[Ip-health] BZ Toespraak: Medicins for the poor, opportunities in Qatar

[James Love]

-------- Original Message --------
Subject: FW: BZ Toespraak: Medicins for the poor, opportunities in Qatar
Date: Fri, 12 Oct 2001 13:49:13 +0200
From: "Lisa Hayes" <Lisa@hai.antenna.nl>
To: "James Love (E-mail)" <love@tap.org>

Dear jamie,

I thought this might be something for the IP health list. Below is a speech
made today by the Dutch Minister for Development Cooperation, Eveline
Herfkens as part of a special debate on access to medicines. It's part of
the Dutch lead-up to Qatar. Ellen will also be speaking there. See if you
want to post it.

Lisa


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Sent: vrijdag 12 oktober 2001 13:39
Subject: BZ Toespraak: Medicins for the poor, opportunities in Qatar

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================

CHECK AGAINST DELIVERY
World Trade talks
TRIPS and health
Conclusion


CHECK AGAINST DELIVERY
============================

Embargo till Friday, 12 October, 16.00

Speech by Eveline Herfkens, The Hague, Friday 12 October

Humour is sometimes the best way of facing a painful truth. That is exactly
where Pieter-Dirk Uys excels. He makes us laugh while forcing us to confront
the immense tragedy of the AIDS epidemic which continues to rage mercilessly
around the world, particularly in southern Africa.

We are not here today to quibble about who should take a bit more or a bit
less of the blame for the epidemic, or who has a bit more or a bit less
responsibility for fighting it. The question is, what are we going to do
about it?

What matters is commitment. Pieter-Dirk Uys is 100% committed. He talks
plain language about sex and the dangers of unprotected sex. He provides
information at hundreds of schools. He urges young people to have
responsible, safe sex. And he is very forthright in his condemnation of the
president of South Africa, whose implausible theories about AIDS are more of
a hindrance to AIDS prevention than a help.

Pieter-Dirk Uys takes the words out of my mouth. At the UNGA Special Session
on HIV and AIDS I insisted that AIDS could not be fought without openness.
President Museveni of Uganda is an example of a leader who has got the
message.

You cannot defeat AIDS with a single drug. The best treatment is a cocktail
of several drugs. If one is missing, the whole cocktail loses much of its
effect. And I see this as a parallel to the fight against AIDS. We must
attack it on all fronts at once. Openness and prevention, yes. But also more
information, research, improved healthcare and access to affordable
medicines. All of these are vital for our cocktail.

They are all interconnected. What’s the use of a well organised healthcare
system if patients can’t afford the drugs? And conversely, even giving drugs
away for free will not achieve much without proper healthcare.

With this in mind, let us focus today on one ingredient in our cocktail: the
cost of medicines. And, connected with that, developing new drugs. We are
talking about patents and Trade-Related Intellectual Property Rights
(TRIPS).

Pieter-Dirk Uys has hammered home how serious the AIDS problem is. But
Trade-Related Intellectual Property Rights go beyond AIDS. The same facts
apply to malaria, tuberculosis and many other diseases. In every case, the
challenge is for the international community to stem the tide of these
diseases. Because they ruin any prospect of development for the poor. And,
in the case of AIDS, with deadly consequences.



World Trade talks
============================

The agreement on TRIPS does not exist in isolation. It is part of the WTO
Ministerial Conference and is the subject of world trade talks. We have a
few weeks to go till Doha, where TRIPS will be on the agenda. Before looking
at  TRIPS in detail I want to touch briefly on the vital framework that it
is part of.

We still don’t know whether Doha can go ahead. The terror attacks on
Washington and New York have already forced us to cancel the Children’s
Summit and the annual meeting between the World Bank and the IMF. It will be
a crying shame if Doha also falls through.

The new WTO round is immensely important. A new round is the best way of
opening up international trade to benefit the poor. The incipient recession
makes it harder to throw the markets open, and the recent attacks will make
it even more so. The IMF forecasts a decline in world trade growth from
12.4% last year to 4% this. The World Bank expects economic growth in
developing countries to fall from 4.3% to 3.5%. The poorest will be hit hard
if this carries on. We can then abandon our hope of meeting our target to
halve world poverty by 2015.

When recession threatens, industrial countries tend to react by boosting
their own economies. Consumers are urged to buy goods made in their own
country. Rich countries pump billions into their own economies. Developing
countries are strictly forbidden to aid their airlines with public money.
But in times of trouble the rich countries feel no compunction about
propping their own carriers up. That is all back to front.

Let me echo Professor Jeffrey Sachs, who told us such an inspiring story of
health and patents here in The Hague almost two years ago. Earlier this
month he wrote that a proactive trade policy was more important now than
ever before to give developing countries confidence in the world trade
system.

Market access is part of that. But fair and balanced TRIPS rules are really
key for restoring confidence in the WTO and thereby creating the conditions
for a global round of trade negotiations that really deserves the name
‘development round’.



TRIPS and health
============================

Fair and balanced TRIPS rules: what does that mean? We are trying to strike
a balance in intellectual property law. On the one hand, we want to provide
incentives for innovation and research. But on the other hand, we want to
make products widely accessible. This balance is in the public interest.
Fair patent rules mean more than industry’s self-interest.

But where we strike the balance differs from country to country and from
situation to situation. It is essential to understand that. Patents must
reward real innovation and top research. The poorest countries stand to gain
little from that at first. They have no knowledge to protect by patents. But
when patent law comes into force they will suddenly have to pay more to
import knowledge in knowledge-intensive products. TRIPS shifted the global
rules in favour of the industrialised countries. Though the more advanced
developing countries may eventually gain as well from patent protection as
they develop further.

