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Now what about the existing system? | 那现存的系统呢？ | en-zh-cn |
I think it does poorly on all these three counts. | أظن أنه غير كفؤ على المعايير الثلاثة | en-ar |
First, universal access: forget about it. | Primo, l'accesso universale: scordatevelo. | en-it |
The vast majority of human beings do not have access to medicines, at least while they're still under patent. | 大部分人并没有药物的获取权， 至少在药物还在专利保护期时。 | en-zh-cn |
There are extremely high markups, and that's the problem. | Aşırı yüksek kâr oranları söz konusu ve sorun tam da burada. | en-tr |
The problem is that even though these medicines are very cheap to produce, they cost a great amount of money during the time that they're under patent, and the reason for that is that rich people can pay a lot of money. | المشكلة هي أنه على الرغم من ذلك هذه الأدوية رخيصة الإنتاج جدًا، إلا أنهم يكلفون قدرًا كبيرًا من المال خلال الوقت الذي تكون قيد براءة الاختراع، والسبب في ذلك يكمن في أن الأثرياء يمكنهم أن يدفعوا الكثير من المال. | en-ar |
Pharmaceutical companies have a temporary monopoly; they price for the rich, they forget about the poor. | Farmaceutische bedrijven hebben een tijdelijk monopolie: ze maken prijzen voor de rijken en vergeten de armen. | en-nl |
The second problem is innovation. | 第二個問題是創新。 | en-zh-tw |
Again, we don't focus on the diseases that do the most damage, and that's often put into the phrase "the 10/90 gap." | We focussen niet op de ziekten die het meest schadelijk zijn, en dat wordt vaak ‘de 10/90 kloof’ genoemd. | en-nl |
Ten percent of all the money spent on pharmaceutical research is focusing on diseases that account for ninety percent of the global burden of disease. | 10% 的全部医药研究费用 花在占全球疾病负担90% 的疾病上面。 | en-zh-cn |
And vice versa -- ninety percent of the money is spent on diseases that account for only ten percent of the global burden of disease. | Y viceversa, el 90 % del dinero gastado en enfermedades que representan solo el 10 % de la de las enfermedades mundiales. | en-es |
So there's a huge mismatch between where we spend the research money and where the greatest problems are. | Il y a dès lors un grand décalage entre l'attribution des dépenses en recherche et la réalité des problèmes. | en-fr |
Now, both these problems -- the problem with innovation and the problem with access -- have to do with this: the distribution of money in the world. | Ces deux problèmes -- l'innovation et le manque d'accès aux médicaments -- s'expliquent ainsi : la distribution de l'argent dans le monde | en-fr |
It's extremely unequal. | É extremamente desigual. | en-pt-br |
The blue area here is the top quarter of the human population. | 蓝色部分是最富有的人口。 | en-zh-cn |
They have more than ninety percent of the global household income. | Hanno più del 90% del reddito familiare del mondo. | en-it |
The bottom half of humanity, on the other hand, has not even three percent of global household income. | از طرف دیگر، نیمه دوم بشریت، حتی سه درصد درآمد خانوار را هم ندارند. | en-fa |
So if you're a pharmaceutical company and you look for profit opportunities, you look at this sort of chart and say, "Where's the money? | Così, se siete un'azienda farmaceutica e cercate opportunità di profitto, cercate un tipo di grafico che dice, "Dove sono i soldi? | en-it |
What am I going to research? | Pour quel type de recherche ? | en-fr |
Who am I going to provide with medicines?" | À qui vais-je fournir des médicaments ? | en-fr |
And again, that is in the context of there being only one way in which pharmaceutical companies make money under the present system, that is, through patent-protected markups. | 同樣的，會有那樣的狀況是因為 在當前的體制之下， 藥廠賺錢的唯一途徑， 就是利用專利保護來賺取暴利。 | en-zh-tw |
That's how they make their money, through markups. | É assim que elas lucram com as margens. | en-pt-br |
