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Science

There is an easy way to make medicine instantly cheaper

Exempting drugs from VAT is a great tool to give patients a break.

COVID-19 has heightened public awareness on the question of drug prices. After vaccine prices had been leaked to the public by Belgian minister Eva de Bleeker, questions arose on the costs associated with creating vaccines. This is essentially a similar debate when it comes to the prices of all drugs.

The question of how to reduce the cost of drugs has led some to make interventionist suggestions. Many blame the greed of the pharmaceutical industry for drug prices, when in reality the truth is much more complicated. To some, the question is about intellectual property rights. Doctors Without Borders (MSF) is running a campaign on access to medicines that distorts the realities of the drug market, while calling for solutions that would undermine scientific innovation. The “Access to Essential Medicines Campaign” seeks to increase the availability of medicines in developing countries by tackling the issue of price and intellectual property rights. In the eyes of MSF, producers and researchers are getting rich on the backs of those who can least afford it.

In reality, drug prices are a result of many considerations: the development costs, the amount of patients able to receive it, intellectual property rights (though not in the sense that MSF would have you believe), and… taxes!

Informed patients will know that all but one European country charge VAT on over-the-counter (OTC) medicine and prescription medicine. Germany charges as much as 19% VAT on both types of medicines, while Denmark ranks the highest, with rates at 25% – that is a fifth of the total price for a drug! There is only one country that does not charge VAT on prescription or over-the-counter drugs: Malta. Luxembourg (3% each) and Spain (4% each) also show that modest VAT rates on drugs are not a crazy idea but something millions of Europeans already benefit from. Sweden and the UK both charge 0% VAT on prescription medicine, yet 25% and 20% respectively on OTC.

One of the significant roadblocks towards more patient access to drugs is the unfair tax policies of some EU member states. Before talking about eroding intellectual property rights and price setting across the block, we should discuss whether we should have a VAT on medicines.

Especially on prescription medicine, where cancer drugs can reach substantial price levels, VAT rates of up to 25% significantly burden patients and their health insurance. 

On prescription medicine, there is little sense in first charging value-added tax, and then have national health insurance providers pick up the tab. As for OTC medicine, the implication that just because it isn’t prescribed, it, therefore, isn’t an essential good, is a blindspot of policy-makers. Many OTC meds, ranging from drug headache pain relief, heartburn medicine, lip treatments, respiratory remedies, or dermatological creams are not only essential medicines for millions of Europeans; they often act as preventative care. The more we tax these goods, the more we are burdening MDs with non-essential visits.

Zero VAT on medicines is a question of fairness. Everyone is burdened with the costs of the COVID-19 lockdowns. While we have become one-sided in our analysis of which medical problems are important, we need to understand that other medical treatments are needed as we speak, and that they represent a burden on all patients.

It is time for European nations to agree on a binding Zero VAT agreement on medicine or at least a cap at 5%, which would reduce drug prices in the double digits, increase accessibility, and create a fairer Europe.

Originally published here.

Will the GMO vaccine change our views on genetic engineering?

New vaccines use genetic engineering, but the European Union has generally remained opposed to this technology…

The most prominent version of a COVID-19 vaccine was developed through genetic engineering. The is a novelty in vaccine science, because it allows for easier processes in the way we fight diseases such as COVID-19. As Cornell’s Alliance for Science explains:

“That’s what the “m” in mRNA stands for : messenger. Messenger RNA just carries instructions for the assembly of proteins from the DNA template to the ribosomes. (Proteins do almost everything that matters in the body.) That’s it.

This is useful for vaccines because scientists can easily reconstruct specific genetic sequences that encode for proteins that are unique to the invading virus. In the COVID case, this is the familiar spike protein that enables the coronavirus to enter human cells.”

For the European Union, this meant that the European Parliament had to approve a derogation of existing GMO legislation. In a statement, the Parliament said that “The derogation will facilitate the development, authorisation and consequently availability of COVID-19 vaccines and treatments”. According to EU legislation dating back to the early 2000s, genetic engineering is generally forbidden, with only a few exceptions. This was particularly driven by the scepticism of genetic engineering in agriculture.

Now that Europe is facing the largest health emergency in our lifetime, scientific innovation is desperately needed. This must be particularly confusing for all patients who could have been given more of a chance of survival if genetic engineering was allowed across the board for all treatments. The unfortunate reality is that GMOs have been so highly politicised that we have moved away from a sober evidence-based conversation. It is now politically viable to allow for scientific innovation to fight this virus but in the area of agriculture, we are still facing a dead end. If it is safe for vaccines, then shouldn’t we also trust the mountain of scientific evidence that it is safe in food?

