[Ip-health] Sign-on to expand WHO Essential Medicines List for products that are cost effective "if available at generic prices"

[Aelaf Worku]

Dear Pharmacy, Public Health, Medical Students and Faculty,

The following is a letter we are circulating for signatures, asking the WHO=
 to expand it's model Essential Medicines List, to include a category for p=
roducts that would be included, "if available at generic prices." Right now=
, there are only 16 patented medicines on the EML, all but two of which are=
 for treatment on one disease -- AIDS.   We want to give this letter to mem=
bers of the WHO's governing body the week of May 14. If you are willing to =
sign, send your name and medical school affiliation to:

fix.the.who.eml@gmail.com

Aelaf Worku, Medical Student ,The Mount Sinai School of Medicine

Please circulate for signatures until May 12, 2007.


Open Letter to the World Health Organization Intergovernmental Working Grou=
p on Public Health, Innovation, and Intellectual Property

We, the undersigned students and faculty of pharmacy, public health and med=
icine, are writing to request a specific reform in the composition of the W=
orld Health Organization's (WHO) model  Essential Medicines List (EML).   T=
his reform is necessary to implement the mandate set out in a variety of Wo=
rld Health Assembly resolutions concerning the need to expand access to med=
icines.  We are deeply familiar with the importance of medications in safeg=
uarding the health of patients.  New drugs continue to elevate the standard=
 of care for countless diseases and extend and improve lives.  Ensuring tha=
t our future patients and patients everywhere, have access to these medicat=
ions is of the utmost concern.  To this end, we applaud the February 7, 200=
7 statement of WHO Director General Dr. Margaret Chan that "WHO unequivocal=
ly supports the use by developing countries of the flexibilities within the=
 TRIPS agreement that ensure access to affordable, high quality drugs."

We are concerned, however, that the WHO's EML does not fully reflect this s=
upport.  WHO evaluates whether medicines are sufficiently cost effective fo=
r inclusion in the list on the basis of current market prices, ignoring low=
er generic prices available to countries that employ patent flexibilities s=
upported by WHO.  As a result, of the 312 medicines on the list, only 16 ar=
e newer patented drugs, including 14 for the treatment of AIDS.  Not a sing=
le patented drug for a non-communicable disease is included =96not for canc=
er, not for diabetes, not for ischemic heart disease.  This is despite the =
fact that non-communicable diseases are the leading cause of mortality in l=
ow-income countries, and that many new drugs offer substantial improvements=
 in the treatment of non-communicable disease.

The existence of a WHO "Essential Medicines List" which does not contain a =
single patented medicine for non-communicable diseases provides rhetorical =
cover for those who oppose public health exceptions to patent laws and who =
argue that patients in developing countries should not expect treatment for=
 "Western" diseases.  The current list also offers little guidance to devel=
oping countries exploring legal, WHO supported options for obtaining drugs =
at lower cost.

For these reasons, we ask the WHO Intergovernmental Working Group on Public=
 Health, Innovation and Intellectual Property to support a change in the EM=
L that is consistent with WHO's support for the use of TRIPS flexibilities.=
  As proposed in a March 2, 2007 request by Knowledge Ecology International=
, the WHO EML should include a category for medicines that would be include=
d in EML "if available at generic prices."  This change in the EML list wou=
ld avoid sending mixed signals on the legitimacy of patent flexibilities an=
d the medical importance of patented drugs.  It would provide developing co=
untry Health Ministries with invaluable information to more effectively neg=
otiate drug prices and make informed decisions on the use of compulsory lic=
ensing.  Finally, such a list would no longer exclude many of the most effe=
ctive drugs for millions of patients in developing countries who suffer fro=
m non-communicable diseases.

As teachers and students of medicine and health, we are firmly committed to=
 the WHO's mission of "the attainment by all peoples of the highest possibl=
e level of health."  Creating an EML that supports developing countries str=
iving to achieve the highest standard of care for all patients would be a v=
ital step towards achieving that goal. We urge the Intergovernmental Workin=
g Group to incorporate this proposal into its Global Strategy and Plan of A=
ction.

David Hoos, MD, MPH
Associate Professor of Epidemiology
Mailman School of Public Health
Columbia University

Corey Bills
Medical Student
University of Chicago Prizker School of Medicine

Aelaf Worku
Medical Student
The Mount Sinai School of Medicine

[your name and affilation will go here]