 Turkey says it's open to Sweden joining NATO as long as Europe first opens its mind to the idea of embracing their long-standing bid to join the European Union. We ask Prabir Pukaesar what this means for global politics and how Turkey and also countries like India, Brazil and South Africa find themselves in a more independent space with regard to international relations in an increasingly multipolar world. And in India, patience rights groups are pleading with the federal government to ease the entry of generic biosimilar drugs into the market with a view to significantly reduce the cost as well as access to medication for patients dealing with different cancers and other rare diseases. Why? When the WHO has released new guidelines on biosimilars, is India lagging behind on a policy front? And in Canada, the Port Workers Strike continues, but there is little understanding of what is going on beyond business news outlets reporting on the impact on the supply chain and the losses to big companies. Why are dock workers fighting not just for a pay hike, but for a better understanding of the very future of their industry? Salam, you're watching Daily Debrief coming to you as always from the People's Dispatch Studios here in New Delhi. I'm Siddharth Ani and first up on the show, should Turkish President Rasip Tayyip Erdogan's latest statement, just the day before the big NATO summit kicked off in the Lithuanian capital, Vilnius, be viewed as a U-turn or is the Turkish leader taking a pragmatic approach towards balancing NATO politics with Turkey's own aspirations towards Europe? Pabir Pukaesta is news clicks editor-in-chief and he joins us in studio to discuss some of the important aspects actually of what's going on on the diplomatic front. Keeping up our coverage, Pabir, of the NATO summit, one point we didn't cover in our previous conversation was Turkey's sort of stand on admitting Sweden into full membership and there's been a U-turn there. How do you look at sort of post-election Erdogan and his position having shifted as far as this negotiation is concerned? Well, it does seem that Erdogan wants to at least try and repair some of the relations he had damaged, shall we say, in the last few years. So the question of NATO, of course, which you have asked, but also on the question, for instance, of letting the people who are captured in Mariapol and he has let some of these people go and they were essentially let to be freed on the condition that they are interned in Turkey and they don't come back to Ukraine. So that's the agreement they seem to have had with Russia. So they seem to have also gone back on that and there seems to be also some softening regarding what you are saying, allowing Sweden to join NATO. NATO operates with the fact that even if one member says no, it's not possible to take that country in. So they have been saying that Sweden's relationship with protecting certain PKK members, the Kurdish party which is fighting against Turkey and wants a separate Kurdistan. So that part of it, they seem to have either solved or weakened. Now, it's also true that Sweden has launched some cases against some of the PKK people in Sweden. So is it because of that, is it something else we don't know? But what is interesting is while they have withdrawn their objection to Sweden, but they have put new conditions to the European Union, which is nothing to do with NATO officially. Of course, we know the same countries play the major role. The United States really decides both at the moment. They're the big bosses of European Union as well. So they have said if the European Union allows Turkey to join and he has said that we have waited 50 years for this and then we shall allow Turkey to join. Sorry, we shall leave you facing it. So that we have waited 50 years to join the European Union or join Europe rather than the European Union. But if we are allowed to join the European Union, then we will withdraw our objections to Sweden's joining NATO. Whether it is precondition, whether it's a gentleman's agreement or a quid pro quo kind of thing, we don't know as of now. And Eddogan, as you know, is never that clear. I think he wants to keep his bargaining position and possibility of withdrawal from that position also if he wants. So all these flexibilities are there, but it is possible that the kind of relationship that Eddogan or Turkey had with the West, which really had been damaged significantly, particularly because Turkey is wanting to play an independent hand in what is called by the European Union or the European countries as the Near East. They have a geographical point of view, which is as if the whole world is being looked over from the center of the universe, which for them is Europe. So if we look at that, then it does seem that they are warming up to Eddogan. Eddogan is warming up to European Union. We have also to see what is the bargaining it does with Russia, because there is a trade deal, the deal of the fertilizers and food exports. And Turkey is again a very important player there because it has really to take place through the waterways which Turkey controls. Out of the Black Sea. So all of this is at the moment in the mix. And there is also another agreement which is in the mix, which is what does Russia and Turkey decide about Syria and those areas of Syria, which are officially not controlled by Turkey, but is