Genetic engineering is technology, unlike any other. The precise genetic modification of crops has arisen not out of a need to interfere with nature, but out of necessity and thanks to human ingenuity. Early application of genetic engineering stood to solve the problems of complicated environments with challenging climates. As climate change progresses, these challenges will only grow larger.

Picture the state of human medicine prior to the development of certain advances. Ear or mouth infections or pneumonia led to the death of millions until penicillin came into widespread use. What is true in medicine, also applies for modern agriculture: high-yield farming has made our societies more advanced, provided us with a safer food supply, and has provided more food for fewer resources. The technologies of today are incomparable with those of 30 years ago. In fact, the invention of gene-editing has opened a new chapter for agriculture, allowing us to act precisely, with trusted experts. Pinpointed DNA-changes allow us to much more precisely target and understand the changes that we are making.

The GMO vaccine derogation is a first recognition that pinpointed DNA changes are safe and viable in human medicine. However, this was a realisation the Parliament was only able to reach because it was faced with unprecedented urgency. The concept of making this structural reform in the 2001 GMO Directive — which are necessary — is something that needs to be overcome politically. The scientific opinions are there: we know that genetic engineering can be conducted in a safe manner. What we now need to do is shift the conversation on the European stage, overcoming the unscientific narratives of many parliamentarians, and ushering in a new age of science in the European Union.

Originally published here.

Europe’s opposition to gene editing, pesticides means higher food prices for world’s poorest people

featured image blog

By 2070 the world will be populated by approximately 10.5 billion people. This means that we will need to be able to feed 3 billion additional humans every year. Fortunately, technological advances in agriculture and technology have helped us provide food for an extra 5.5 billion people in the last century compared to the 2 billion humans that populated the earth in 1920. According to the World Food Summit, since 1992, the number of hungry people in lower-middle-income countries has fallen by over 200 million, from 991 million to 790.7 million.

Stanford University estimated that if we would still use the farming technology of 1960, we would need additional farm land of Russia’s size, the world’s largest country, to earn the same yields as current technology. This is a huge success but also leaves us to the task of improving the situation of the remaining children and adults facing hunger as a daily challenge.

Unfortunately, the current political narrative in one of the world’s wealthiest regions seems to ignore the challenges ahead of us and wants us to turn to less efficient farming. The European Union’s Farm to Fork (F2F) strategy sets out to create a more sustainable food system by the end of this decade. However, looking at the currently proposed ideas, it is worrisome that this new policy framework will achieve the opposite of sustainable farming and lead not just Europe but the entire world in a potential food crisis with massive geopolitical ramifications.

The EU plans to increase the share of organic farming as a total of agricultural production from currently 7.5% to 25%. Additionally, they plan a reduction of 50% in pesticides. At the same time, the F2F strategy does not embrace new technologies that allow farmers to achieve the same yields they are able to produce using the current level of pesticides.

For several reasons, including its low yields and the consequent need to bring more land into agricultural production, organic farming is particularly detrimental to meeting the world’s food demand.

What does this mean for feeding 10.5 billion people in 2070?

world population

More organic farming in Europe means lower yields of EU food production and higher prices for consumers. The shortage in Europe will be likely compensated by additional food imports from other parts of the world. This will lead to a global increase in food prices. For affluent regions of the world such as Europe, this will be rather a nuisance for consumers. This will have very negative consequences for people already living at the edge of existence and facing hunger.

The Food and Agriculture Organization of the United Nations (FAO) estimated that farmers globally would lose 30%-40% of their crops due to pests and diseases if they don’t have crop protection tools such as insecticides or herbicides on hand. Up to 28% of all liver cancers worldwide can be attributed to aflatoxins, a mycotoxin type. Without allowing farmers to apply fungicides that reduce human exposure to these toxins, we keep risking millions of lives.

food production

In the last 100 years, pesticides have been proven to be a necessary evil in achieving higher and more predictable crop yields. In the past 60 years, we have seen a reduction of 40% in pesticide use per acre, and many less safe substances have been phased out. The emergence of genetically modified crops and the latest breakthroughs in gene editing allows a further reduction of spraying chemicals on the fields.

About 20% of the world population lives in South Asia. Due to India’s caste system farmers of the lowest castes live and farm on land that is more likely to experience regular floodings, with detrimental results for their rice harvest. Gene-edited crops allow the rice to submerge underwater for up to two weeks and still provide high yields. Such technologies are a clear game-changer for the poor and hungry and should be embraced. There’s no humanitarian case against them but a strong one for them.

gene editing game changer

Unfortunately, many critics of pesticides also oppose the use of gene editing. This leads to a dilemma that ultimately brings us to less food produced while global food demand will keep growing. One does not need to be an economist to understand that this will result in higher food prices.

