[Pharm-policy] Jim Murray's BEUC talk on access to medicine
James Love
love@cptech.org
Tue Mar 20 00:40:01 2001
-------------------
Date: Mon, 19 Mar 2001 19:33:50 +0100
From: "jim.murray@chello.be" <jim.murray@chello.be>
To: "'love@cptech.org'" <love@cptech.org>
European Consumers' Day
Address by Jim Murray, Director of BEUC, the European Consumers
Organisation, to the conference to mark the third annual European Consumers
Day
Brussels
15th March 2001, 11.00AM
I am grateful for the invitation to join you here today in plenary session
to mark the third European Day of the Consumer. The issues of food quality,
safety and nutrition are indeed topical, partly for unfortunate reasons,
and I look forward to the outcome of the panel discussions later today. I
will not talk about food in my intervention but rather about two more
general issues of importance to European Consumers, one within a specific
EU context and the other with European and global dimensions. It is good
to see and hear so many representatives of different EU institutions
supporting here the cause of European consumers. May I appeal to you, each
in your own institution, to develop an action programme to give concrete
expression to the new provisions on consumer policy in the Amsterdam
Treaty. These provisions for the better integration of consumer policy in
EU policies were supported by all the member states and of course bind the
institutions represented here. BEUC has been calling for some time for the
institutions each to prepare their own programme for giving effect to these
provisions but so far without much positive response. Could I set this task
as a challenge for you over the 364 days before the next European Day of
the Consumer? (When we quote the provisions of the Amsterdam Treaty as a
sign of hope for the future, many journalists and others say " But you know
they mean nothing". Please prove them wrong.)
This is European Consumers' Day but it is also the day designated by
Consumers International as World Consumer Rights Day and the theme chosen
for this year is Corporate Citizenship in the Global Marketplace. In Europe
we have seen in recent years a substantial increase in interest in
Corporate Social Responsibility and this is the main subject of my
intervention today.
Corporate Social Responsibility may be driven by marketing considerations
or may be little more than an exercise in "reputation management". It can
also arise from enlightened self-interest and may also be driven by men and
women of genuine good will who welcome the possibility of doing certain
good things in the course of their employment. Nevertheless it seems to me
that there is one fundamental flaw in the move towards Corporate Social
Responsibility. It does not usually extend to the core political and public
policy agendas that the companies seek to promote, particularly at the
level of the world trading system.
Take, as an example, the current (and increasingly notorious) court case
where 40 pharmaceutical companies are seeking to enforce their patent
rights in South Africa. The list of corporate plaintiffs is a long one
(see Slide 1) and shows that the world-wide pharmaceutical companies are
united and fiercely determined to pursue a particular policy goal. That
goal is to ensure that they, and they only, will control the supply,
distribution and price of patented medicines world-wide.
This is an exercise in power and control and a policy that is morally
repugnant. It also shows the absolute irrelevance of corporate social
responsibility to the core commercial trading and public affairs policies
of the companies concerned.
I am not indulging in the usual anti-multinational and anti-globalisation
rhetoric that is so prevalent nowadays. I am making a specific criticism
of the specific public policy goals pursued by a specific industry. I am
not against the profit motive or the protection of intellectual property.
I recognise the utility of both and the fact that without them we would
not have most of the medicines we have today. I also recognise the
potential benefits of trade liberalisation. On balance, BEUC supported
ratification of the Uruguay Round although we were strongly critical of the
TRIPs agreement. My criticism of the pharmaceutical industry is that it
has used its economic and political power to shape world-trading rules
largely to its benefit and to the detriment of developing countries. The
industry pressed for the TRIPs agreement in the Uruguay Round and now uses
or abuses that agreement to deny access to medicines in the third world.
Countries that can hardly secure the most elementary security and rights
for their citizens must give priority to enforcing patent laws.
In the negotiations for the Uruguay Round, the pharmaceutical industry
pressed hard for the TRIPs agreement under which countries who want
admission to the world trading system would eventually have to ensure
respect in their national laws for patent rights to medicines and other
products. This requirement was qualified by a compulsory licensing
provision by which a country could insist that certain medicines be
manufactured under license on terms to be settled between the parties. The
pharmaceutical industry has mustered its formidable legal, economic and
political power to oppose even that limited option. I say political power
also because for many years the US government was persuaded to apply
political pressure and the threat of trade sanctions to any country
contemplating compulsory licensing. The industry continues to fight the
provision by economic and legal threats, as in South Africa, or to head it
off by voluntary reductions in prices. These price reductions are not
without merit but they also ensure that the industry retain control and
power over the supply of the medicines in question.
