João L. Carapinha, Brook K. Baker

The spice trade of antiquity and contemporary medicine trade appear to share much in common.

For centuries, Greeks and Romans traded spice with Asia using trade routes over land and sea to India and China. They were the Indian-Roman routes and Incense routes with paths crossing the Red Sea and Asia Minor – the same routes that Marco Polo used and later detailed in his book The Travels of Marco Polo. When the Ottomans defeated the Byzantine Empire in 1453, all spice trade between Asia and Europe ceased because Europeans refused to pay exorbitant taxes on goods traveling west through the Ottoman Empire. Europeans were left with no option but to explore alternative trade routes to the east. In 1497, Vasco da Gama, the great Portuguese explorer and navigator, pioneered a Portuguese trade route that connected Lisbon to India around the tip of South Africa, and thus started the Age of Discovery. Much of his work was built on the efforts of Bartholomeu Dias, another Portuguese navigator, who nine years prior rounded the Cape of Good Hope, currently Cape Town.

In 2008 and 2009, customs officials in the Netherlands, Germany, and France seized nearly 20 shipments of unpatented generic medicines lawfully produced in India that were being transshipped through Europe on their way to Africa, Latin America, and other destinations where they could be lawfully imported and consumed without violating any domestic patent rights.  What was the problem according to complaining Big Pharma companies and border officials – transshipment violated fictional patent rules that provided that the medicines should be treated as if they had been manufactured in Europe.  In one instance there was confusion about an alleged trademark infringement for a medicine that merely was labeled with the international non-proprietary name.  Indian, Brazil and access-to-medicines activists complained bitterly and Brazil and India brought separate complaints at the World Trade Organization challenging the seizures and the law (EU Border Measures Regulation 1383/2003) upon which they were based.  The European Court of Justice has since clarified that goods shouldn’t be seized unless they are intended for the European market and the EU is discussing a proposed amendment to its border regulations to the same effect.  However, the current debate overlooks a much bigger question that history can help answer. India, why do you continue to rely on European trade routes for medicine exportation to low- and middle-income (LMI) countries?

It seems odd from a geographical perspective that medicines bound for Sub-Saharan Africa, for example, should transit through Europe. If alternative, efficient trade routes were established and expanded, will it negate the need for much of the debate on EU odious border regulation?  Alleged patent and trademark infringements may become superfluous when medicines are not routed through Europe. Like Europe after 1453 that refused to pay high taxes on goods resulting in Portuguese-led alternative trade routes, perhaps India should do the same. Follow the preliminary lead of some India producers who have already changed their routes, cut all medicine trade through Europe and look to new trade routes that connect generic medicine producers in India directly to the poor in Sub-Saharan Africa. There are many risks and the costs of doing so are probably high, but so was the Age of Discovery – a treacherous and time-consuming path to India around Africa compared to those through the Ottoman Empire. It brought Europe out of the Middle Ages and it may open a new age for India’s development and South-South trade more broadly. Medicine prices may increase in the short-term but it is a price worth paying to secure favorable trade routes in the long-term. Better direct trade-route partnerships between India and LMI countries are needed. Infrastructure improvement at ports (air and sea), tax exemption on all medicine trade between partner countries, and an independent agency to certify medicine authenticity and to expedite product registration may be among the tools used to optimize direct and improved trade in medicines.

Ancient spice trade and current medicine trade share much in common. History has taught us that if trade routes become unfavorable because of geopolitical changes, then it may be time to look to alternatives. It has also taught us that the risks are high but the benefits overshadow these when assessed retrospectively. India, why do you continue to rely on European trade routes for medicine exportation to low and middle-income (LMI) countries? Do what the Europeans did after 1453; you will not regret it in the long-term.