[Ip-health] Globe & Mail: Ottawa scrambles to meet AIDS-drug pledge (Oct 4/03)

[Richard Elliott]

Ottawa scrambles to meet AIDS-drug pledge
A key initiative shapes up in public view and the
government rushes to keep up

By DREW FAGAN,HEATHER SCOFFIELD AND STEVEN CHASE
The Globe & Mail
Saturday, October 4, 2003 - Page A20
http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20031004/UAI=
DSN/International/Idx

OTTAWA -- Last Tuesday, some of the federal cabinet
lingered after their weekly meeting. As Prime Minister
Jean Chr=E9tien squinted into the TV cameras outside --
joking, in light of the Radwanski affair, whether
reporters' own expense accounts were up to snuff --
the six ministers congregated at one end of the ornate
cabinet room to ponder what they had wrought.

They'd caused an international stir like nothing
Ottawa had done in years. Accolades were pouring in
from Africa, from aid organizations and from a New
Democrat long removed from Canadian politics. Stephen
Lewis, the United Nations special AIDS envoy, was
praising a Liberal government, of all things, and
those six Liberals couldn't help but be pleased.

Pleased, but apprehensive. For they also knew Ottawa
suddenly was the focus of the global fight against
AIDS on the basis of what really had amounted to just
a statement of intent days earlier. Canada, the world
now thought, would lead the rich West in sending
inexpensive drugs to poor countries to fight the AIDS
pandemic.

Yet this was the first time the six ministers -- all
with some responsibility on the issue -- had even
gathered to discuss how it could be done. Everyone
from senior bureaucrats to the drug firms affected had
been caught off guard.

"This had come at us like a bolt of lightning," a
senior official said.

International Trade Minister Pierre Pettigrew chaired
the meeting, although responsibility for the Patent
Act, which would need to be changed, fell to another
of the six -- Industry Minister Allan Rock. Health
Minister Anne McLellan, who quietly met with Mr. Lewis
in the spring, was there. So was Susan Whelan, the
Minister for International Co-operation. Foreign
Affairs Minister Bill Graham and House Leader Don
Boudria, whose chief responsibility is pushing
legislation through Parliament, filled out the group.

They met for 20 minutes and emerged determined that a
bill would be jammed into the packed fall agenda
within a few weeks. Bureaucrats drafting legislation
-- trying to get the wording just right so that
brand-name drug manufacturers won't threaten to slash
investment -- would have to hurry up. Some government
lawyers were working flat out already.

"A fast timeline was set. It was full steam ahead,"
said one of the dozen or so political aides and
federal officials who also attended. "Who in their
right mind is going to say this is a bad idea?"

Who, indeed? That seems to have been the calculation
of some of those ministers, who five days earlier had
declared virtually off the cuff that Canada would go
to Africa's aid now.

Government initiatives usually follow a process. Those
affected are consulted. Documents are drafted for
consideration by a cabinet committee. Then it's on to
cabinet. There's a decision and a formal announcement.

What happened on Thursday, Sept. 25, was something
else again. To some, it encapsulates the strange last
months of Mr. Chr=E9tien's 10-year regime, as the
"friendly dictator" loses his power and, in the
parlance of Ottawa, the centre no longer holds.

Mr. Lewis's challenge the day before that Canada lead
implementation of a World Trade Organization drug pact
set off a stunning reaction, a kind of rolling wave of
ministerial intent. Mr. Rock spoke first -- not
surprising because Mr. Lewis had challenged him by
name, noting that Mr. Rock had been willing to waive
patent law in a flash during the anthrax panic after
the Sept. 11, 2001, terrorist attacks.

Suddenly, Mr. Rock pledged action. Only then did he
huddle with Mr. Boudria in a parliamentary corridor
and gain his promise to help. Meanwhile, Mr.
Pettigrew, who was in Toronto, responded positively
too (he and Mr. Rock had discussed the issue
informally days earlier), as did Mr. Graham in New
York. The next morning, as it became apparent that a
major initiative was taking shape in public view, Ms.
Whelan was momentarily displeased. It had all happened
in such an ad hoc way that no one had thought to query
the minister most involved in the AIDS fight.

Nor had anyone checked with Mr. Chr=E9tien. Indeed, his
entire office was taken unawares. Mr. Rock had gambled
that the Prime Minister would support action even if
he wasn't consulted. Mr. Chr=E9tien, after all, had made
Africa the focus of the Group of Eight summit in
Kananaskis, Alta., last year.

Mr. Rock gambled right. The Prime Minister called 48
hours later and declared his support -- with a twist;
Mr. Chr=E9tien didn't want Mr. Rock to lead the effort.

Mr. Pettigrew would do so. If the bid to ramp up
production of generic antiretroviral drugs was to
succeed, it had to quarterbacked by someone with good
relations with Canada's multinational drug
manufacturers -- companies that have fought
vociferously to maintain their 20-year patent
protections.

Some name-brand manufacturers viewed the AIDS
initiative as potentially the thin end of the wedge of
weaker intellectual-property rights. How would it be
guaranteed that the low-cost generic copies of
patented drugs would go exclusively to poor countries
incapable of making their own? How would they be
packaged and shipped? What about security at the
Canadian plants? Wouldn't some inevitably leak into
the domestic market, or be smuggled back into the
industrialized world after export?

