Sophie Bloemen and David Hammerstein
Commons Network (CC-BY-SA)
Full Paper | Press Release
Introduction: From the 15th-20th century tens of thousands of powerful individuals, aided by state institutions, enclosed and privatized commonly-held land managed by local communities around the world. This process displaced hundreds of millions of small-scale farmers who, to a great degree, lost their autonomous means of sustenance and were forcibly cast into urban labour markets. This enclosure of life-supporting common land was a vast revolution of the rich against the poor.[1]
In the late 20th century and early 21st century a similar enclosure movement has taken place, aided by international intellectual property laws and treaties, regulatory capture and international trade agreements. This time, the action has transformed the public good of scientific medical knowledge and related health-related technologies into highly protected, privatized and expensive products. Although our current biomedical system has produced important lifesaving and quality-of-life treatments, today billions of people around the world are unable to afford and access these medicines, resulting in over 10 million preventable deaths each year.[2] These outcomes are perpetuated by an unacceptable policy paradigm for biomedical research.
At the same time, across a range of sectors, from wikipedia to renewable energy cooperatives, from open access academic publishing to urban agriculture, from local land trusts to self-managed cultural hubs, from car-pooling to patent pooling, we see people responding with new cooperative attitudes and social structures that promote the common social-environmental good. This means regenerating value for the community rather than enclosing the commons for individual profit and replenishing knowledge and resources rather than extracting utility for competitive advantage.
This paper reviews the main debates around how biomedical innovation is managed in the context of European Union (EU) policy. We build on previous work by Commons Network authors in 2017[I] and 2012[II] which explored EU policy opportunities and suggested a new structural environment promoting the knowledge commons for public benefit.
In 2018, we go further, showing how a commons approach in biomedical research & development (R&D) can help pull us out of the current crisis of over-diagnosis, over-prescription, low innovation, secrecy and sky-rocketing costs for both patients and health systems. While not exhaustive in our analysis of the many factors affecting biomedical innovation and public health, we propose entry points in the form of policies with the power to transition society away from the current proprietary, centralised and extractive model. In a second step, we put forward a vision for future initiatives in line with commons principles, where the EU should be investing for long-term benefit.
Instead of proposing small tweaks the commons vision challenges the idea of handling medicines principally as a commodity or product, and proposes structural changes in order to approach health as a common good, managed in a democratic, public and equitable manner. There is a growing social willingness to address today’s encroachment on the right to health in the biomedical sector, but where would we begin transforming a complex system which today has increasingly been commercialized and commodified? How can we turn the tables and start to ‘commonify’ what the majority of EU citizens have always considered a common good?
EU institutions should ally themselves with citizens calling for meaningful change so that we can together address taboos around intellectual property and health-care commodification. We must question the root causes, not just the symptoms, of today’s biomedical innovation model.
By looking at problems through the lens of the commons, EU institutions can ensure the stewardship of health by ushering in a more democratic, affordable and sustainable biomedical system.
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FOOTNOTES
1.Vandana Shiva, The Enclosure and Recovery of the Commons, (Research Foundation for Science, Technology, and Ecology,1997).
2.UN Special Report on The Right to Health, submitted in accordance with Human Rights Council resolution 6/29 on August 11, 2008.
*I. The EU and the Commons: A Commons Approach to European Knowledge Policy, 2015 (Commons Network).
*II. Time for the EU to lead on Innovation: EU Policy opportunities in biomedical innovation and the promotion of public knowledge goods, 2012 (HAI, TACD)
