|
Get AfricaFocus Bulletin by e-mail!
Print this page
|
Note: This document is from the archive of the Africa Policy E-Journal, published
by the Africa Policy Information Center (APIC) from 1995 to 2001 and by Africa Action
from 2001 to 2003. APIC was merged into Africa Action in 2001. Please note that many outdated links in this archived
document may not work.
|
Africa: Treatment Access Update, 1
Africa: Treatment Access Update, 1
Date distributed (ymd): 010419
Document reposted by APIC
Africa Policy Electronic Distribution List: an information
service provided by AFRICA ACTION (incorporating the Africa
Policy Information Center, The Africa Fund, and the American
Committee on Africa). Find more information for action for
Africa at http://www.africapolicy.org
+++++++++++++++++++++Document Profile+++++++++++++++++++++
Region: Continent-Wide
Issue Areas: +economy/development+ +health+
SUMMARY CONTENTS:
This posting contains a brief Africa Action commentary by director
Salih Booker on the withdrawal of the drug company law suit against
South Africa. It also includes two documents from the workshop on
drug pricing held on April 8-11, 2001 in Hosbjor, Norway, organized
by the World Health Organization, the World Trade Organization, the
Norwegian Foreign Ministry, and the Global Health Council. The
documents included are a statement by five non-governmental
organizations after the workshop and the official press release
from the workshop.
Additional background on the Norway workshop can be found at:
http://wto.org/english/tratop_e/trips_e/tn_hosbjor_e.htm
An extensive analysis of the current status of drug-pricing by
Jamie Love of the Consumer Project on Technology, entitled 'How to
Help the Poor, Really (and how not to), prepared for the Norway
workshop, can be found at:
http://lists.essential.org/pipermail/pharm-policy/2001-April/000923.html
For documentation on the South African court case, see the web site
of the Treatment Action Campaign
(http://www.tac.org.za/archive.htm).
An additional posting today has a press release on next week's OAU
summit, an NGO commentary on the proposed UN statement of position
on treatment for the UN Special Session, and a brief update on new
World Trade Organization discussions on intellectual property
rights and drug patents.
+++++++++++++++++end profile++++++++++++++++++++++++++++++
AFRICA ACTION COMMENTARY
April 19, 2001
The decision by multinational drug companies to withdraw their suit
against South Africa is a major victory for Africans and people
around the world who support Africans' equal rights to health.
Coordinated worldwide protests have had a profound impact.
At the same time, this victory does not yet bring treatment to
those in need. International agencies as well as African
governments are moving to recognize that treatment is necessary and
not optional. But meetings in the weeks since the South African
case opened on March 5 still reveal pervasive ambivalence about
what needs to be done, reluctance to open the doors widely for
lowest-cost generic production, and a false dichotomy between
treatment and prevention.
The Organization of African Unity hosts a summit on HIV/AIDS and
other diseases next week. The United Nations is in the last stages
of preparation for the UN Special Assembly Session on HIV/AIDS in
June. These meetings will set the tone for governmental and intergovernmental
policies over the next year. It is essential that they
avoid vague language and clearly affirm the universal right to
health, the legitimacy of low-cost generic medications, and
the global obligation to fund both treatment and prevention for
HIV/AIDS as part of a strategy to prioritize public health as a
fundamental human right.
Once the principles are established, the real tests will come in
practice. Are the funds quickly appropriated and spent not only for
drugs (at the lowest possible cost) but also for infrastructure to
address treatment, prevention and the underlying social injustices
that are fueling the AIDS pandemic?
Let's celebrate the victory. And let's keep the pressure on.
Salih Booker
Director, Africa Action
Joint Statement of Consumer Project on Technology (CPT), Health
Action International (HAI), Medecins sans Frontieres (MSF), Oxfam
and Treatment Action Group (TAG) on the WTO/WHO on Differential
Pricing & Financing of Essential Drugs
April 11, 2001
Hosbjor, Norway - Representatives of the five non-governmental
organizations (NGOs) who participated in the three day WHO / WTO
Workshop on Differential Pricing & Financing of Essential Drugs
issued the following joint statement on the goals, proceedings, and
outcome of the workshop.
