not caused by a lack of drugs specifically related to their problems and diseases," but rather "ensuring that these populations can actually access vital medicines." I also tend to agree that a treaty mandating development of certain classes of drugs and limiting intellectual property rights would risk cutting off the the flow of innovation essential to dealing with the world's health problems. However, I'm not sure that I buy into his conclusion that the profit motive is the best way to make sure these poor countries get access to these drugs. For one thing, even if bad fiscal policies were fixed and taxes on drugs removed, many countries still would not have the resources to assure that their citizens had adequate access to vital drugs.