And if you make money through markups, then obviously, you will go to where the people have the most income. | 如果你通过加价去赚钱， 那么，很明显你会向 那些最富有的人群收费。 | en-zh-cn |
Now in terms of overall efficiency, the system also does very, very poorly. | In termini di efficienza generale, il sistema funziona molto, molto male. | en-it |
A lot of money goes for lobbying politicians in order to extend patent periods -- to "evergreen," as it's called. | 許多錢被花在遊說政客， 這樣才能將專利期延長—— 到所謂的「長青」。 | en-zh-tw |
Data exclusivity and so on. | 資料獨有性等等。 | en-zh-tw |
A lot of money goes for gaming, where brand-name companies pay generic companies to delay entry, for example. | Molto denaro va in strategia: I marchi famosi pagano le aziende generiche | en-it |
A lot of money goes to take our patents in all the different jurisdictions. | Veel geld gaat naar octrooiaanvragen in alle landen. | en-nl |
Money goes – even larger amounts – for litigation. | הכסף מבוזבז - בסכומים אף גדולים יותר - על משא ומתן. | en-he |
They're litigating endlessly -- brand-name company against brand-name company, brand-name company against generic company ... | 기업들은 끝도없이 소송을 진행합니다. 대기업과 대기업... 대기업과 중소기업을 상대로 서로 싸우고 있죠. | en-ko |
Enormous amounts go there. | 어마어마한 돈이 소송에 쓰입니다. | en-ko |
People say pharmaceutical companies make a lot of profit. | On dit que l'industrie pharmaceutique est très rentable. | en-fr |
Well, yes and no; they do, but a lot of it goes to these wasteful activities. | Beh, sì e no. Ne fanno, ma molto di questo viene sprecato in queste attività. | en-it |
Deadweight losses -- I won't even tell you what they are, because it's too complicated. | Welvaartsverliezen –- ik zeg niet eens wat het is, omdat het te ingewikkeld is. | en-nl |
But there's also wasteful marketing. | Maar er is ook verspilzuchtige marketing. | en-nl |
A lot of the money that pharmaceutical companies make goes into advertising campaigns, trying to win favor with doctors, trying to persuade patients to try this medicine. | Molto denaro che le aziende farmaceutiche fanno va in campagne pubblicitarie, cercando di conquistarsi i dottori, di persuadere i pazienti a provare le loro medicine. | en-it |
And these marketing battles, of course, are a pure waste, because what one company spends to get patients over to their drug, another company spends to win them back. | 이 마케팅 전략은 정말로 쓸모 없습니다. 한 회사가 환자를 끌어오려고 돈을 쓰면 다른 회사도 똑같이 반복합니다. | en-ko |
And then there is counterfeiting in the developing countries. | En dan is er de namaak in ontwikkelingslanden. | en-nl |
A lot of the drugs there, often more than fifty percent of what's sold, are counterfeit drugs, where people say, "Because the drug is so expensive, I can offer you a cheaper version." | où beaucoup de traitements, souvent plus de 50% des ventes, sont des contrefaçons, vendues sous le prétexte que les produits sont si chers alors qu’une version moins chère existe. | en-fr |
But of course it's not the real thing, it's either diluted or it's completely inert. | Mais ce n'est pas pareil, le produit est soit dilué, soit complètement inefficace. | en-fr |
So on the whole, all the money that is spent on pharmaceuticals -- and it's roughly a trillion dollars now, per annum -- much of that money is absolutely going to waste, it's not going to where it should be going, namely, to the development of new medicines and to the manufacturing of ones that we already have. | En general, todo el dinero gastado en productos farmacéuticos, y es casi USD 1 billón año ahora mismo, mucho de este dinero se desperdicia totalmente no está yendo adónde debería, es decir, al desarrollo de nuevos medicamentos y a la fabricación de los que ya tenemos. | en-es |