The WHO/WTO workshop provided a new forum for health and trade
experts to come together to work on eliminating trade barriers to
long-term, affordable drug access. However NGOs expressed
disappointment about the fact that no real progress was made to
bring drug prices for essential drugs in developing countries down.
NGOs present at the meeting stressed that one proven effective way
to bring prices down is to increase competition by encouraging
generic competition.
In June following an initiative of a group of African countries a
special session of the WTO TRIPS Council will be devoted to health.
For the first time countries will discuss how the requirements of
the TRIPS Agreement can be reconciled with health needs in
developing countries. NGOs will work together to ensure that their
proposals voiced at this workshop in Norway are addressed at the
upcoming WTO TRIPS Council meeting in June 2001 in Geneva. These
proposals include a call on the TRIPS Council to extend the
deadline for the least developed countries to comply with the TRIPS
Agreement and to design mechanisms to ensure R&D for neglected
diseases in developing countries.
Comments on the Meeting - Progress & Frustration
A diverse group of stakeholders including rich and poor country
governments, multilateral UN agencies, multinational pharmaceutical
companies and generic drug companies, and NGO representatives
gathered to discuss whether differential pricing of essential drugs
could be used as a tool to expand access in developing countries
while preserving incentives for future drug development.
The meeting focused on differential pricing, which the NGOs feel
can be a crucial tool to help broaden access to affordable
medicines in developing countries. But differential pricing
mechanisms cannot come with onerous conditions attached, such as
forcing poor countries to surrender their rights guaranteed under
the TRIPS agreement.
Besides differential pricing, other tools -- such as voluntary
licensing, compulsory licensing, and parallel importing - are
available to help broaden access to affordable medicines.
After 2 + days of discussion not a single company disclosed plans
to actually implement differential pricing for their drugs.
Current offers for AIDS drugs are ad hoc, inadequate, and still far
below the prices that can be obtained from generic manufacturers.
CPT's Jamie Love said, "It's ironic that in a meeting organized to
help the poor, the main drug company proposals were to increase
intellectual property protection and ask for the elimination of
national price controls. At one point, Oxfam actually offered to
give the industry a grant, since they were pleading poverty."
The Way Forward -- Global Access to Essential Medicines
The NGOs issued a series of recommendations to enhance research and
development (R&D) and to ensure that intellectual property (IP)
protection, serves public health needs rather than the reverse. The
NGOs stressed that there is no single solution; rather, a mix of
mutually supportive strategies will be required to assure
dramatically reduced drug prices in developing countries. Policies
to achieve this goal should:
- be sustainable and not be solely based on charity or donations
- strengthen developing countries' autonomy
- attract donor funding
- include all essential medicines and should not be limited to
drugs for HIV/AIDS and related conditions only.
Greater Competitiveness Helps Lower Drug Prices
MSF's Ellen 't Hoen made the following proposals at the meeting:
Equity pricing strategies should not depend solely on voluntary
offers by the multinational drug firms. Hitherto, most drug
companies have preferred low-volume-high price strategies. Equity
or differential pricing should be combined with mechanisms to
increase competition and encourage sustainable approaches. For
example, it should not have a negative effect on the development of
a generic industry in the South.
One proven effective way to decrease drugs prices is to increase
competitiveness:
- In Brazil, antiretroviral prices for certain anti-HIV drugs
came down by 82% within five years after Brazil initiated local
production and provided universal free HIV treatment to Brazilians
who needed it.
- Recent offers from generic producers have sparked a price war
for antiretrovirals and have brought the annual price for triple
therapy down from $10,000 to $350 in a single year.
