[Ip-health] Fwd: News from Atimes Online on WHO and US

[James Love]

For those who did not read the web version, here is the text of the
very interesting and disturbing story that Susan Sell referred to.
Jamie

* According to senior and middle-ranking WHO officials familiar with
the situation, Lee blatantly bent to US government pressure in March
when he made the controversial decision to recall the WHO country
representative to Thailand, William Aldis, who had served less than
16 months in what traditionally has been a four-year or longer posting.

* Aldis had made the mistake of penning a critical opinion piece in
the Bangkok Post newspaper in February that argued in consonance with
WHO positions that Thailand should carefully consider before
surrendering its sovereign right to produce or import generic life-
saving medicines as allowed by the World Trade Organization (WTO) in
exchange for a bilateral free-trade agreement (FTA) with the United
States, which is currently under negotiation.

* The WHO official also wrote that the stricter intellectual-property
protection measures in the proposed US-Thai FTA would inevitably lead
to higher drug prices and thereby jeopardize the lives of "hundreds
of thousands" of Thai citizens who now depend on access to locally
produced cheap medicines to survive. He noted too that the Thai
government's current production of generic treatments had allowed the
country to reduce AIDS-related deaths by a whopping 79%.

* A US ambassador to the UN in Geneva paid a private visit to Lee on
March 23 to express Washington's displeasure with Aldis' newspaper
commentary, according to WHO officials familiar with the meeting. A
follow-up letter from the US government addressed to Lee strongly
impressed Washington's view of the importance of the WHO to remain
"neutral and objective" and requested that Lee personally remind
senior WHO officials of those commitments, according to a WHO staff
member who reviewed the correspondence.  The next day, Lee informed
the regional office in New Delhi of his decision to recall Aldis.

* Suwit Wibulpolprasert, senior adviser to the Thai Ministry of
Public Health, early this month sent a formal letter to acting WHO
director general Anders Nordstrom, requesting an official explanation
for Aldis' abrupt removal.  According to a WHO official in Geneva
with knowledge of the correspondence, the letter raised questions
about possible US influence behind the irregular personnel rotation
and said that if the WHO decision was motivated by Aldis' comments on
the US-Thai FTA, then the WHO should reconsider the transfer.

* Suwit also raised his concerns about the level of transparency and
freedom of speech inside the WHO. In e-mail communication with this
correspondent, Suwit said WHO officials had already denied that
Aldis' recall was related to the opinions stated in the Bangkok Post
article. A regional WHO official in New Delhi told a senior Thai
public-health official that Aldis' removal was related to
"inefficiency" in performing his functions - a characterization that
Thai officials who worked alongside him through the 2004 tsunami and
ongoing avian-influenza scare have privately contested.



http://www.atimes.com/atimes/Southeast_Asia/HF17Ae01.html

Asia Time Online - Daily News

AN ATol INVESTIGATION
World health: A lethal dose of US politics
By Dylan C Williams

BANGKOK - When World Health Organization (WHO) director general Lee
Jong-wook died of a cerebral hemorrhage last month before the start
of the United Nations agency's annual World Health Assembly, the
world's most prominent public-health official was arguably of a
conflicted mind.

The WHO veteran was caught in the middle of an intensifying global
debate over how to reconcile intellectual-property protection with
the pressing public-health need to expand access to expensive life-
saving medicines, a hot-button issue that has sharply divided WHO
member states along developed- and developing-country lines.

An Asia Times Online investigation reveals that at the time of his
death, Lee, a South Korean national, had closely aligned himself with
the US government and by association US corporate interests, often to
the detriment of the WHO's most vital commitments and positions,
including its current drive to promote the production and marketing
of affordable generic antiretroviral drugs for millions of poor
infected with the human immunodeficiency virus (HIV), which can cause
AIDS.

According to senior and middle-ranking WHO officials familiar with
the situation, Lee blatantly bent to US government pressure in March
when he made the controversial decision to recall the WHO country
representative to Thailand, William Aldis, who had served less than
16 months in what traditionally has been a four-year or longer posting.

A wrong opinion
Aldis had made the mistake of penning a critical opinion piece in the
Bangkok Post newspaper in February that argued in consonance with WHO
positions that Thailand should carefully consider before surrendering
its sovereign right to produce or import generic life-saving
medicines as allowed by the World Trade Organization (WTO) in
exchange for a bilateral free-trade agreement (FTA) with the United
States, which is currently under negotiation.

The WHO official also wrote that the stricter intellectual-property
protection measures in the proposed US-Thai FTA would inevitably lead
to higher drug prices and thereby jeopardize the lives of "hundreds
of thousands" of Thai citizens who now depend on access to locally
produced cheap medicines to survive. He noted too that the Thai
government's current production of generic treatments had allowed the
country to reduce AIDS-related deaths by a whopping 79%.

Aldis' arguments directly mirrored stated WHO positions, but
significantly were at direct odds with the objectives of current US
trade policy, which through the establishment of bilateral FTAs aims
to bind signatory countries into extending their national
intellectual-property legislation far beyond the parameters of
current WTO agreed standards.