actually controlled by Turkey. And they are with some of the Islamist forces, which are predicted by Turkey. So I think a lot of unresolved issues over there, but let us all speak clear. Eddogan has not said Sweden can join NATO. I withdraw my objections, period. He has said a conditional yes. And that condition is what European Union has to fulfill and not NATO. So I think I will say at the moment, the looking glass is not still clear, what the future holds. So I think we'll have to see how this plays out. Yes, it is a change. Is it a new spin to the old decision? Or is it actually a change of position? This is what we have to see. From the perspective of the adversaries in the current conflict, Pravir, and you can look at it as Ukraine or Ukraine and the European Union on the one side, Turkey has, like you were saying, been able to at least have some conversations with both sides. How will this kind of affect that position both vis-a-vis, of course, the European side and the Russian side? I think we are seeing a change in the world in which certain flexibilities for countries like Turkey, even countries like India opening out, which means that the world in two blocks is not the way it is now operating. And therefore, a lot of countries are willing to play a role, which gives them a more flexibility, if you will, more bargaining power, if you will, or as the Europeans and the Americans used to say, play both sides of the street, which is what they talked about, the non-line movement. But really what it means is the stability of blocks are no longer there. At the edges, they are free. So core of this block is the European Union. Turkey is not a core member today of NATO because it's playing an independent hand, whether it was Syria, whether it's West Asia, whether it's the Black Sea, they are playing an independent Turkish hand. On economic matters, they are even more independent of all of this. So I think what is happening, whether we have a Saudi Arabia in West Asia or we have a Turkey in what the Europe calls the Near East, the Anatolian Plateau, I think these are all playing a relatively more flexible hand than what they had earlier. And if the hegemonic role that the US was playing, if that weakness, which it is at the moment, the Russian-Ukrain war, the Ukraine war and the Russian-NATO war to be exact, that I think is creating much more fishers in the world and also flexibilities for countries across the globe. And I think that is something which is new that we are seeing. And it gives powers like Turkey, powers like India, powers like Brazil, and also for countries like South Africa, for instance, a lot more flexibility in the international relationships than it was there earlier. So both the weakening of the US hegemony, the fact that the NATO has found itself not able to break Russia, the fact that the European Union and the United States and the UK put together has not been able to sink the Russian economy, means there is an opening out. And let's face it today, if we take for instance, what would be called the BRICS. The BRICS countries GDP is larger than that of the G7, if you take purchasing power parity into account. And if you take even the two largest countries in this bloc, which is India and China, then you will see it's bigger than G5 in terms of the economies that we are talking about. So there is a global shift in economic power. What it means for the strategic set of forces to play out, this is something which is at the moment shifting and it is changing. And I think what we are seeing is countries like Turkey to be able to assert a bigger or play a bigger hand than what they would have otherwise been able to do. And these are the changes we are seeing. It doesn't mean you're going to get alignment with one side or the other. And I think all of them want to play a more independent role. And I think therefore this is where the politics of the future is going to be relatively more unstable, more shifting alliances and therefore more difficult to predict. And I think that's the phase that we are entering into now. Thank you very much for that, Praveer. Next up, nine patients rights groups in India have written a joint letter to the federal government urging it to remove barriers in the production of biosimilars, which are generic low cost versions of medicines made from proteins, sugars or other biologically occurring molecules. This will greatly reduce the cost of these medicines that are widely used to treat a range of cancers and other ailments including arthritis and irritable bowel syndrome. Currently without the generic version of these drugs being available in country, accessibility is extremely limited given the prohibiting prohibitive pricing of these medications which are imposed by innovator companies and big pharma. Jyotsana Singh of the People's Health Movement is here to give us a full picture on this very important story that actually impacts millions of patients across the country. Jyotsana, thanks for joining us on daily debrief. Important story today that we are discussing. If it's relevant, tell us who these patients rights groups are, but more importantly, what is the content of the appeal that they've made to the central government? Yeah, so there are nine organizations who have written to the government of India, its various departments and ministries, asking for certain changes in guidelines