[Ip-health] [Fwd: [HEALTHGAP] (Ottawa) Hill Times op-ed: Canada has an opportunity to show real leadership on 'big pharma']

[Mike Palmedo]

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Date: Mon, 27 Oct 2003 18:54:13 -0500
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From: Richard Elliott <relliott@AIDSLAW.CA>
Subject: [HEALTHGAP] (Ottawa) Hill Times op-ed: Canada has an opportunity t=
o
    show real leadership on 'big pharma'
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The Hill Times (Ottawa)
Canada's government and politics newsweekly
Monday, October 27, 2003: page 11

CANADA HAS AN OPPORTUNITY TO SHOW REAL LEADERSHIP ON 'BIG PHARMA'
by Richard Elliott

Recently, Industry Minister Allan Rock and International Trade Minister Pie=
rre
Pettigrew announced Canada would change its patent laws to give generic
pharmaceutical companies permission to produce cheaper versions of
patent-protected medicines for export to developing countries.  The Ministe=
rs
were responding to a call from Canadian civil society organizations and fro=
m
Stephen Lewis, UN special envoy on HIV/AIDS in Africa, to implement a recen=
t
agreement loosening WTO rules on patents in order to allow just such a
response.

We joined the chorus, here and abroad, congratulating the government for mo=
ving
swiftly to clear the legal path for developing countries to get more afford=
able
medicines.  We also welcomed the recent public statements by the United Sta=
tes
and Mexico that they will not use identical rules in NAFTA to block Canada'=
s
initiative, in essence agreeing to the same flexibility under NAFTA that ha=
s
just been agreed to at the WTO.

Canada will be the first country to take this step. We can set an example f=
or
others. But with that leadership role comes the responsibility to implement=
 the
WTO decision in good faith.  Canada's move is being watched closely around =
the
world by other countries contemplating similar measures to test the new
flexibility of WTO rules.  And, with one-third of the world's population
lacking access to even essential medicines =96 some 2 billion people by the=
 World
Health Organization's estimate =96 the world desperately needs other countr=
ies to
follow suit.  Canada's approach can set a precedent.

This is why, beyond the headlines, the fine print of Canada's legislative r=
eform
matters.  So far we have heard vaguely worded promises of action, with freq=
uent
references to "AIDS drugs", "pandemics" and "health emergencies". Conspicuo=
usly
absent is any reference to medicines for other diseases and for situations
other than crises.  It is time for the Ministers to publicly commit that Ca=
nada
will not limit its initiative to such narrow circumstances or a handful of
diseases.

Why is this significant?  Because of what has happened in the almost two ye=
ars
it has taken for countries to agree on loosening WTO rules to allow generic
medicine exports.  During that time, some developed countries (led by the
United States) and the brand-name drug companies pushed hard to limit the s=
cope
of any such agreement. They even attempted to limit any supply of generic
medicines to just those needed for treating specific "epidemic" diseases (s=
uch
as HIV/AIDS, tuberculosis and malaria) and only in cases of "emergencies".

The gall of this effort was all the more shocking given an earlier unanimou=
s
declaration by WTO countries that WTO rules should be interpreted and
implemented in a way that allows countries "to promote access to medicines =
for
all", with no such qualifications or caveats. Furthermore, developing count=
ries
represent but a very small portion of the companies' total sales and profit=
s,
meaning competition from generic producers in those markets will have littl=
e or
no impact on their incentive to invest in researching new medicines.

Fortunately, this misguided attempt to compromise global health failed.
Developing countries and human rights activists rejected these cynical
proposals to leave poor people to suffer and die without medicines unless t=
heir
illness were on an "approved" list.  They rejected as equally unsound the
notion that developing countries should only have affordable medicines once
problems have reached "emergency" proportions.  Such proposals are ethicall=
y
repugnant and unsound from a public health perspective.

This is why, as Canada now moves to amend its patent laws, we must remember=
 that
avoiding such limitations was the outcome of an intense global debate at th=
e
WTO.  Why would Canada re-open a settled debate and renege on the internati=
onal
WTO agreement it has just endorsed?  Countries have agreed to address the
"public health problems" facing developing countries.  Nowhere do WTO rules=
 say
Canada may allow exports of generic medicines only for "epidemic" diseases,=
 or
only for infectious diseases, or only for specifically named diseases.  Not=
hing
in WTO rules prevents Canadian manufacturers from supplying generic medicin=
es
to developing countries before their health problems become health crises. =
 As
the first nation to take advantage of the recent WTO decision, Canada shoul=
d
not undermine its full benefit by re-introducing such restrictions, to the
detriment of poor people in developing countries.

Therefore, the question for Ministers Rock and Pettigrew =96 and indeed, fo=
r
current and future Prime Ministers Chr=E9tien and Martin, who have often st=
ated
their concern for the welfare of developing countries =96 is whether Canada=
 will
arbitrarily and unnecessarily limit our country's response to the health ne=
eds
of the developing world.

Ministers, will you introduce legislation that allows access to cheaper
medicines for people in developing countries only if they have specific
illnesses and if their country is facing an emergency?  Would we accept suc=
h an
approach if Canadian lives were at stake?  How can it be morally or medical=
ly
right to decide that we may supply medicines for treating people with HIV/A=
IDS
or malaria but not people with meningitis or cancer?  Why should Canada be =
in
the business of telling developing countries that a given health problem is=
 not
serious enough to constitute an "emergency" and therefore poor people must =
go
without medicines until more of them are ill or dead?

Canada has an opportunity =96 and an obligation =96 to show leadership with=
 this
effort to increase access to affordable medicines in the developing world.
Will the government give in to pressure from "big pharma" to deny medicines
except for a handful of diseases or for emergencies?  Or will it introduce
legislation that helps as many people as possible by taking full advantage =
of
the flexibility now allowed by the recent WTO decision?

Ministers, do the right thing.  Follow through quickly on this laudable
initiative, without compromising either principle or global health.

- Richard Elliott is a lawyer with the Canadian HIV/AIDS Legal Network in
Toronto (relliott@aidslaw.ca).


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