We all have seen the dramatic refugee crisis in 2015 including all the terrible suffering and drowning of children and women in the Mediterranean. While the EU’s policies did not trigger this crisis, our future agricultural policies might cause widespread famines in parts of Africa and Asia. They might start a migration wave we haven’t seen since the migration period in the 5th and 6th centuries. History unfortunately shows that such massive uncontrolled migration streams usually also come with war and unrest.

The ‘western’ idea of making farming more organic will lead to a global food price inflation and hurt those that already struggle. We indeed all share one planet and therefore need to have sensible food policies that acknowledge hunger still being a problem 10% of the world population faces daily. No one, no matter if one is a proponent of mass migration or not, should desire a massive influx of starving people. Several adjustments to the EU’s future policies are needed in order to mitigate many negative drivers of poverty and hunger.

The EU’s Farm to Fork strategy needs to take this into account and not jeopardize our ability to feed an ever-growing population.

Fred Roeder is a consumer advocate and health economist from Germany and has worked in healthcare reform in North America, Europe, and several former Soviet Republics. Since 2012 he has served as an associated researcher at the Montreal Economic Institute. Fred can be found on Twitter @FredCyrusRoeder

Originally published here.

Our “sustainable” food policy leaves us with unsustainable trade

The ambitious targets of the F2F strategy will cause headaches for the EU’s trade policy.

The European Commission has laid out an ambitious plan with the Farm to Fork strategy, which is set to flip agriculture in Europe upside down. For the EU, agriculture is to blame for much of the lack of sustainability in Europe, forcing farmers to pick up much of the burden of the fight against climate change. To do so, it sets out two flagship targets: 25% organic farming by 2030, and a reduction of pesticides by 50% in the same timeframe.

Some experts have pointed out the adverse effects of bringing organic food production up, since a) organic food also needs pesticides, and b) it emits more carbon dioxide emissions than conventional agriculture. The same goes for pesticides: the amount of pesticides used today is incomparable to the level of substances used in the 1960s. Existing chemical substances are declared safe by EU agencies, and countless regulators in the member states. However, those facts are stories in themselves. What is often forgotten in the debate is the import of “unsustainable” food.

On the one hand, Europe’s increasing food standards worsen the effect of illicit trade. Take the example of fraudulent organic food imports. In its 2019 report titled “The control system for organic products has improved, but some challenges remain“, the European Court of Auditors found structural problems with the control system of organic food trade, despite controls being implemented in 1991.

 In a section on the communication on non-compliance, the ECA writes:

“In Bulgaria, we found that some control bodies notified the competent authority about certain types of non-compliances only through their annual reporting. The competent authority did not notice this during its supervisory activities. In Czechia, we found that on average control bodies took 33 days in 2016 and 55 days in 2017 to report a non-compliance affecting the organic status of a product to the competent authority.” 

The report also notes that non-compliance communication delays are 38 calendar days on average in the European Union, while existing regulations stipulate that reporting should happen without delay. This means that non-compliant organic products, i.e. fraudulent organic trade, continue a month on average in the legal circulation of the European single market, before being flagged to consumers. 

If the European Union and its member states are serious about quality control and consumer information and protection, they need detection and reporting mechanisms that outperform the supply chain. The ECA also notes that member states were delayed in their reporting to the European Commission by an average of 4 months and that 50% of all analysed reports were missing information. China is the largest exporter of organic food to the European Union (based on weight, 2018 figures, from ECA report, see below). With significant difficulties concerning quality control of a large range of products originating from China, it should be clear that EU institutions must prioritise the authenticity of these food imports.

Further than that, legal imports will also eventually fall under the category of unsustainable under the rules and regulations of the European Union. This is already leading to a considerable problem with the adoption of the Mercosur-EU free trade agreement, and has in the past prevented agreements like TTIP. Europe will face a difficult choice: double down on the planned standards, and thereby risking to raise protectionist barriers, or even create food insecurity, or rather re-evaluate the necessity for certain environmental goals. 

Some voices want the first option, and prevent unsustainable imports through carbon border taxes, which are import tariffs. They forget to ask themselves, if production in Europe has slowed, will prevention imports really be the solution that manages to keep farming in Europe afloat?

The targets set in the Farm to Fork strategy are set to have dire impacts. According to an impact assessment conducted by USDA, the strategy would lead to a decline in agricultural production between 7-12%. Meanwhile, the EU’s decline in GDP would represent 76% of the decline in the worldwide GDP. Adding to that, the situation of food security and food commodity prices deteriorates significantly under a worldwide adoption scenario, as USDA researchers have found.