The need for competitive markets will require flexibility in
implementation and a pro public health interpretation of the TRIPS
agreement. The NGOs welcome a special TRIPS Council meeting as
proposed by a group of African countries and which will take place
in June 2001.
Global procurement strategies and funding should include measures
to increase and upgrade generic production in the south.
Voluntary licensing and compulsory licensing can help increase the
number of generic producers in the market.
Voluntary licensing agreements have the added advantage that they
would effectively deal with the companies' fear that low-priced
drugs in developing countries might flow back into high income
country markets.
Research & Development
The NGOs called for a new global Convention on research &
development, designed to strengthen both public- and private-sector
research. At every gathering to discuss access to medicines, the
big pharma companies raise the specter that any effort to help the
poor will harm R&D. Some claim proposals to lower drug prices in
developing countries, including the use of compulsory licensing of
patents on essential medicines, may lower their profits. The idea
of the Convention is to create new mechanisms to boost global R&D
funding in ways consistent with access to medicines and health
needs by encouraging research on neglected diseases. Country
support for R&D funding could take a variety of forms, including
publicly funded R&D, mandatory R&D requirements for companies, or
the big pharma solution, which is high levels of patent protection
and high prices.
The NGOs will ask the World Health Assembly in May to request the
WHO to convene the negotiations by the end of the year.
The NGOs noted with interest the proposal by Jeffrey Sachs of
Harvard University, who addressed the workshop by video uplink, for
a global infectious disease prevention and treatment fund which
would pool resources from rich countries to provide access to
low-cost drugs for HIV/AIDS, tuberculosis, and malaria. However,
they opposed any effort to link the endowment of such a fund to
conditions such as the surrender by developing countries of their
rights under TRIPS to utilize compulsory licensing, parallel
imports, and other mechanisms to assure sustainable access to low
priced, high quality essential medicines.
The NGOs will continue working to support the development of an
effective, long-term, sustainable, global strategy and a drug
procurement and distribution system to provide affordable drugs for
people with HIV/AIDS in developing countries.
For additional information please contact:
CPT - James Love: + 1 202 3613040 (mobile)
HAI - K. Balasubramaniam (Malaysia) - + 603 77261599
MSF - Ellen 't Hoen: + 33 6 22375871 (mobile)
Oxfam - Phil Bloomer: + 44 186 5312251 mobile: + 44 7720259769
TAG - Mark Harrington: + 33 1 43267246
11 April 2001
Joint WTO-WHO-Norwegian Foreign Ministry-Global Health Council
press release
http://www.wto.org/english/news_e/pres01_e/pr220_e.htm
Hosbjor, NORWAY - Making life-saving medicines more affordable for
poor countries is vital for improving public health. More
importantly, it is realistic, experts said in a three-day workshop
that ended today (11 April 2001).
In particular, 'differential pricing' - companies charging
different prices in different markets according to purchasing power
- is a feasible means of achieving this, provided certain
conditions are met.
That was a widely held view among a diverse group of 80 experts
from 21 countries and a wide range of professional backgrounds,
participating in a workshop organized jointly by the World Health
Organization, World Trade Organization, Norwegian Foreign Ministry
and Global Health Council, a broad-based US organization in the
healthcare field.
The workshop examined in detail ways to reduce pharmaceutical
prices in low-income countries and how to increase financing so
that the world's poorest people can obtain necessary medicines and
healthcare. HIV/AIDS, malaria and tuberculosis featured
prominently, but a wide range of other diseases that affect poor
people were also discussed.
WHO Director-General Gro Harlem Brundtland said the meeting had
been constructive and helpful.
'It is clear that the price of medicines does matter - especially
for people in poor countries,' she said.
'We heard from the experts that much lower prices can be achieved
for the poorest countries. Equally important is strengthening
health systems, and, for the poorest countries, securing additional
international financing,' Dr Brundtland said.