about some of the latest medicines which can impact prices for medicines of cancers, rare diseases and many others to a great extent. Organizations are from across many diseases and conditions. The Delhi network of positive people which is a prominent organization of people living with HIV. There is also a network of various people, academicians, doctors and NGOs which is called a working group on access to medicines and treatment. They are also part of it, the cancer rates association. There are many, many organizations sign rare diseases groups of course. So the thing is at the core of the matter is so the way we have known medicines traditionally, there are small molecules. So all of your paracetamols and analgesics and antibiotic, they're essentially chemical products which are being produced in the labs and then the medicines which we can consume are made out of them. But over the past couple of decades, completely new technology has taken over which is and those are called the biologics, which are actually biological materials in other words, things that exist in the nature. So they are proteins, they can come from the plants, they can come from certain human cells also and various such natural materials. Now these are really big molecules. It's nowhere compared to small molecules. So initially when one innovative company, the company which has researched and come up with a new molecule of this sort, biologic as we call them. So once they produce that new drug and they bring it to the market, they obviously would have patents on it and that has been the case with the smaller molecules also. However, as soon as the patent on the medicine generally gets over, our understanding is that the generic manufacturers would be able to start producing them and the prices will come down. That is not happening in the case of biologics because of the requirements in India. So apart from what we have known in the smaller molecules, the way you have to establish a generic manufacturer has to establish that their medicine is similar to the original medicine. In addition to that in biologic, when a biosimilar is produced, which is the generic version of original biologic, they are called biosimilars, they have to also produce animal studies and go through a part of clinical studies where they have to show that their product is quite similar to the original product. Now there are multiple problems with it. Once that makes the entire, this becomes a huge barrier because it is very cost intensive. It takes a lot of money, a lot of money goes into it, a lot of time goes into it and that becomes a problem for the generic manufacturers who actually start producing these medicines. So this letter by these groups, access medicine groups, it basically is saying that the government removes some of these barriers may make life easier for generic manufacturers because also presumably those generic manufacturers are surviving on relatively smaller margins and therefore don't have the kind of capital to invest in long processes like this. What is the current policy framework and is it just a case of the government's policies in various departments not having come up to speed with best practices or established practices from around the world or is it something that is critical to ensuring patient safety in this sense? Indian guidelines came out or were adopted in 2016 but in 2021 the UK guidelines were amended and in UK you do not require animal testing and the comparative studies. WHO last year in 2022 changed its guidelines and is saying that you can do away with these two clauses, the main clauses. So the government of India should also do away with that. UK doing it, US has done it, Canada has done it, European Union has also done it. So all the established medical agencies have regulatory agencies have pretty much done it. The problem is obviously the innovator companies, the Roche, the Pfizer, the Glexus, McClines because they want to maintain monopoly in the market for as long as possible and this has become one of the ways for them to maintain monopoly because earlier it was only patents and now I think even after the patent is over they get a very good margin many years even if a generic manufacturer is ready to invest because it takes years to finish all those studies because you have to pretty much do a lot of things again. So it is a lot of time, countless investment as you have correctly pointed out which the generic manufacturers may not have that much of money so they retain their market monopoly for a longer time and I think this is one thing which is to be fought apart from asking the government to do it. So your fight is at both the levels and asking the big pharma to say that do not push you already earn enough money through patents. Yeah, enough of a chunk I think of the pie goes any way to big pharma. If you can just quickly Jyotsa put it in some numbers for us. What are the kind of numbers of patients who would benefit from the removal of these kind of barriers and also what would be the cost differential on average let's say if you or I are a patient of or suffering from one of these rare diseases if we are spending today 100 units of whatever currency how much would it come down to if some of these barriers are removed? Yeah, so just to give a sense of what are we talking about for example there is a molecule and a biologic called