Europe should not get ahead of itself and worsen the standards of living for consumers and farmers alike. The Farm to Fork strategy either needs a serious rethink or a long-term moratorium.

Originally published here.

European Green Deal wird für Verbraucher teuer werden

Eine Folgenabschätzung der Europäischen Kommission legt die Kosten des “European Green Deal” dar – für Verbraucher wird es wohl teuer werden. Von Gastautor Fred Röder.

Der European Green Deal (EGD) ist einer der Eckpfeiler der Von der Leyen-Kommission in Brüssel. Es ist in den letzten Jahren klar geworden, dass es größeren Wählerdruck gibt um eine grünere Politik zu betreiben. Auf EU-Ebene hat dies zu hitzigen Debatten beim Thema Freihandel, Landwirtschaftsreformen und Emissionshandel geführt.

Der EGD ist ehrgeizig – er strebt an, bis 2050 null Nettoemissionen zu erreichen, wobei “Wirtschaftswachstum von der Ressourcennutzung abgekoppelt” werden soll. Dies soll durch Strukturreformen im Bereich der Landwirtschaft, die Entkarbonisierung des Energiesektors und die Einführung neuer Besteuerungssysteme zur Vermeidung nicht-nachhaltiger Importe nach Europa erreicht werden. Eine entscheidende Frage wird jedoch ausgeklammert:: zu welchen Kosten? Die zusätzlichen Ausgaben für die Europäische Union werden sich auf satte 260 Milliarden Euro pro Jahr (zwischen 2020 und 2030) belaufen. Es wird allerdings nicht nur der EU-Haushalt belastet, sondern direkten Kosten für Verbraucher werden ebenfalls steigen.

Ende September hat die Europäische Kommission eine Folgenabschätzungsstudie veröffentlicht. deren Ergebnisse sowohl von der Kommission als auch in der breiteren Medienlandschaft weitgehend ignoriert wurden. Das ist jedoch überraschend, denn in fast allen Modellen kommt es zu einem Rückgang des europäischen Bruttoinlandsprodukts. Die teilweise gravierenden Einbrüche werden vor allem durch Rückgänge bei Beschäftigung, Konsum und Exporten verursacht. Besonders verheerend wird der wirtschaftliche Schaden für die Mitgliedstaaten sein, die stark von Exportindustrien abhängig sind und für viele Menschen mit begrenzten Wiederbeschäftigungsmöglichkeiten in diesen Ländern. Deshalb wird insbesondere Deutschland die Folgen dieser Politik zu spüren bekommen Als Exportnation wird es Deutschland härter treffen als weniger von Industrie abhängige Länder..

Bereits bestehenden soziale Ungleichheiten werden durch steigenden Energiepreise für Verbraucher noch extremer werden. Wie die Energiewende in Deutschland bereits zeigte, hat ein überstürzter Umstieg  erneuerbaren Energiequellen, der über Subventionsprogramme und nicht Verbrauchernachfrage erfolgte, die Energiepreise für die Verbraucher stark erhöht. In der Folgenabschätzung der Kommission wird dies anerkannt, allerdings in einer Formulierung die von wenig Mitgefühl für die betroffenen Bürger zeugt: “Ein Nachteil aus sozialer Sicht sind die höheren Energiepreise für die Verbraucher”. Es als “Nachteil” zu bezeichnen, wird den immensen Kosten für einkommensschwache Verbraucher nicht gerecht.

In der Debatte um den European Green Deal wird häufig davon gesprochen, dass umweltpolitische Veränderungen die Schaffung von Arbeitsplätzen und Wohlstand ermöglichen. EGD-Superkommissar Frans Timmermans spricht gerne von “grünen Arbeitsplätzen” und bezieht sich dabei auf die Möglichkeiten, die durch die Pläne der Kommission geschaffen werden. Anstatt dass ihn die COVID-19-Krise einen sanften Ton anschlagen lässt, meint Timmermans, dass “unsere Antwort auf die Covid-19-Krise es uns ermöglicht, Arbeitsplätze nicht für Jahre, sondern für Jahrzehnte zu retten und neue Arbeitsplätze zu schaffen. Wir werden vielleicht nie wieder so viel ausgeben können, um unsere Wirtschaft wieder anzukurbeln – und ich hoffe, dass wir das nie wieder tun müssen”. Wird er es sich jetzt noch einmal überlegen, nachdem die Folgenabschätzung seiner eigenen Kommission drei Wochen nach seiner Rede ergeben hat, dass die Kosten für diese Strategie erheblich sind und insbesondere die unteren Einkommensschichten treffen werden?