Many of the more advanced developing countries have their own drugs
companies, producing generic medicines. The Western pharmaceuticals industry
often dismisses them as “copycat companies”, but I am less negative. You
could see this sort of production as an important step towards developing
their own products. And their policy has a social objective as well: making
medicines affordable. They would be much more expensive with patents. The
economist Jayashree Watal has found that patent protection would almost
certainly lead to patent medicines doubling or tripling in price. This
includes treatment for major diseases like AIDS in countries where patents
apply.

The developing countries went along with including the TRIPS in the Uruguay
Round in the hope of making compensatory gains on other fronts, such as
access to rich countries’ markets for agricultural products and textiles.
Their hopes have not yet come true.

But the TRIPS agreement itself is less rigid than is sometimes suggested.
And the WTO countries agree that there is no need to throw it out of the
window. Broadly speaking, it leaves countries free to protect their national
health interests. The problem is not the agreement itself. The problem is
more about how to interpret the rules. Consensus in the WTO by means of a
separate declaration by the ministers, should really put an end to that
problem.

The provisions on compulsory licences and parallel imports are the key here.
The agreement gives countries some freedom. And they must be allowed to make
use of it without rich countries putting a knife to their throat. It is
totally unacceptable for rich countries to put bilateral pressure on them to
be stricter than TRIPS allows. Or to be stricter than the rich countries
themselves. Surely the whole point of multilateral agreements is to protect
countries from the bilateral jungle where the strongest always win?

I also want to stress the need to re-examine the provision that governments
can issue a compulsory licence only to national companies producing
predominantly for their own national market. That shuts the poorest
countries out. They have no industry of their own to give licences to. I am
pleased to see the EU is trying to get the WTO members to agree on a
solution. The EU has already drawn up a legal framework to this end.

A balanced interpretation of the TRIPS agreement has everything to do with
universal human rights. And to UN initiatives aimed at allowing more freedom
for health issues in trade agreements. Take, for instance, the UNGA World
Summit on Social Development and the UNGASS on HIV and AIDS.

In its July 2000 resolution on Intellectual Property Rights and Human
Rights, the Commission on Human Rights invited the High Commissioner to
undertake an analysis of the human rights impact of the TRIPS agreement. The
resolution also invited the Secretary-General to submit a report on the
issue.

The High Commissioner’s recent report makes several clear recommendations.
The 141 WTO members are bound by the TRIPS agreement to provide a minimum
level of protection for intellectual property rights. A total of 111 out of
141 members have also ratified the International Convention on Economic,
Social and Cultural Rights. The High Commissioner maintains that WTO members
are bound to implement the TRIPS agreement in the light of their human
rights obligations.

This, she says, means that countries must be encouraged to prevent the abuse
of intellectual property rights through effective competition policy. And
that they must be encouraged (yes, encouraged) to incorporate TRIPS
provisions on compulsory licences and parallel imports into their national
legislation. “As safeguards to protect the right to health and to access to
essential drugs”. Not, I’d point out, to give them up, as Jordan was forced
to do in order to conclude a bilateral trade agreement with the United
States.

This is a vital issue. National legislation is crucial. TRIPS allows plenty
of leeway, but national legislation must be in place. Many countries do no
realise this.

These are the ingredients I think we must deal with in the separate
ministers’ declaration on TRIPS which is currently in the pipeline. The
declaration must give developing countries the security that they can make
full use of the freedom TRIPS allows in the interests of their nations’
health. A failure to agree on such a declaration would be sending quite the
wrong signal to the developing countries.



Conclusion
============================

Does the flexible interpretation of TRIPS that I call for amount to an
attack on the pharmaceuticals industry? Of course not. We are talking about
perfectly legal instruments under a global, rules-based system. Industry
sometimes gives the impression of seeing it as an attack. It has a powerful
lobby for a narrower interpretation.

But its arguments do not convince me. The main one is that any relaxation of
patent rules will slow down research into new medicines. I have my doubts
about the gloomy announcement that AIDS research has already been scaled
down because of compulsory licences. Income from patent protection in poor
countries is of very little importance when decisions on research investment
are made. People in those countries will not be able to afford patented AIDS
antiretrovirals anyway. The deciding factor is the home market in rich
countries.

Industry also claims that pressure groups exaggerate the importance of
patents. says that surveys suggest that only 16% of AIDS drugs are patented
in Africa, leaving plenty of scope for cheaper drugs. But  even these
cheaper drugs are too expensive for the poor, so patents have no relevance
whatsoever, money is the bottleneck. Here industry is contradicting itself:
one moment it says that patents don’t matter, another moment it says they
are vital to stimulate research.

I will be happy to continue discussing sensible differential pricing
proposals with industry. It is a question of solidarity for patients in rich
countries to pay what they can afford while the poor pay much less. That
allows industry to get a return on its investment from the rich. But we have
to make absolutely sure that cheap medicines can’t trickle back into our own
markets.

Another idea is for new medicines (particularly vaccines) to be developed
with some public money from rich countries. And remember, a lot of health
research is already publicly funded. That is another way of making sure that
expensive research is not paid for out of the empty pockets of patients in
developing countries.

Patent protection might indeed give future generations of AIDS patients more
hope, as Nefarma director Cees Visser says. But I do not think that should
be a reason to give AIDS patients in poor countries less hope now. We can’t
allow patents to make their lives even more difficult.



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