pembrolizumab. Now this is a cancer medicine and it actually cures multiple types of cancers the cancer of lungs cancer of neck and head a different types of breast cancer cervical cancer all of these and if you know I mean cervical cancer and breast cancer are among the top killers in India and the government is really keep saying that they're really worried about it. Now one vial of this biologic currently is costing rupees two lakh actually a little bit more than that and you have to take that for one and a half to two years and the cost comes to something like 60 to 70 or even more lakhs for a lot of patients. That is the amount we are talking about and usually what we have seen is that the production cost is less than 10 percent. That's so just to put it for our international viewers that's about if I'm not wrong around 70 000 euro. It will be yeah so yeah so it is it is that costly and I mean and just to give a sense that an average Indian's monthly income is something 8 to 10 000 rupees and we are talking about 60 to 70 lakh rupees for a treatment but 7 million rupees yeah it would be yes so that is what we are talking about and generally what we have seen always that the cost of production is less than 10 percent of what the cost of medicine is and therefore it is the entire margin actually goes to the company which is producing the medicine. So generally companies once they come into the market they do reduce the prices for a very very great extent. We have had instances where the prices came down to five to six percent of the original cost so that is what we expect can happen in this is just that it is a relatively new field as we know that because India has a huge capacity to produce these medicines and our guidelines do not support generic manufacturing at the moment so the cost for the manufacturers will also remain high at the moment but if this is done we can really produce these medicines at peanuts cost and it will be really good for the patient. Yeah absolutely all right thanks very much for that Jyotsana I saw all the time we have thanks very much for but giving us a pretty full picture of what's happening on this front and we'll catch up with you very soon again on daily debrief and finally 7500 also dock workers on the western seaboard of Canada have been striking for 10 days and the federal government has now entered the picture saying it will play mediator in a dispute over wages work conditions and the future of the ports. A labour intensive line of work where technology is playing a growing role but discourse is sadly lacking. People's dispatches Anish covers the region and joins us now with insights on a part of the story that has been virtually ignored why workers and the unions have been forced into this extreme measure. Anish a common theme that we see when it comes to reportage of these kind of industrial actions that happen on a large scale it generally tends to be from business sort of publications and looking at it from the angle of how it will affect supply chains and lead to inflation etc etc but the aspect that unions tried to sort of take all measures before resorting to this sort of strike action is never fully developed as as part of that narrative and a strike is essentially a last resort and this is another case in which we're hearing very similar kind of or looking at very similar coverage from Canada of the ongoing dock workers agitation. Tell us about how firstly the scale of this action and give us a little bit of perspective on why workers have been pushed into taking this extreme course of action. Yeah so as you quite rightly pointed out it's the coverage is quite skewed if you even look at some of the recent reports I mean apart from the day one of the strike the reports from day one of the strike which basically included some parts of the demands a very concise part of the demands that the workers and the trade unions had actually put out as part of the strike you really see nothing on from the workers perspective or the trade unions perspective at this point in time right now it's basically just how many millions of dollars something like 300 millions of dollars a day is being estimated as to have been lost because of the strike but there has been no mention of how many months like these negotiations have been going on for months actually and it began very early this year and the fact that there has been no resolution so far and the fact that the company has been employers especially have been quite adamant at you know at their position especially in terms of contracting out which is something that has attracted a significant attention in this current set of strikes that we see on the western coast of Canada it's basically something that they are not attending to there is also nothing like one of the significant factors about the strike is that it has focused significantly on automation and how that is going to affect current jobs and also jobs for the future generation and that is something that that is that should be part of the conversation with all this talk of AI and everything or this talk of technological leap forward that you know all the mainstream media has been talking about but there has been no talk about how that is going to affect the workforce especially employment and how it is going to even affect those who are currently employed and that is something that the