There are many other factors that impede the delivery of medicines to poor
people in the third world. These include problems of infrastructure,
quality control, counterfeiting, compliance, lack of trained personnel and
so on but availability and price are basic factors entirely within the
control of the pharmaceutical companies. Fear of parallel imports is often
cited as a reason for the tough line adopted by the industry but I refuse
to believe that there are no other ways of counteracting that problem. I
know too that most medicines essential to the developing world are not
protected by patent, but the medicines needed to counteract the appalling
spread of AIDs and its consequences are mostly patented, and expensive.
According to MSF, about 95% of the infected people in the world have no
access to treatment that can improve the quality of life, prolong survival
and allow them to continue contributing to their families and society. For
most of them their domestic resources can hardly even begin to touch the
need - look at this list of Gross Domestic Product per infected person for
a selection of countries (Slide 2).
The current problems were neither unexpected nor unforeseen. BEUC and
other consumer organisations criticised the TRIPs agreement while it was
being negotiated and warned that it would force some countries to apply
patent laws when they could hardly enforce any other laws.
Development NGOs, including MSF have been campaigning for compulsory
licensing for many years and the Transatlantic Consumer Dialogue (TACD)
took up the same cause two years ago. At a meeting in the White House in
December we raised the issue directly with Presidents Chirac, Clinton and
Prodi. In assessing corporate social responsibility we must look at the
totality of policies pursued by the company or companies in question. More
particularly, on European Consumers Day, we must look at a company's policy
world-wide. We must not judge corporate social responsibility only by our
own direct experience in Europe. This is an essential concomitant of the
globalisation process.
Consumers International and Consumentenbond in the Netherlands are working
to develop a "Rapid Alert System for Bad Business Behaviour". The project
will pair up consumer groups in multinational corporation home and host
countries to investigate and highlight if necessary cases of double
standards and unethical corporate conduct. (Europe is home to many
trans-national corporations.) If all goes well a pilot project could be
launched during 2001.
To return to the medicines issue, many pharmaceutical companies also are
based in Europe. They value their reputation in Europe. With the US and
Japan, Europe holds the key to access to essential medicines in developing
countries. Public opinion, or consumer opinion, matters more and has more
political weight in Europe than in many other parts of the world. The EU
has an important influence in developing, implementing and interpreting
international trade rules.
One of the ironies of the current court case is that already it is seen as
a public relations disaster, and so it is. Nelson Mandela heads the list
of respondents in the case in his representative capacity as President of
South Africa. (Slide 3) He has certainly faced worse adversaries in court
before now and has emerged triumphant. To mitigate the public relations
disaster some companies have already decided to lower prices on a voluntary
basis and others may follow - perhaps even settling the case in the
process. It is essential however that this issue is not resolved on public
relations terms without any structural change in power and control.
On the wider issue of world trade, it is also morally repugnant and
contrary to any real sense of corporate social responsibility to support
the world trading system while washing ones' hands of any responsibility
for avoidable and detrimental consequences of that system. Trade policies
and trade rules can be changed and improved without damaging the profit
motive. Economic, legal and political power can be used to good ends.
Progress on trade liberalisation can and should be accompanied by progress
on non-trade areas also.
In the High Court of South Africa (Transvaal Provincial Division) Case
number: 4183/98 Applicants in order from First to Forty-second:
1.THE PHARMACEUTICAL MANUFACTURERS' ASSOCIATION OF SOUTH AFRICA 2.ALCON
LABORATORIES (S.A.) (PROPRIETARY)
3.BAYER (PROPRIETARY) LTD
4.BRISTOL-MYERS SQUIBB (PROPRIETARY) LTD
5.BYK MADAUS (PROPRIETARY) LTD
6.ELI LILLY (SOUTH AFRICA) (PROPRIETARY) LTD
7.GLAXO WELLCOME (SOUTH AFRICA) (PROPRIETARY) LTD 8.HOECSHT MARION ROUSSEL
LTD 9.INGELHEIM PHARMACEUTICALS (PROPRIETARY) LTD. 10.JANSSEN-CILAG
PHARMACEUTICA (PROPRIETARY) LTD.
11.KNOLL PHARMACEUTICALS SOUTH AFRICA (PROPRIETARY) LTD.
12.LUNDBECK SOUTH AFRICA (PROPRIETARY) LTD.
