[Ip-health] Open Letter to WHO/UNAIDS India re Margaret Chan's Comments on Thai CL

[chan park]

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Dr. Samlee Plianbangchang
  World Health Organization
Regional Office for South-East Asia
World Health House
Indraprastha Estate
Mahatma Gandhi Marg
New Delhi 110 002, India
  Fax: +91.11.23370197

  Dr. S. J. Habayeb
  World Health Organization
  India Office
  534, =93A=94 Wing, Nirman Bhawan,
  Maulana Azad Road,
  New Delhi =96 110 011
  Fax: +91.11.2301.2450

  Dr. Denis Broun
  UNAIDS
  A2/35 Safdarjung Enclave
  New Delhi 110029
  Fax: +91.11.4135.4534

  9 February 2007

  Dear Drs. Plianbangchang, Habayeb and Broun:

  We write to express our dismay at some comments that Dr. Margaret Chan, t=
he new Director General of the World Health Organization, was reported as h=
aving made during her recent visit to Thailand=92s National Health Security=
 Office.  In response to Thailand=92s recent decisions to improve its citiz=
ens=92 access to essential medicines by issuing compulsory licenses on thre=
e essential drugs, she allegedly stated, =91=91I=92d like to underline that=
 we have to find a right balance for compulsory licensing. We can=92t be na=
ive about this. There is no perfect solution for accessing drugs in both qu=
ality and quantity.=94

  These comments, if accurate, not only represent an attitude which is not =
in conformity with WHO=92s mandate to attain, for all peoples, the highest =
possible level of health, but also reflect a deeply flawed understanding of=
 the compulsory licensing mechanism and its indispensability in promoting a=
ccess to essential medicines.  As Dr. Chan=92s first public comments on thi=
s crucial topic, we harbour grave reservations about her ability to carry f=
orward Dr. Lee Jong-wook=92s legacy of promoting access to treatment for th=
ose most in need.

  Dr. Chan=92s observation that we have to find a =93right balance=94 for c=
ompulsory licensing appears to imply that the financial concerns of the pat=
ent holding pharmaceutical companies must be given equal weight against the=
 urgent need to provide lifesaving treatment to those who are unable to aff=
ord the exorbitant prices that these patent monopolies create.  Such an att=
itude is not in conformity with that of even the World Trade Organization, =
which stated through the Doha Declaration that the TRIPS agreement =93can a=
nd should be interpreted and implemented in a manner supportive of the WTO =
Members=92 right to protect public health, and in particlular, to promote a=
ccess to medicines for all.=94

  The Doha Declaration admits of no requirement for determining the =93righ=
t balance=94 between patent rights and patients=92 rights.  Rather, the Doh=
a Declaration places the affirmative duty on member states to use all TRIPS=
-flexibilities available to it, including the compulsory licensing mechanis=
m, to promote access to medicines for all.  As the Director General of the =
organisation responsible for promoting global health, she should be applaud=
ing, rather than condemning, Thailand=92s actions to drastically reduce the=
 costs of essential medicines for its people.

  Furthermore, we would like to question who, exactly, is being =93naive=94=
 about compulsory licensing.  When Dr. Chan claims that =93there is no perf=
ect solution for accessing drugs in both quality and quantity,=94 does she =
mean to imply that Thailand=92s decision to issue a compulsory license on c=
lopidogrel, which will have the effect of lowering the price of this critic=
al treatment for heart disease from 70 baht per day to 6 baht per day, was =
naive?  Or that a 92% reduction in cost is not something close to a perfect=
 solution?  Or, perhaps, that switching to the Thai GPO=92s or Indian manuf=
acturers=92 generic versions would be a sacrifice in quality in exchange fo=
r quantity?  As these comments came without explanation or elaboration, we =
are left bewildered as to their meaning.  At the very least, we feel that w=
e are entitled to an explanation.

  In September of 2003 WHO and UNAIDS declared the lack of access to ART fo=
r HIV/AIDS a =93global health emergency=94. Countries like Thailand and Ind=
ia are responding to this and other emergencies in access to affordable med=
ication by using all means necessary to ensure that the right of every pers=
on to the highest attainable standard of health =96 an international law an=
d human rights obligation higher than that of TRIPS =96 is not compromised =
by profiteering on life and death.

  As the India office, we trust that you are aware of and understand the cr=
itical importance of measures like compulsory licensing in ensuring access =
to treatment. We urge you to communicate to WHO HQ the importance of priori=
tizing peoples=92 health over the monopoly and profits of pharmaceutical co=
mpanies and the detrimental impact of Dr Chan=92s statements on treatment a=
ccess.

  Developing countries asserting the right to life and health of their peop=
le must be fully and publicly supported by the WHO and UNAIDS.

  Sincerely,

  Delhi Network of Positive People
  Indian Network for People Living with HIV/AIDS
  Affordable Medicines and Treatment Campaign
  Community Health Cell


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