A recent US Congressional Research Service report states that the
United States' main purpose for pursuing bilateral FTAs is to advance
US intellectual-property protection rather than promoting more free
trade. The Bipartisan Trade Promotion Authority Act of 2002, the
applicable US legislation for bilateral FTAs, states explicitly that
Trade-Related Intellectual Property Standards, or TRIPS, are by law
non-negotiable and must reflect a standard of protection similar to
that found in US law.

A US ambassador to the UN in Geneva paid a private visit to Lee on
March 23 to express Washington's displeasure with Aldis' newspaper
commentary, according to WHO officials familiar with the meeting. A
follow-up letter from the US government addressed to Lee strongly
impressed Washington's view of the importance of the WHO to remain
"neutral and objective" and requested that Lee personally remind
senior WHO officials of those commitments, according to a WHO staff
member who reviewed the correspondence.

The next day, Lee informed the regional office in New Delhi of his
decision to recall Aldis.

Perhaps strategically, Aldis' removal coincided with the height of
Thailand's recent political crisis, and failed to generate any local
media attention at the time. Internally, Lee had characterized Aldis'
transfer to a research position of considerable less authority in New
Delhi as a promotion.

But a Geneva-based WHO official familiar with the situation said the
article "was seen as stepping over unseen boundaries which the
director general set for himself and his staff when dealing with the
US. It was a disappointing reaction, a sad reaction, but under Lee's
administration not a surprise."

Suwit Wibulpolprasert, senior adviser to the Thai Ministry of Public
Health, early this month sent a formal letter to acting WHO director
general Anders Nordstrom, requesting an official explanation for
Aldis' abrupt removal.

According to a WHO official in Geneva with knowledge of the
correspondence, the letter raised questions about possible US
influence behind the irregular personnel rotation and said that if
the WHO decision was motivated by Aldis' comments on the US-Thai FTA,
then the WHO should reconsider the transfer.

Suwit also raised his concerns about the level of transparency and
freedom of speech inside the WHO. In e-mail communication with this
correspondent, Suwit said WHO officials had already denied that
Aldis' recall was related to the opinions stated in the Bangkok Post
article. A regional WHO official in New Delhi told a senior Thai
public-health official that Aldis' removal was related to
"inefficiency" in performing his functions - a characterization that
Thai officials who worked alongside him through the 2004 tsunami and
ongoing avian-influenza scare have privately contested.

News of Aldis' transfer, which oddly was first leaked by a Bangkok-
based US official, quickly spread through the global health
organization. The June edition of the highly regarded medical journal
The Lancet, which otherwise painted a flattering portrait of Lee's
tenure, drew on anonymous WHO sources to characterize Lee's decision
on Aldis as a "clear signal of US influence on WHO".

A senior WHO official who spoke to Asia Times Online on condition of
anonymity believes that Lee's decision and its subsequent leak by the
US government was specifically designed to engender more self-
censorship among other WHO country representatives when they comment
publicly on the intersection of US trade and WHO public-health policies.

A large number of WHO staff members are employed on renewable 11-
month contracts, meaning that their standing inside the organization
is on perpetually shaky ground and hence curbs their ability to voice
critical opinions.

Mixing health and commerce
Aldis, a US national and permanent WHO staffer, was known among his
colleagues for privately airing views critical of the Bush
administration and its policy toward the WHO, particularly in
relation to the US government's alleged tendency to mix its
commercial and public-health agendas.

Aldis reportedly chafed at WHO regional headquarters' instructions to
receive representatives from US corporations and introduce them to
senior Thai government officials to whom the private company
representatives hoped to sell big-ticket projects and products.

In recent months, major US companies such as pharmaceutical giant
Pfizer and technology company IBM have asked the WHO in Thailand to
facilitate access to senior Thai officials. In turn, some senior WHO
staff members have expressed their concerns about a possible conflict
of interests, as the requested appointments were notably not related
to any ongoing WHO technical-assistance program with the Thai
government.

It's not the first time that the US has played hardball with the WHO
and Thailand. In 1998, when member nations proposed that the WHO be
granted more power to monitor international trade agreements and
their effects on global public health, particularly in relation to
the access to patented medicines in developing countries, the US
government threatened to withhold funding to the organization.

Under that financial threat, the WHO has since largely refrained from
commenting critically on the drug-patent issue. International and
independent non-governmental organizations (NGOs) such as Oxfam and
Medecins Sans Frontieres have filled the WHO's leadership vacuum on
the issue by filling the information gap with highly critical
research reports.

 From the United States' perspective, Aldis, and by association the
WHO, had publicly sided with Thailand on the pivotal drug-patent
debate during a crucial stage in the FTA negotiations. Washington
reportedly hopes that the comprehensive deal it is pursuing with
Thailand will serve as a template for other bilateral trade pacts in
the region, including soon-to-be-negotiated deals with Malaysia and
Indonesia.

Thai civil-society groups, meanwhile, have complained about the lack
of transparency surrounding the negotiations, which caretaker Prime
Minister Thaksin Shinawatra has unilaterally conducted without
consultations with parliament.