Angesichts der angespannten Lage, in der die Wirtschaft und dadurch auch die Bürger besonders leiden, sollten die Diskussion um die Energiewende, wie die des EGD, alle relevanten Aspekte beinhalten – auch die negativen Auswirkungen auf die Konsumenten. Natürlich kann man meinen, dass die Kosten des EU-Plans im Angesicht der klimapolitischen Ziele gerechtfertigt sind, doch man sollte dabei nicht vertuschen, dass Verbraucher, Arbeiter, und kleine Unternehmer besonders unter diesen Entscheidungen leiden werden. Eine offene Diskussion im Sinner der Prinzipien Transparenz und verantwortlicher Regierungsführung ist notwendig, bevor Millionen von Menschen die Rechnung für diese Energiepolitik vorgelegt bekommen.

Originally published here.

Fight mycotoxin contamination with modern technology

Every consumer will know this problem: you come home from a long trip but the fruits, vegetables, and yoghurt are still in the fridge. “Expiry dates are just an industry trick to sell more food” is a thought that leads some to disregard the mould that has formed on all of these items over time, or even to consider that the food is therefore healthy.

According to a study by the University of Copenhagen, many consumers believe that mold is a sign of “naturalness”. “What is objectively referred to as dirty is less frightening to us than apples which never rot. Similarly, having dirt under one’s nails has become a sign of health”, says Kia Ditlevsen, associate professor of UCPH’s department of food and resource economics.

However, the reality is very different. Mould carries mycotoxins, which are dangerous to human health, and in some cases, can be deadly. These toxic metabolites are divided into subcategories, namely aflatoxins, ochratoxin A (OTA), fumonisins (FUM), zearalenone (ZEN), and deoxynivalenol (DON – also known as vomitoxin), which can all be ingested through eating contaminated food, including dairy products (as infected animals can carry it into milk, eggs, or meat). 

In a home fridge, mould can develop through bad storage — the electricity went off for long and the cooling chain was interrupted, or direct sun exposure for a long period of time — or simple expiry of the product. 

Most disconcertingly, up to 28% of all liver cancers worldwide can be attributed to aflatoxins, and its immunosuppressant features leave humans weakened against other diseases. The features have been known to modern science since the turn of the century. 

In Africa, this is a deadly epidemic. Aflatoxin exposure is more deadly than exposure to malaria or tuberculosis, with 40% of all liver cancers in Africa being related to it. Mycotoxin contamination can occur through inadequate food storage, but more importantly, it occurs in the absence of the correct crop protection measures, including chemicals.

In modern agriculture, we prevent most of the exposure to mycotoxins by using fungicides. However, chemical crop protection products have been seen with increasingly critical eyes. All too often, those calling for bans of XYZ chemical pretend that farmers ought just use “an alternative”, but all too regularly these alternatives do not exist, or have, as with the example of genetic engineering, been outlawed already.

Gene-editing technologies such as CRISPR-Cas9 can help solve farm safety concerns such as the ones raised by fungi. Fungal pathogens, such as Fusarium proliferatum, which attacks diverse crops, including wheat, maize, rice, asparagus, date palm, garlic, onion, can be studied and better understood using this technology. In the case of Fusarium oxysporum, which befalls both plants and animals, gene-editing can disrupt the genes of interests. A different method of genetic engineering, known as gene-silencing (arrived to through a method known as RNA interference), can create aflatoxin-free transgenic maize. Particularly for developing nations, this would mark a breakthrough improvement of consumer health and food security.

However, if the European Union keeps its current legislation on genetic engineering, and goes even further by exporting these rules and regulations to development aid partners in Africa, then these innovations will not be of use to consumers domestic and abroad. In order to tap into the potential of the gene-revolution, we need to change outdated legislation and Europe and usher in a new century of biotechnology.

We owe it to ourselves.

Putting a price on the European Green Deal

A Commission impact assessment lays out what happens if the EGD is implemented, and it does not look good, writes the Consumer Choice Center’s Bill Wirtz.

The European Green Deal (EGD) is one of the cornerstones of the Von der Leyen Commission. It is hardly controversial to say that European policymakers have responded to public pressure with more environmentally friendly policies, which have, in turn, created heated debates over many other EU policies, ranging from CAP reform to the EU-Mercosur free trade agreement or the reform of the Emissions Trading System.

The EGD is ambitious – it seeks out to reach zero net emissions by 2050, with “economic growth decoupled from resource use“. It intends to do so through structural reform in the field of agriculture, decarbonising the energy sector, and laying out new taxation schemes to avoid unsustainable imports into Europe. However, the appropriate question is: at what cost? The additional expenditure for the European Union per year (between 2020 and 2030) will be a whopping €260bn. But it does not stop there.