Now, many people think that the solution to the problem is moral pressure on pharmaceutical companies. | Pek çok insan sorunun çözümünün ilaç şirketlerine ahlaki baskı yapmaktan geçtiğini düşünüyor. | en-tr |
And, sure -- pharmaceutical companies have moral obligations, just like we do. | Por supuesto, las compañías farmacéuticas tienen obligaciones morales, como nosotros. | en-es |
When we have to make a choice, often between having a little extra money and saving a human life, we often feel that we have a duty to spend the money and save the life. | Quando temos que escolher, entre ter um pouco de dinheiro extra e salvar uma vida, muitas vezes sentimos que temos a obrigação de desembolsar dinheiro para salvar uma vida. | en-pt-br |
And why should pharmaceutical companies be any different? | 그러면 제약회사는 차별점이 있어야 할까요? | en-ko |
But really, it isn't realistic to expect pharmaceutical companies to act as well as you or maybe I might act. | Maar toch is het niet realistisch te hopen dat farmaceutische bedrijven net als jij, of misschien ik, zouden handelen. | en-nl |
And the reason is threefold. | وذلك لثلاثة أسباب. | en-ar |
One is that pharmaceutical companies are bound to their shareholders. | یک اینکه شرکتهای دارویی به سهامداران خود متعهد هستند. | en-fa |
The executive of such a company wouldn't last very long if he gave a lot of money away, or she, for good purposes, and thereby lost money for the shareholders. | 제약회사와 같은 회사의 간부는 누구든 어떤 이유에서 건 주주에게 손실을 가져오면 살아남지 못합니다. | en-ko |
They would be replaced. | تعویض خواهند شد. | en-fa |
Also, pharmaceutical companies stand in fierce competition with one another, and if you do more, if you are nicer than the other company, sooner or later, you'll be driven out of the market. | כמו כן, חברות התרופות נמצאות בתחרות עזה אחת כנגד השניה, ואם אתם יוזמים יותר, אם אתם נחמדים יותר מחברה אחרת, במוקדם או במאוחר תדחפו החוצה מן השוק. | en-he |
You will not survive. | 살아남지 못 할 겁니다. | en-ko |
The other company will gain market share. | الشركات الأخر سوف تكسب حصة السوق | en-ar |
And finally, remember -- the entire industry is dependent for its income on one thing and one thing only: markups. | Finalmente, lembre-se, toda indústria depende de sua própria receita em apenas uma coisa: margem de lucro. | en-pt-br |
And ultimately, you have to be sustainable. | Infine, dovete essere sostenibili. | en-it |
If you spend a lot of money on helping poor people and you don't get paid for it, and you lose this money; you cannot continue with your innovative activities. | Si gasta mucho dinero en ayudar a personas pobres y nadie paga por ello; y pierde este dinero; no podrá continuar con tus actividades innovadoras. | en-es |
So for these reasons, it's just unrealistic to expect that pharmaceutical companies will solve the problem on moral grounds. | Bu nedenlerden dolayı ilaç şirketlerinin sorunu ahlaki temelde çözmesini beklemek düpedüz hayalcilik. | en-tr |
Who, then, should solve the problem? | پس چه کسی باید مشکل را حل کند؟ | en-fa |
I suggest it has to be us. | אני מציע שאלה יהיו אנחנו. | en-he |
We, citizens and politicians, have to do better in terms of regulating the pharmaceutical industry, focusing them, giving them the right incentives, focusing them on the problems that really matter. | 시민과 정치인들 모두 제약산업에 합리적인 제도를 제공하고 현실적인 문제에 초점을 맞추어, 규제를 좋은 방향으로 이끌어야 합니다. | en-ko |
The potential gains here are enormous. | I potenziali guadagni sono enormi. | en-it |
About one third of all deaths each day, each year, are due to the diseases of poverty in the developing world. | 每年每天，開發中國家死亡的人當中 有三分之一死於窮人的疾病。 | en-zh-tw |
Fifty thousand people every day die prematurely from these diseases. | Ogni giorno 50 000 persone muoiono prematuramente a causa di queste malattie. | en-it |
And that's not even counting all the diseases that we know only too well in the rich countries: cancer, heart disease and so on. | E questo senza contare quelle malattie che conosciamo molto bene nei paesi sviluppati: come il cancro e le malattie cardiache. | en-it |