workers have been trying to bring light attention to and that is something that they do not want to discuss especially the current coverage and that is very significant and it also kind of shows how things work because if you see right now on Tuesday they the government the federal government has already intervened and will be mediating the talks now and that pretty much is what we've seen before we've seen we have covered the another set of strikes in the eastern coast of Canada earlier this year and in that the government eventually created imposed a contract and imposed it by law actually by legislation by means of legislation pretty much shutting down the strike altogether without any consent from the trade unions and that is pretty much where the where the current set of negotiations with the government is mediating is headed to and that is the direction that they're taking which is also not going to be talked about at this time what you're seeing is a very skewed coverage that is that it's not just anti-worker it's just completely non-worker there's no perspective from trade unions at the moment and that is the very jarring aspect of the current set of strikes that we see. So bring us a little bit of that perspective Anish how many workers and families are being affected by the lack of movement on this negotiation and what are the sort of what is the industry talking about in terms of what lies ahead because this is presumably again negotiations not based on like a six month or one year but a slightly longer term discussion. Yeah so apparently there are about 7000 or more workers right now on strike and this is pretty much what we're looking at is about 30 ports across the west coast of Canada and this pretty much basically shuts down the entire west coast and the west coast is quite important for Canada because especially with the port of Vancouver there which is considered as the gateway to the east and the east of Asia and Asia is essentially and so a lot of consumer products that pretty much travel from there and also from you know the west coast of the United States are kind of stuck and they do not have a place to go for and this is something that pretty much the workers understand the very you know the need their importance in this entire process as well. So we are also seeing some level of solidarity from workers on the US west coast that is that should also be pointed out we have seen unions in the Californian ports talking about the fact that they will not be you know undocking any of the ships that are you know cargo ships that are redirected away from the west coast at the current moment when the strike is going on. So that clearly shows a very significant level of you know workers solidarity because these are pretty much the same struggles that they are going through. Absolutely conditions must be pretty much the same down the coast. Exactly and as I said like these are probably one of the first strikes that are actually talking about automation in a you know labor intensive industry and that that is something that really needs to be talked about that really needs to be addressed and they are actually looking forward to having that like a resolution of that in their contracts and that is something that is going to be groundbreaking if it actually happens but and this will actually set a precedent for everybody not just in Canada but also the whole of the North American and maybe beyond that and so these factors are definitely something that is being you know refreshed it's apart from wage hikes which is like the common theme at this moment because of the spiraling cost of living these are facts these are facts that are going to affect a future working class at the event and that is something that these workers are right now trying to address and the fact that they do not there is you know it's quite a kind of sad that there is little coverage on that those aspects of it there is little investigation of how how much it is going to be affected like well we do not really know the kind of estimates an estimated job loss that automation is going to bring into industries like these we're talking about IT and other stuff but we do not know how labor intensive industries will be affected especially places like the port so these are things that that that needs to be highlighted but obviously it is not and that is the sad part of this entire situation right now. Thanks very much for bringing that perspective in an important one and and also one that can I guess then connect dots between various kinds of action that workers are taking across industries around the world at this point and also because we don't know is why these points need to be discussed I guess at these levels in in these meetings at these negotiating tables so that the workforce and the public at large can at least be aware of the kind of situations they're getting into thanks Anish for joining us on Daily Deed Beef that's all we have on this episode of the Daily Deed Beef but as always we urge you to head to our website peoplesdispatch.org for details on these stories and all of the other work we do don't also forget to follow us on the social media platform of your choice if you haven't done so already and of course even if it is Twitter. We'll be back tomorrow with another episode same time same place until then stay safe thanks for watching goodbye.