[Ip-health] US Pressure and Recall of WHO Thailand Rep

[Stephanie Weinberg]

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From: Phil Robertson [mailto:reaproy@gmail.com]
Sent: Saturday, June 17, 2006 1:11 AM
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Subject: [thaifta] US Pressure and Recall of WHO Thailand Rep



Asia Times, June 17, 2006 (www.atimes.com)

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.



--
Philip S. Robertson Jr.
Consultant -- Human Rights, Labor, Migration, Human Trafficking, &
Development
in Thailand: (05) 060-8406 (mobile)
   fax: (66-2) 672-0592
in US: (508) 566-2526 (mobile)
email:  Reaproy@gmail.com