At the end of September, the European Commission released an impact assessment that answers this question. This document has largely remained uncommented by Commission officials, or in the broader media landscape, which is surprising because it contains crucial data points. For once, in most models laid out in the assessment, GDP is expected to shrink. This is in close relationship with declines in employment, consumption, and exports. The latter will be particularly devastating for countries that heavily rely on export industries, which employ people with limited re-employment opportunities. As service industries – such as the financial sector – will be less affected, this will widen the opportunity gap in the labour market.

“We should be transparent about the effects of the European Green Deal, especially if it implies a worsened situation for consumers”

Another weight on existing inequalities will be rising energy prices for consumers. As the German energy shift (Energiewende) has shown already, a quick change to renewable energy sources, arrived through subsidisation programmes, has sharply increased consumer energy prices. The Commission’s impact assessment recognises that, though in a way that puts into question their consideration of the importance of social sustainability: “A drawback from a social perspective are the higher energy prices for consumers.” Calling it a “drawback” hardly does the immense cost for low-income consumers any justice.

A common narrative in the debate surrounding the EGD is that environmental policy shifts enable job and wealth creation. EGD Commissioner Frans Timmermans likes to talk about “green jobs”, referring to the opportunities created by the Commission’s plans. Instead of the COVID-19 crisis giving him pause, Timmermans says that “our response to the COVID-19 crisis allows us to save jobs not for years but for decades to come, and create new jobs. We may never again spend as much to reboot our economy – and I sure I hope we will never again have to.” Will he reconsider now that the impact assessment of his own Commission revealed three weeks after his speech that the cost for this strategy is significant? You would be courageous to hold your breath.

Given the current situation surrounding COVID-19, as GDP contraction expectations approach those of the 2008 financial crisis, we cannot adopt these kinds of policies without proper consideration. Some will claim that the price is that the noble goal justifies the means, but in any way, we should be transparent about the effects of the European Green Deal, especially if it implies a worsened situation for consumers. We owe it to the principles of transparency and accountable governance.

Originally published here.

Il faut repenser, non réformer, la PAC

Les institutions de l’Union européenne renégocient la structure et les ambitions de la politique agricole commune (PAC). Les différents groupes politiques jonglent avec des propositions écologiques, plus ambitieuses les unes que les autres, sans le moindre esprit critique envers le système des paiements en lui-même. Dans quelle autre industrie du monde serions-nous prêts à subventionner structurellement un secteur entier, indépendamment de toute analyse des véritables besoins des consommateurs ?

Mon intention n’est pas de contredire tout ce que le Parlement européen a décidé dans sa éunion plénière de la semaine du 19 octobre. En effet, il est important de souligner un point positif : les parlementaires se sont prononcés pour une limitation des paiements directs aux paysans jusqu’à un maximum de 100.000 €. Ce plafond est une réaction aux faits qu’une grande partie des paiements reviennent à des personnes moins méritantes que d’autres. Il garantit de réduire les pressions corporatistes de cette
politique agricole commune.

En République tchèque, le plus gros bénéficiaire des subventions de la
PAC est Andrej Babis, un milliardaire agronome qui détient également une
grande partie des médias du pays. Ses entreprises en République tchèque ont perçu au moins 37 millions € de subventions agricoles l’an dernier. Vous l’ignorez peut-être, mais Andrej Babis est le Premier ministre de République tchèque et est donc responsable de la redistribution de cet argent.

En Bulgarie, les subventions sont devenues le bienêtre de l’élite agricole. L’Académie bulgare des sciences a constaté que 75% des subventions agricoles européennes finissent entre les mains d’environ 100 individus. Dans un article intitulé «The Money Farmers: How Oligarchs and Populists Milk the E.U. for Millions» de novembre de l’année passée, le New York Times avait d’ailleurs effectué une enquête à ce propos. Ce que les négociations pour une réforme de la PAC veulent faire est de réunir les ambitions écologiques de deux stratégies européennes : la stratégie «Farm to Fork», qui veut augmenter la production bio en Europe de 7% à 25% et réduire l’utilisation de pesticides de 50% jusqu’en 2030, ainsi que la stratégie pour plus de biodiversité.

Ces deux stratégies ont leurs défauts propres, qui méritent toutes les deux des articles à part entière. Cependant, la question devrait être jusqu’à quel point une subvention structurelle du secteur alimentaire est un petit plus bienvenu et non une aide essentielle. Dans l’UE, le protectionnisme agricole force les consommateurs européens à payer de 1 à 17 % de plus que le reste du monde les produits agricoles. Aux États-Unis, les effets de distorsion du marché sont également évidents.