Participants attended as experts in their own right. They came
from: developed and developing country governments; international
research-based companies; generic pharmaceutical companies from
Asia, Africa and Latin America; non-governmental organizations;
consumer and treatment groups; universities; and international
organizations.
'Although participants clearly approached the issues from different
points of view, there was broad recognition that differential
pricing could play an important role in ensuring access to existing
drugs at affordable prices, particularly in the poorest countries,
while the patent system would be allowed to continue to play its
role in providing incentives for research and development into new
drugs,' said Adrian Otten, director of the WTO's Intellectual
Property Division.
Two of the organizers, the WHO and WTO, will each report on the
outcome to forthcoming meetings in their organizations to be held
in the next few months. In May, the WHO holds its World Health
Assembly, and in June the WTO's Council on Trade-Related Aspects of
Intellectual Property Rights (TRIPS) will hold a special discussion
on intellectual property and access to drugs.
All participants will be able draw on the ideas and experiences
exchanged in the workshop, for use in their own work, together or
separately.
Differential pricing has already been achieved for commodities such
as vaccines, contraceptives and condoms through a combination of
high-volume purchasing, reliable and adequate financing, advocacy,
corporate responsibility and market forces.
The challenge is to find ways to expand this to life-saving
medicines. The participants accepted that there is no single
formula to achieve this. A wide mix of options is needed, they
said.
'Intellectual property rights stimulate development of new
medicines, but must be implemented in an impartial way that
safeguards public health. We also need to ensure that there are
additional incentives for the development of the drugs needed to
address the health problems of people in poor countries,' Dr
Brundtland said.
Among the ideas emerging from the meeting were:
Differential prices
Differential pricing would allow companies that make patented drugs
to recover most of the costs of research and development in richer
markets and at the same time to sell or license production at lower
prices in lower-income countries. Advocates said this could be a
win-win solution if consumers in richer countries do not face
higher prices as a result.
Critical to the success of this would be methods of preventing
lower priced drugs from finding their way into rich country
markets. A number of speakers were also concerned that lower prices
in development countries should not be used as reference points for
price controls in industrialized countries.
Options for appropriate strategies suggested in the workshop
included: creating the right conditions so that the market
determines differential pricing; discounts negotiated bilaterally
between companies and purchasers (which could include bulk
purchasing on behalf of many customers); licences agreed
voluntarily between patent owners and generic manufacturers; and
global procurement and distribution systems.
Competition and generic drugs
Several speakers also felt that generic drug manufacturers play an
important role in bringing competition to pharmaceutical markets
and improving production efficiency, which would reduce prices
further.
Intellectual property and TRIPS safeguards
Participants acknowledged that intellectual property protection is
an important incentive for research and development into new drugs.
Some said there are also other ways to encourage research and
development.
At the same time, countries need to be able to make use of the
public health safeguards built into the TRIPS Agreement - including
compulsory licensing (governments allowing others to produce a
patented invention without the patent owner's permission) and
'parallel' imports (i.e. imports of products supplied by the patent
owner or a licensee at a lower price in another country).
Financing
When drug prices fall - and many low priced essential drugs are
already available - there is still no guarantee that poor
communities can afford them. This is particularly true for HIV/AIDS
drugs. Even with costs coming down to $500 per patient per year,
this is well beyond the reach of the many countries whose total
health expenditure is less than $10 to $20 per year. In these
cases, significant amounts of external financing is needed.
Many of the participants also said financing for drugs should not
be considered in isolation. They called for massive increases in
finance to develop effective healthcare systems in general,
including training, education and delivery, as well as for buying
the drugs.
This material is being reposted for wider distribution by
Africa Action (incorporating the Africa Policy Information
Center, The Africa Fund, and the American Committee on Africa).
Africa Action's information services provide accessible
information and analysis in order to promote U.S. and
international policies toward Africa that advance economic,
political and social justice and the full spectrum of human rights.
|
