[Ip-health] Patents, medicines and lobbies

[Ira Glazer]

http://www.atimes.com/atimes/Southeast_Asia/HF24Ae01.html

According to a recent Asia Times Online report (World health: A lethal
dose of US Politics, June 17), the World Health Organization's country
representative to Thailand, William Aldis, was removed for expressing
views contrary to Western corporate interests. Such arm-twisting is
neither new to international organizations nor unbelievable - nor even
unexpected.

Many global organizations, including the United Nations, offer "freedom
of speech" without guaranteeing "freedom after the speech". If the
report is correct, Aldis I salute you. Poor people in the Third World
need more advocates like you. I wholeheartedly endorse the view that
corporate interests have obstructed the global poor's access to
medicines. The mechanism that works against the poor and in favor of the
rich multinationals is more of an invisible arm-twisting rather than a
problem of reaching an agreement at the negotiating table.

What is important to realize is that this is just a part of a bigger
problem. The reality of today's globalization is that in trade
negotiations, governments - whether in the developed or the
underdeveloped world - are steered both by strong domestic lobbies and
by pressure groups, which include multinational companies,
agriculturists' and industrialists' groups, trade unions, and other
politically powerful entities whose particularistic interests don't
necessarily represent the broad national interest.

On an intellectual plane, rich countries argue that protection of the
patents is necessary to enable them to continue research and development
to produce better medicines. On a "situation on ground" basis, however,
the interests of millions of patients suffering from lethal epidemics
cannot just be ignored.

The statistics are uncomfortable from a humanitarian perspective. Total
consumption of medicines in the Third World constitutes just a small
fraction of the total global pharmaceutical market. The main consumer
market of pharmaceutical products lies in the United States, the
European Union and Japan. And it is only a few medicines that save and
critically affect the lives of hundreds of millions of people in the
poorer parts of the globe.

What is vital from a welfare point of view represents only a small slice
of the world pharmaceutical industry's revenues and sales. People
starving in Africa and South Asia do not demand anti-wrinkle creams or
fancy weight-reducing pills, which constitute a major share of
pharmaceutical sales in the US or EU.

The WTO's Trade-Related Aspects of Intellectual Property Rights (TRIPS)
agreement provides ample flexibility to poor countries to safeguard
their vital public-health interests. While the agreement had its own
inadequacies, it notably gave strength and protection to the Third World
through not only the right to grant compulsory licenses but also the
freedom to determine the grounds on which such licenses could be granted.

That is, individual countries rather than the World Trade Organization
(WTO) had the latitude to determine what constituted a national
public-health emergency, including outbreaks of "HIV/AIDS, tuberculosis,
malaria and other epidemics". That is not to say that TRIPS was all rosy
for the poor. The agreement - like many other Uruguay Round agreements -
had several issues that needed to be resolved.

The WTO Doha Declaration of November 2001 gave further assurances to
poor countries. Global trade ministers recognized that members with
insufficient or no manufacturing capacities in the pharmaceutical sector
could face difficulties in making effective use of compulsory licensing
under TRIPS. They instructed the WTO's Council for TRIPS to find an
expeditious solution to this problem and to report to the General
Council before the end of 2002.

Further, the ministers reaffirmed the commitment of developed-country
members to provide incentives to their enterprises and institutions to
promote and encourage technology transfer to least-developed countries.
Above all, the declaration clearly and categorically stated that the
TRIPS agreement can and should be interpreted and implemented in a
manner supportive of WTO members' right to protect public health and, in
particular, to promote access to medicines for all. Such an expression
in the declaration gave primacy to ensuring access of the poor to cheap
medicines over protection of intellectual-property rights.

With all those on-paper assurances, why does the issue still linger on,
and linger on in such huge dimensions? For starters, there is no doubt
that the developed world still needs to do a lot to fulfill its Doha
commitments to the developing one. The important question is whether
that's all that needs to be done.

There is an urgent need for soul-searching on the part of poor countries
as well. Drug patents were one of the many issues that led to
post-Uruguay Round friction between the WTO's developed and
underdeveloped member states. Other important issues that fell in the
category were those related to agricultural subsidies, cotton and textiles.

These and a bundle of other issues were reopened at Doha in 2001. Five
years later, there have been endless discussions and raucous street
protests by non-governmental organizations (NGOs) on agricultural
subsidies and non-agricultural tariffs. Granted, a lot of actual
progress on these contentious issues has been achieved. But it is still
urgent for poor countries to achieve a more unified voice on issues that
lack strong domestic lobby groups.

By contrast, how much emphasis have Third World governments put on drug
patents? In today's Internet-connected world, readers can go straight to
the WTO website and read the developing-world ministers' statements at
recent WTO meetings in Cancun and Hong Kong. Compare the emphasis that
they put on drug issues with that of agricultural subsidies and
textiles. Improving access to patented medicines has not received even
5% of the attention that agricultural subsidies have. It would appear
that developing-world commerce ministries are being steered by their own
lobby groups, similar to the way the industrialized world's agenda is set.
It is clear that the issue of medicines to the poor is far more
important - most certainly from a welfare point of view - for a larger
number of developing countries than developed-world agricultural
subsidies. Why is it that these subsidies have been a favorite of the
developing-country governments, while the issue of drug patents has been
raised only by NGOs and humanitarian organizations such as Oxfam and
Medecins Sans Frontieres? There have been dozens of declarations made at
various Third World forums on the issue of agricultural and
non-agricultural tariffs, but one would be hard-pressed to unearth
similar proclamation on provision of medicines for the world's poor.

While such issues as agricultural subsidies are tied to strong
feudalistic lobbies, access to patented, life-saving medicines cuts
across the world's poor without a strong unified voice or pressure
group. Lack of domestic pressure on developing-world governments has
contributed to the problem, similar to the way corporate lobby pressure
against the Western governments has. It is not my objective to shift the
criticism from industrialized to Third World governments, but rather to
see the drug-patent issue in a wider view.

M Javed is a medical doctor and author of the book Chessboard of WTO.