Ce protectionnisme fonctionne sur trois plans différents : la subvention de nos produits agricoles, les normes et standards de production, ainsi que les barrières tarifaires directs (taxes d’importations). Ces trois facteurs provoquent une réduction drastique de la concurrence et une augmentation des prix des biens présents dans nos supermarchés. Si, dans une telle situation de protectionnisme, le secteur agricole ne peut pas garantir des prix acceptables pour les consommateurs, alors il est temps de se demander si une politique de subvention est vraiment adéquate.

Il est nécessaire de faire quelques comparaisons. Les prix alimentaires en Nouvelle-Zélande et en Australie sont pratiquement identiques aux prix moyens du marché mondial. La raison est que les producteurs agricoles de ces pays sont largement laissés libres de gérer leurs affaires et ne sont pas lourdement encadrés par les autorités. En Europe, un agriculteur moyen doit plus d’un quart de ses re- venus à diverses mesures de soutien de l’État. En Nouvelle-Zélande et en Australie, les agriculteurs doivent simplement gagner leur vie en vendant des produits que les gens veulent manger.

Ces deux pays possèdent certains des secteurs agricoles les plus importants et les plus productifs du monde. Cela présente un certain nombre d’avantages économiques. À titre d’exemple, sans la suppression des aides publiques, la Nouvelle-Zélande n’aurait peut-être jamais développé son secteur d’exportation de sauvignon blanc, désormais célèbre dans le monde entier. Mais c’est aussi un moyen extrêmement simple d’améliorer le niveau de vie des personnes à faible revenu en leur permettant d’obtenir des aliments à plus bas prix. La PAC est un vieil outil politique qui ne correspond ni à la demande du marché, ni aux volontés des consommateurs. Nous avons besoin de plus de liberté pour les producteurs, plus de libre-échange, moins d’interventionnisme étatique dans le do-
maine de l’agriculture, et, par ce fait, plus de choix pour les consommateurs.

POUR PLUS D’ACCÈS AUX SOINS, RÉDUISONS LA TVA À ZÉRO SUR LES MÉDICAMENTS !

Alors que les Européens sont confrontés à une crise de santé publique, il serait nécessaire d’accroître l’accessibilité des médicaments en supprimant la TVA sur les biens les plus essentiels.

La pandémie de Covid-19 a remis à l’ordre du jour la politique de santé des décideurs européens. Avant l’épidémie, l’Europe était engagée dans un débat sur le prix des médicaments, mais cela n’intéressait que les échelons supérieurs des institutions politiques.

Les entreprises pharmaceutiques sont souvent blâmées, de même que le manque de transparence des prix. Un examen plus approfondi des coûts des médicaments montre cependant que l’une des principales causes de ces coûts élevés est la taxe sur les ventes de médicaments.

Les patients informés savent que tous les pays européens, sauf un, appliquent la TVA sur les médicaments en vente libre et les médicaments délivrés sur ordonnance. L’Allemagne impose jusqu’à 19% de TVA sur les médicaments, tandis que le Danemark se classe en tête, avec des taux de 25%, soit un cinquième du prix total d’un médicament !

La France applique un taux relativement faible de 2,1% de TVA sur les médicaments remboursables et 10% sur ceux qui ne sont pas remboursables.

Et chez les autres ?

Il n’y a qu’un seul pays qui ne perçoit pas de TVA sur les médicaments délivrés sur ordonnance ou en vente libre : il s’agit de l’île de Malte. Le Luxembourg (3%) et l’Espagne (4%) montrent également que les taux modestes de TVA sur les médicaments ne sont pas une idée folle, mais quelque chose dont des millions d’Européens bénéficient déjà.

La Suède et le Royaume-Uni appliquent tous deux un taux de TVA de 0% sur les médicaments délivrés sur ordonnance, mais de 25% et 20% respectivement sur les médicaments en vente libre.

Il est évident que l’un des principaux obstacles à un meilleur accès aux médicaments est la politique fiscale inadéquate de certains Etats membres de l’Union européenne (UE).

La TVA à 0% partout ?

Lorsque les autorités discutent de l’accès aux soins, il serait intéressant qu’elles se penchent sur ce problème dont elles sont les seules responsables avant de parler de l’érosion des droits de propriété intellectuelle ou de l’influence des grandes sociétés pharmaceutiques sur la fixation des prix.

C’est particulièrement le cas des médicaments délivrés sur ordonnance ou les médicaments contre le cancer qui peuvent atteindre des niveaux de prix substantiels avec des taux de TVA allant jusqu’à 25%. De telles taxes pèsent lourdement sur les patients et leur assurance-maladie.