Again, poor people die often much earlier, because they don't have good medical care, including good medicines. | از قضا، افراد فقیر اغلب خیلی زودتر میمیرند، چون مراقبت بهداشتی مناسب از جمله داروهای خوب ندارند. | en-fa |
And even in rich countries, many patients are not getting the best medicine. | 甚至在富裕的国家，很多病人 也没能得到最好的药物。 | en-zh-cn |
That's sometimes due to the fact that insurance companies won't cover it, because the price is so absolutely ridiculous. | Isso se deve ao fato das companhias de seguros não cobri-los, porque o preço é absolutamente ridículo. | en-pt-br |
And it's also due, sometimes, to the fact that doctors and patients are falsely influenced by advertising campaigns of pharmaceutical companies. | Y también es debido, a veces, al hecho de que los médicos y pacientes son falsamente influenciados por campañas publicitarias o compañías farmacéuticas. | en-es |
So what can we do? How can we change the system? | Alors que pouvons-nous faire ? Comment changer le système ? | en-fr |
I want to show you a way in which we can better incentivize pharmaceutical innovation and the provision [of] medicines to poor people and rich alike. | میخواهم راهی را نشانتان دهم که بهتر میتوانیم انگیزه بدهیم به نوآوریهای دارویی و تهیه داروها برای مردم فقیر و همچنین ثروتمندان. | en-fa |
And that is the Health Impact Fund. | 这就是健康影响基金。 | en-zh-cn |
The Health Impact Fund is basically opening up the second track with which pharmaceutical innovators can be rewarded for their activities. | 健康影响基金开通了第二条通道， 使得制药创新者的活动 可以得到奖励。 | en-zh-cn |
They have a choice. | Tienen una opción. | en-es |
They can either go with the old system, with patent-protected markups, or they can go with the new system, being rewarded on the basis of the health impact of the medicines that they develop. | Podem continuar com o sistema antigo com patentes protegidas por margens de lucro ou podem seguir com o novo sistema, sendo recompensados de acordo com o impacto na saúde dos medicamentos que desenvolvemos. | en-pt-br |
And with each particular medicine, they have their choice. | הברירה קיימת במקרה של כל תרופה. | en-he |
So they can be partly on one track, partly on the other, with different products. | כך, הן יכולות לתפקד חלקית במסלול האחד וחלקית במסלול השני, במוצרים שונים. | en-he |
Now, how would the Health Impact Fund work? | Alors comment fonctionnerait le « Health Impact Fund » ? | en-fr |
There would be a fixed reward pool every year. | Her yıl sabit bir ödül havuzu olacak. | en-tr |
We start with maybe six billion dollars, but that can eventually be revved up. | 最开始可能是 6 亿美元， 但最后可以是加速的。 | en-zh-cn |
Remember that the total money that the world spends on pharmaceuticals is a trillion. | Unutmayın, dünyada ilaç sektörüne harcanan toplam meblağ 1 trilyon dolar. | en-tr |
So it's a thousand billion; six billion is a drop in the bucket. | Son mil millones; seis mil millones son una gota en el mar. | en-es |
It's relatively small, but it would work with six billion, and we'd get a lot of bang for the buck if we introduced the Health Impact Fund with just six billion dollars. | إنها صغيرة نسبيًا، لكنها ستعمل مع ستة مليارات، وكنا سنحصل على الكثير من الفائدة إذا قدمنا صندوق التأثير الصحي مع ستة مليارات دولار فقط. | en-ar |
If you have a product and you want to register it with the Health Impact Fund, you will be rewarded for a period of 10 years. | Si vous avez un produit que vous voulez inscrire au « Health Impact Fund », vous obtiendrez une rétribution pour une période de 10 ans. | en-fr |
During these 10 years, you get a share of these annual reward pools. | Bu 10 yıl boyunca, yıllık ödül havuzundan pay alacaksınız. | en-tr |