13.MERCK (PROPRIETARY) LTD
14.MSD (PROPRIETARY) LTD
15.NOVARTIS SOUTH AFRICA (PROPRIETARY) LTD
16.NOVO NORDISK (PROPRIETARY) LTD
17.PHARMACIA & UPJOHN (PROPIETARY) LTD
18.RHONE-POULENC RORER SOUTH AFRICA (PROPRIETARY) LTD
19.ROCHE PRODUCTS (PROPRIETARY) LTD
20.SCHERING (PROPRIETARY) LTD
21.SCHERING-PLOUGH (PROPRIETARY)
22.S.A. SCIENTIFIC PHARMACEUTICALS (PROPRIETARY) LTD
23.SMITHKLINE BEECHAM PHARMACEUTICALS (PROPRIETARY) LTD
24.UNIVERSAL PHARMACEUTICALS (PROPRIETARY) LTD
25.WARNER-LAMBERT S.A. (PROPRIETARY) LTD
26.WYETH (PROPRIETARY) LTD
27.XIXIA PHARMACEUTICALS (PROPRIETARY) LTD
28.ZENECA SOUTH AFRICA (PROPRIETARY) LTD
29.BAYER AG
30.BOEHRINGER-INGELHEIM INTERNATIONAL GmbH
31.BOEHRINGER-INGELHEIM KG
32.BRISTOL-MYERS SQUIBB COMPANY
33.BYK GULDEN LOMBERG CHEMISCHE FABRIK GmbH
34.DR. KARL THOMAE GmbH
35.ELI LILLY AND COMPANY
36.F HOFFMAN-LA ROCHE AG.
37.MERCK KGaA
38.MERCK & CO., INC.
39.RHONE-POULENC RORER S.A.
40.SMITHKLINE BEECHAM
41.WARNER-LAMBERT COMPANY
42.OLIVER CORNISH - Pharmacist
GDP Per Person Living With HIV/AIDS
Country Estimated number of people living with HIV/AIDS, end 1997 1 GDP
per person living with HIV/AIDS (US dollars)
Finland 500 239,668,000
Sweden 3,000 75,879,667
Germany 35,000 59,780,571
Luxembourg 300 56,563,333
Denmark 3,100 54,850,645
United Kingdom 25,000 51,459,520
Ireland 1,700 44,135,294
Belgium 7,500 32,336,400
Austria 7,500 27,497,600
Netherlands 14,000 25,734,143
Greece 7,500 16,392,800
Italy 90,000 12,728,444
France 110,000 12,659,100
United States of America 820,000 9,553,702
Spain 120,000 4,433,617
Portugal 35,000 2,918,086
South Africa 2,900,000 44,515
Ghana 210,000 32,781
Cote d'Ivoire 700,000 14,644
Uganda 930,000 7,077
Kenya 1,600,000 6,400
Central African Republic 180,000 5,661
Rwanda 370,000 5,035
Zambia 770,000 5,019
United Rep. of Tanzania 1,400,000 4,943
Ethiopia 2,600,000 2,454
Mozambique 1,200,000 2,294
1- from 1997 UNAIDS/WHO report
RESPONDANTS (FROM FIRST TO TENTH)
1. THE PRESIDENT OF THE REPUBLIC OF SOUTH AFRICA, THE HONOURABLE MR N.R.
MANDELA N.O.
2. THE SPEAKER OF THE NATIONAL ASSEMBLY, THE HONOURABLE DR. F.N.
GINWALA N.O.
3. THE CHAIRPERSON OF THE NATIONAL COUNCIL OF PROVINCES, THE HONOURABLE MR.
M.G.P. LEKOTA N.O.
4. THE MINISTER OF HEALTH, THE HONOURABLE DR. N.C. DLAMINI ZUMA N.O.
(Dr Manto Tshabalala-Msimang)
5. THE CHAIRPERSON OF THE PORTFOLIO COMMITTEE ON HEALTH [NATIONAL
ASSEMBLY], THE HONOURABLE DR. A.S. NKOMO N.O.
6. THE CHAIRPERSON OF THE SELECT COMMITTEE ON SOCIAL SERVICES [COUNCIL OF
PROVINCES], THE HONOURABLE DR. S.C. CWELE N.O.
7. THE CHAIRPERSON OF THE MEDICINES CONTROL COUNCIL, PROFESSOR P.I.
FOLB N.O.
8. THE PREMIER OF THE GAUTENG PROVINCE, THE HONOURABLE MR. M. MOTSHEKGA
N.O.
9. THE MEMBER OF THE EXECUTIVE COMMITTEE FOR HEALTH OF THE GAUTENG
PROVINCE, THE HONOURABLE MR. A. MASONDO N.O. 10.THE REGISTRAR OF PATENTS
MR. C. BURTON-DURHAM N.O.