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Increasing access to medicines 149Table 2 Duties and taxes on retail medicinesCountry Combined total duties and taxesIndia 55%Sierra Leone 40%Nigeria 34%Pakistan 33%Bolivia 32%Bangladesh 29%China 28%Jamaica 27%Morocco 25%Georgia 25%Mexico 24%Table adapted from European Commission, 2003.They are regressive because they adversely affect the poor and thesick. Such government policies effectively impose a wedge betweenthe demand for drugs and their supply. In markets where profitmargins are already low, drug companies have fewer incentives tosupply their existing products, much less to innovate new productsspecifically aimed at these markets. As Levison (2003) observes:“Economically…tariffs impede the action of a competitive marketwhere the best drug will achieve the best price and [they] protectinefficient [local] producers who charge high drug prices.”(Appendix Figure 2 shows how taxes restrict the demand for medicines.)Non-tariff barriersBeyond visible barriers such as tariffs, manufacturers wishing toexport to overseas markets often face significant hurdles and complexityin registering their products. These tend to emanate from localdrug approval agencies, and often appear to be designed to protectlocal industry rather than achieving better outcomes for patients.