The US and Thailand have in the past sparred over the Thai
government's decision to use its WTO-approved compulsory licensing
rights to produce certain generic antiretroviral drugs for HIV
carriers and AIDS sufferers. In 2001, for example, Washington
threatened retaliatory trade sanctions, including curbs on sensitive
Thai export products, if the Thai government allowed the production
of certain generic antiretroviral drugs.

Thai activists, meanwhile, have given certain US pharmaceutical
companies legal fits. In 2001, for instance, they challenged the
legality of US pharmaceutical company Bristol Meyer Squibb's patent
over the antiretroviral drug didanosine, or DDI, because it was
originally developed by a public US agency, the National Institutes
of Health.

In 2002, a Thai court cited international statutes when it ruled that
Thai HIV/AIDS patients could be injured by patents and had legal
standing to sue if drug makers holding patents restricted the
availability of drugs through their pricing policies.

The verdict was upheld in January 2004, and as part of an out-of-
court settlement Bristol Meyer Squibb decided to "dedicate the [DDI]
patent to the people of Thailand" of that particular version of the
drug by surrendering it to the Thai Department of Intellectual Property.

The dedication, however, did not carry over to third countries. Under
the provisions of a US-Thai FTA, future legal challenges to US-held
drug patents would be nearly impossible, Thai activists and
international NGOs contend.

WHO at the crossroads
Lee's unexpected death has already engendered some serious soul-
searching inside the WHO. Lee was widely lauded after his death, but
his final legacy to the organization he served for 23 years is very
much in doubt.

US President George W Bush said, "Lee provided tremendous leadership
to the international community as it confronted the challenges of the
21st century." UN Secretary General Kofi Annan, Microsoft founder
Bill Gates and former US president Jimmy Carter all made similar
eulogies to Lee's long commitment to improving global public-health
standards.

Lee frequently denied allegations that US political pressure
influenced his decision-making, most notably perhaps during a recent
television interview with the British Broadcasting Corp. However, it
is just as likely that Lee will be remembered for the many times he
caved to US pressure on crucial public-health issues, frequently in
areas where WHO positions and commitments required that he take a
stronger stand, some WHO officials contend.

Moreover, the secretive way that Lee sometimes conducted WHO
business, apparently in some instances at the United States' behest,
already has some officials inside the UN agency talking about the
need for greater transparency and accountability under the next
director general. "It will be very rough waters ahead for the new
[director general]," said a Geneva-based WHO official, speaking on
condition of anonymity.

As the United States' strong influence over Lee comes into posthumous
light, the selection process for his replacement will almost
certainly be politicized along rich- and poor-country lines, and if
the US openly pushes its favored candidate, that divide could widen
into a full-blown schism inside the traditionally cohesive
organization. Those sharp lines are already emerging.

A report by a WHO-mandated independent commission recently
recommended that as a general rule governments should avoid bilateral
free-trade treaties that reduce access to medicines in developing
countries. An annex to that report, signed by mainly Western experts
who adhered to positions held by big pharmaceutical companies,
highlighted the glaring differences in opinion emerging among WHO
member states.

For its part, the US has long advanced the argument that without
strong intellectual-property protection, the pharmaceutical industry
will not have the commercial incentive to conduct research and
development for crucial new medicines.

However, Brazil and Kenya recently claimed that about 90% of total
global health-related research and development of Western
pharmaceutical companies went toward addressing the medical needs of
about 10% of the world's population. Those two countries have since
called on the WHO to adopt systems for intellectual-property
protection that would increase developing countries' access to health
innovations and medicines.

WHO staffers say they resent what they view as the United States'
political agenda toward vital public-health concerns, ranging from
reproductive-health issues to promoting good dietary standards.

At the 2004 World Health Assembly (WHA), the US broke with the
meeting's proposed resolution that reproductive and sexual rights
should be considered human rights, and strongly protested the
meeting's focus on the public-health risks of unsafe abortions.
Lee had earlier that year held up a list of essential WHO-recommended
medicines drafted by an independent expert committee for more than
two months because of US objections about two listed abortifacient
drugs that could be used to induce abortions in emergencies.

The US delegation to another recent WHA took issue with a WHO-
proposed diet and health resolution, particularly concerning the
acceptable level of sugar content in foods, which by the WHO's expert
assessment would have cast US fast-food and soft-drink companies in
an unfavorable light. Lee famously bent to the US objections and
signed off on a significantly watered-down version of the original
resolution.

US interference with UN personnel and policy decisions, of course,
isn't an entirely new phenomenon. The US is the largest donor to the
UN and by association to the WHO, and in light of the US-inspired
events in Bangkok, senior WHO representatives throughout the
organization are likely to be more guarded when commenting on public-
health issues that Washington considers sensitive.

The Bush administration's tactics, often cloaked as reform measures,
in reality aim to bring UN agencies like the WHO more in line with US
commercial and political interests.

At the WHO, at least, that process has come at the expense of the UN
agency's stated mission, commitments and, perhaps most significant,
its global credibility as an impartial and apolitical actor.

Dylan C Williams is a Bangkok-based correspondent.