Dr. Kieran Harkin:

It is achievable and we are already seeing it in the area of antimicrobial resistance. This area does not have much commercial attractiveness for drug companies because if a company develops a new antibiotic, it must use it sparingly and be very selective regarding where it is used. The last thing a company wants is sales representatives knocking on every GP's surgery door advising them what to use and for what. Once a company develops the drug, it must hold it close to its chest so nobody is interested in it. I do not think any new antibiotics have been developed in the past 15 years, although I may be corrected. Many drug companies have simply declared that they are not even researching new antibiotics, so this is an area that is open. The WHO and the UN have an intergovernmental forum looking at how to develop new antibiotics and, when they are developed, how to distribute them. Clearly, there is no conflict because there is no conflict of interest between the interests of pharmaceutical companies and public health.

Pharmaceutical companies' responsibility is to their shareholders. They do not have a remit when it comes to public health. Any CEO who goes out of his or her way to jeopardise profit in the service of public health will be fired fairly soon. Obviously, to be effective as companies, companies need to be seen to have products that are useful and contribute to public health, but companies' remit is not public health. Their remit is making money. I am sure all of us around the table know that this is the case. This ties into the fact that when companies set the price of a drug, the price bears no relationship to how much it costs to bring it to market. Even if we did know how much it cost to bring a drug to market, companies would still say that they are going to charge €100,000, €200,000 or €300,000. It is like playing poker. It is a case of thinking someone has money or that someone is desperate enough and will pay. That is how price is determined at the moment. As long as we have a model that allows the manufacturer of a drug to charge what it likes, we will pay more than we can afford. By definition, we will be squeezed as much as we can bear.