Canada's Research-Based Pharmaceutical Companies, a
lobby group for the brand-name firms, agreed that the
country should act. But it didn't want it done at its
members' expense, and it was still stunned -- as was
the generic industry -- at the speed with which Ottawa
seemed to be moving.

Any amendment to the Patent Act, which may be the most
litigated law in Canada, had to be airtight -- a
surgical strike. And so too, for implementation. The
brand-name companies had to have confidence that this
would be the case.

Mr. Rock just didn't have the credibility to ease
these concerns. During the 1990s, as health minister,
he was adamantly in the generics' camp. The anthrax
debacle had worsened his reputation with Big Pharma
when he moved precipitously to allow a generic company
to produce the drug Cipro while it was under patent.

Mr. Pettigrew, on the other hand, had a solid
reputation with the brand-name companies -- many of
which are based, as he is, in Montreal. He understood
their concerns, they believed, because he had
responsibility for the continuing world trade talks.
Those talks had led to the WTO agreement on Aug. 30 to
allow poor countries to import generic drugs to deal
with AIDS, tuberculosis, malaria and anything else
that was ravaging their population.

But the WTO deal, reached after prolonged opposition
from the Bush administration, set out little more than
a principle. The details were the key. The Prime
Minister's Office believed, an official said, that
giving Mr. Pettigrew the file "would be the most
prudent way to proceed."

Last Tuesday, Paul Martin -- who is expected to give
Mr. Pettigrew a more senior post in his cabinet --
spoke out in favour of the AIDS initiative. As for Mr.
Lewis, he could hardly contain himself: Canada was
doing nothing less, he said, than reasserting the
country's moral leadership in the world.

Mr. Lewis's words were certainly welcome in Ottawa.
But he is a divisive figure in the capital, the
subject of both high praise and much criticism.

Ms. Whelan's office, in particular, had chafed over
the years at his low estimation of Canada's commitment
to the fight against AIDS. Officials in the Canadian
International Development Agency, which Ms. Whelan
oversees and is the major conduit for Canada's AIDS
expenditures, believe that Mr. Lewis -- as a Canadian
-- singled his own country out unfairly.

CIDA has committed $150-million to Mr. Lewis's primary
vehicle -- the Global Fund to Fight HIV/AIDS,
Tuberculosis and Malaria. As well, Ottawa has
earmarked $270-million through 2005 for
social-development priorities, especially concerning
AIDS, and Mr. Chr=E9tien made a commitment at Kananaskis
of $50-million for AIDS vaccine research. This makes
Canada, by federal calculations, the world's
seventh-largest donor to AIDS efforts. Hardly
deserving of condemnation, in the eyes of the
bureaucrats delivering the programs.

More galling still was that Ms. Whelan had met with
Mr. Lewis about a year ago and had asked for proposals
for which CIDA could help. An aide says Mr. Lewis's
staff did not respond. Some in Ottawa wondered whether
Mr. Lewis just wasn't a fan of CIDA's work.

Two floors above Ms. Whelan's office, though, Mr.
Lewis was making a different impression. Ms. McLellan,
galvanized by a newspaper article last January about
Mr. Lewis's efforts in Africa, had invited him to
Ottawa to discuss what her department could do to
help.

Ms. McLellan's staff produced a "concept paper" that
praised much of CIDA's work but noted that aspects of
the fight against AIDS in poor countries weren't being
addressed through Canada's existing efforts.

Drug costs, the unreleased document stated, are one
impediment. But the paper highlighted the World Health
Organization's target of two million Africans in
treatment programs by 2005 (the number now is no more
than 75,000), and concluded that Ottawa could play a
significant role in delivering comprehensive care
programs, including new antiretroviral drugs.

Ottawa's tight fiscal situation now blocks Ms.
McLellan's proposal. But the philosophy of leadership
was the very rationale used by the six ministers in
pressing forward with the drug initiative, which need
not cost Ottawa anything so long as it has no impact
on domestic investment. Big impact, low cost -- what
could make politicians happier?

Yesterday, Mr. Boudria said he has obtained the
general support of the four opposition parties to push
through Parliament the needed changes to the Patent
Act.

A final decision still depends on the wording of the
amendments. But Mr. Rock, whose department remains in
charge of drafting the legislation, said on Thursday
that Ottawa's goal is to have the process completed
before Christmas.

Mr. Pettigrew, for his part, emphasized yesterday that
Canada is now on track to become the first country to
move forward with this measure, one of huge global
importance.

"We may well become the model," he said.

[ends]



Richard Elliott
Director, Policy & Research / Directeur, politiques et recherche
Canadian HIV/AIDS Legal Network / R=E9seau juridique canadien VIH/sida
890 Yonge Street, Suite 700, Toronto, Canada M4W 3P4
Tel : +1 (416) 595-1666 Fax +1 (416) 595-0094
E-mail: relliott@aidslaw.ca Web: www.aidslaw.ca

The Canadian HIV/AIDS Legal Network is a partner organisation of the
AIDS Law Project of South Africa, and a non-governmental organization in
Special Consultative Status with the Economic and Social Council of the
United Nations. //
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Law Project
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et social des Nations Unies.

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