At the end of September, the Indonesian parliament passed a controversial new patent law that could drastically affect access to life-saving medicines. Health justice activists warn that the law, by relaxing patent requisites, will ultimately drive up healthcare costs.
“The changes to Article 4F are particularly concerning,” said Budi Larasati of the Indonesia AIDS Coalition to People’s Health Dispatch. The original article aimed to prevent pharmaceutical companies from re-patenting existing drugs without improving their efficacy—a common tactic known as patent evergreening. She explains that such safeguards can help block secondary patents on medications that do not offer new therapeutic benefits, protecting the health system from excessive drug prices.
Lutfiyah Hanim, from Indonesia for Global Justice, also voiced concerns about the weakening of this article: among other things, the original version allowed the public to oppose patents that didn’t serve the public interest, providing a check against corporate exploitation. The amendment removes this possibility, making it harder to contest unfair patents.
The consequences of reducing protections against patents are apparent from past cases. Hanim cites the case of Gleevec (imatinib), a drug used to treat leukemia. She points out that before the patent expired in 2019, Indonesia’s national health insurance program paid approximately USD 74 per tablet—a prohibitive cost. Once the patent expired and generic versions became available, the same tablet could be bought for as little as USD 2 per tablet.
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This gap in costs is not just an economic issue but also a question of public health, particularly in relation to Indonesia’s HIV/AIDS programs. Newer antiretroviral drugs, like lenacapavir and cabotegravir, have proven effective but come with sky-high price tags. At USD 40,000 for two doses of lenacapavir per year, the drug is far out of reach for the average Indonesian patient, whose yearly income averages around USD 2,300. Not even the government can afford to procure enough doses to ensure wide coverage through its subsidized HIV/AIDS program.
“That’s why we advocate for generics,” said Larasati. “Because we believe that if the price is more affordable, then the national HIV program will be able to afford it, and it will be available for regular Indonesian people.”
Part of the reasoning behind the new law seems to have been that easing patent restrictions will foster local innovation by making the patenting process more accessible. However, Hanim quickly points out that this is a wrong assumption. The beneficiaries of the new patent landscape are likely to be large producers with the capacity to produce at an industrial scale—not local inventors. In other words, the same pharmaceutical corporations that are already known for setting high prices on potentially life-changing medicines.
In fact, the law seems to push Indonesia closer to TRIPS+ provisions, which prioritize intellectual property over public health needs. “Why are we pushing ourselves to high-income countries’ standards when we don’t have to?” questions Larasati.
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Adding to the concerns, the new law was passed in a cloud of secrecy. Health justice organizations were completely excluded from the discussions. Even the Ministry of Health, whose work will be significantly affected by the changes, told civil society organizations that it was not fully involved in the discussion. According to Larasati and Hanim, only industry representatives and select academics were allowed to participate, leaving the public in the dark about the potential outcomes.
“This patent law was passed alongside several other bills just one day before a new parliamentary session began,” Hanim pointed out. The timing and lack of transparency raise serious questions about what will follow.
Although the final text of the new patent law has not been made publicly available yet, activists are preparing to oppose negative consequences when they arise. They argue that by introducing the changes, Indonesia risks exacerbating inequality in access to healthcare. Both Larasati and Hanim emphasized that their organizations will continue to advocate for mechanisms that improve access to medicines for everyone in Indonesia in the light of the new patent law.
People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and subscription to People’s Health Dispatch, click here.