En ce qui concerne les médicaments délivrés sur ordonnance, il n’est guère judicieux de commencer par appliquer une taxe sur la valeur ajoutée, puis de laisser les compagnies d’assurance-maladie nationales payer la note.

Pour les médicaments en vente libre, les décideurs politiques sont aveuglés par l’idée que le simple fait qu’ils ne soient pas prescrits par les médecins en fait des biens secondaires et non-essentiels.

De nombreux médicaments en vente libre, qu’il s’agisse de médicaments contre les maux de tête, les brûlures d’estomac, les remèdes respiratoires ou les crèmes dermatologiques, ne sont pas seulement des médicaments indispensables pour des millions d’Européens ; ils font souvent office de soins préventifs. Plus nous taxons ces produits, plus nous accablons les médecins de visites non essentielles.

A l’instar de Malte, les pays européens devraient abaisser leur taux de TVA à 0% sur tous les médicaments. Le but de la TVA est de réduire l’activité commerciale, en s’assurant que toutes les transactions commerciales paient ce qui est considéré comme leur juste part. Cela permet de toucher également les entreprises qui ne paient traditionnellement pas d’impôts sur les sociétés.

Cependant, considérer la vente de médicaments comme une transaction purement commerciale, du point de vue des patients, est une erreur. Des millions de citoyens ont besoin chaque jour de médicaments spécifiques délivrés sur ordonnance, et d’autres comptent sur l’aide de médicaments en vente libre pour soulager la douleur ou traiter des problèmes qui ne nécessitent pas de soins médicaux professionnels.

Il est temps que les nations européennes se mettent d’accord sur un accord contraignant de TVA zéro sur les médicaments ou au moins sur un plafond de 5%, ce qui permettrait de réduire drastiquement les prix des médicaments, d’accroître l’accessibilité aux soins et de créer une Europe plus juste.

Originally published here.

Tarif PPN untuk Obat-Obatan Diusulkan Maksimal 5%

Tarif PPN untuk Obat-Obatan Diusulkan Maksimal 5%

BRUSSELS, DDTCNews – Insentif pajak untuk barang-barang farmasi dinilai masih dibutuhkan mengingat kebutuhan masyarakat Eropa untuk produk kesehatan terus meningkat di tengah pandemi virus Corona atau Covid-19.

Analis Kebijakan dari The Consumer Choice Center Bill Wirtz mengatakan pembuat kebijakan di Eropa perlu merumuskan ulang kebijakan fiskal untuk produk farmasi pada masa pandemi Covid-19, terutama mengenai tarif PPN.

“Dalam komponen harga obat pendorong utama yang membuat harga menjadi lebih tinggi karena adanya pajak penjualan obat,” katanya dikutip Rabu (4/11/2020).

Saat ini, lanjut Wirtz, sebagian besar negara Eropa masih memungut PPN untuk resep atau obat yang dijual secara bebas. Pungutan paling tinggi diterapkan Denmark dengan tarif PPN 25%. Lalu, Jerman mengenakan PPN 19% untuk resep obat dan produk obat yang dijual secara bebas.

Sementara itu, satu-satunya negara yang tidak memungut PPN atas resep obat atau obat yang dijual bebas adalah Malta. Kemudian negara seperti Luksemburg menerapkan tarif PPN rendah sebesar 3% untuk obat-obatan dan Spanyol dengan tarif PPN 4%.

Swedia dan Inggris menerapkan PPN 0% untuk resep obat yang dikeluarkan dokter. Namun, tetap memungut PPN 25% di Swedia dan PPN 20% di Inggris untuk obat yang dijual secara umum tanpa harus menyertakan resep obat dari dokter.

“Negara anggota Uni Eropa harus mencontoh Malta yang menurunkan tarif PPN sampai 0% untuk semua obat untuk mengurangi aktivitas komersial dan memastikan harga dijual dengan wajar,” ujar Wirtz.

Wirtz berharap terdapat kesepakatan di antara negara anggota Uni Eropa untuk memastikan obat-obatan yang saat ini sangat vital dapat diakses oleh seluruh masyarakat dengan harga terjangkau. Misal, dengan mematok tarif PPN untuk obat-obatan maksimal 5%.

“Perlu adanya perjanjian mengikat untuk kebijakan tarif PPN dengan batas maksimal tarif 5% untuk menurunkan harga obat, meningkatkan aksesibilitas dan menciptakan Eropa yang lebih adil,” tutur Wirtz seperti dilansir eureporter.co. (rig)

Originally published here.

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