That share would be proportional to your share of the health impact achieved by all these registered products. | 分到的比例就看你所達成的健康影響 在所有登記產品所達成的 影響中佔多少百分比。 | en-zh-tw |
So if your product accounts for eight percent of the health impact of all the registered products, you get eight percent of the reward money that year. | Se seus produtos estão estimados em 8% do impacto na saúde de todos os produtos registrados, você recebe 8% de recompensa naquele ano. | en-pt-br |
That repeats for 10 years, and at the end of the 10 years, your product goes generic, so you basically lose any further income from it. | 這個流程會重覆十年， 十年結束時，你的產品 就成為非專利藥， 基本上，你就會失去 所有它後續帶來的收入。 | en-zh-tw |
Each year, the health impact from your product would be evaluated, and you would be paid on that basis. | Cada año, el impacto en salud de su producto sería evaluado, y se pagaría en base a ello. | en-es |
Now, if you take that reward from the Health Impact Fund, you can't claim the other reward, you can't mark up the price. | Caso você receba essa recompensa do Health Impact Fund você não terá outra recompensa, não poderá elevar o preço. | en-pt-br |
You have to sell at cost. | Vous devez vendre à prix coûtant. | en-fr |
Well, it doesn't mean that the pharmaceutical company tells us what their cost is; but rather, our preferred way of determining what the real cost is of making a medicine, of manufacturing it, is to ask the registrant to put the production of the medicine out for tender, let generic companies compete for the production... | Ce ne sont plus les entreprises pharmaceutiques qui dictent leurs coûts ; nous préférons en fait déterminer le coût réel de la fabrication d'un médicament en demandant au dépositaire d'en soumettre sa production à un appel d'offres ouvert à la concurrence des fabricants de génériques, ainsi les innovateurs achèteraien... | en-fr |
So the innovator would make no money at all on selling the product, but would make all its money from the health impact rewards. | پس، نوآور از فروش محصول هیچ سودی نخواهد داشت اما میتواند تمام پول را از پاداشهای اثرگذاری سلامت دریافت کند. | en-fa |
Now, how do we assess the impact of the introduction of a medicine? | 那麼，我們要如何評估 一項藥物推出之後的影響？ | en-zh-tw |
Well, we assess it relative to the preceding state of the art. | Lo evaluamos en relación a su innovación. | en-es |
So some people, before the medicine came along, had no treatment at all. | 所以，在这个药物出来前， 有些病无药可医。 | en-zh-cn |
Now for the first time, they have treatment, because it's cheap; people can afford it. | 如今，他们第一次有了 治疗方法，因为它很便宜； 人们负担得起。 | en-zh-cn |
So here, the impact is the difference between being treated and not being treated. | 所以在这里，影响是得到治疗 和没法得到治疗的差别。 | en-zh-cn |
In other cases, the new product is better than the old products, and so a person gets switched over to a better product, and we pay for the impact, for the difference the new product makes. | Dans d'autres cas, le nouveau produit est meilleur que l'ancien, donc une personne peut changer pour le meilleur produit et nous payons pour cet impact, la différence apportée par le nouveau produit. | en-fr |
If you have a product on the Health Impact Fund and you simply switch somebody from an existing product to another product, to your product, and it's no better, you get no money. | إذا كان لديك منتج في صندوق التأثير الصحي وأنت ببساطة تبدل شخصًا ما من منتج موجود إلى منتج آخر، إلى منتجك، والوضع لم يتحسن، لا تحصل على المال. | en-ar |
That's in stark contrast to the existing system, where you get a lot of money for switching somebody from one product to an equal product that is your product. | Cela est en fort contraste avec le système actuel, qui rémunère largement la substitution d'un produit par un autre équivalent, le vôtre. | en-fr |
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