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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 Please note that many outdated links in this archived document may not work.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, 2

Africa: Treatment Access Update, 2
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 press release on next week's OAU summit on HIV/AIDS, Tuberculosis and other related infectuous diseases, a commentary from the NY Commanity Advocacy Treatment Working Group on the proposed UN statement of position on treatment for the UN Special Session, and a brief update from BRIDGES Trade newsletter on new World Trade Organization discussions on intellectual property rights and drug patents.

An additional posting today has 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.

+++++++++++++++++end profile++++++++++++++++++++++++++++++

ECA Press Release No. 01/2001(ENGLISH)

ABUJA SUMMIT TO ENDORSE ADF 2000 CONSENSUS ON FIGHTING HIV/AIDS

Addis Ababa, 18 April 2001 (ECA) -- The African Development Forum (ADF) Consensus and Plan of Action agreed in Addis Ababa in December 2000 is to be endorsed by Africa's leaders next week, when they convene in Abuja, Nigeria for the African Summit on HIV/AIDS, Tuberculosis and other related infectious diseases (26 - 27 April).

More than 20 Heads of State are expected at the Summit, to be held at the Abuja International Conference Centre. The Summit, to be preceded by a Ministerial Technical meeting (24 - 25 April), is being organised by the Organization of African Unity (OAU) in collaboration with the Government of the Federal Republic of Nigeria, the Economic Commission for Africa (ECA), UNAIDS and other key partners.

The Summit, first proposed by President Olusegun Obasanjo of Nigeria, is being convened to focus Africa's leadership on reversing the alarming rate of infection of HIV/AIDS, Tuberculosis and other related infectious diseases on the continent. Unlike ordinary summits of the OAU, this gathering will include participation from different stakeholder groups, including People Living with HIV/AIDS, TB and other diseases. Africa's development partners will also be represented at the Summit.

The Summit's objectives are to: translate the commitments made by African leaders into social and domestic and external resource mobilisation for prevention, care and treatment of the diseases and sustainable programming of primary health care; and develop strategies aimed at preventing and controlling the impact of the pandemic on socio-economic development in Africa.

Among dignitaries attending the Summit will be Kofi Annan, the UN Secretary-General, who has been at the forefront of the global fight against HIV/AIDS, and who is placing a special emphasis on Africa. Mr. Annan is scheduled to deliver an opening statement at the Summit of Heads of State and Government on 25 April.

A number of UN senior UN officials are also expected in Abuja, among them UNAIDS Executive Director Peter Piot, WHO Director-General Gro-Harlem Bruntland, ECA Executive Secretary K.Y. Amoako, and UNICEF Executive Director Carol Bellamy. These officials will participate in a panel on the 'Way Forward' (25 April).

ECA has been working closely with the OAU, UNAIDS and other members of the Technical and Steering committees to ensure that the Summit builds on previous efforts to develop a strong African response to HIV/AIDS.

In particular, ECA has sought to mainstream the outcomes of ADF 2000, which the Commission organized around the theme "AIDS: The Greatest Leadership Challenge", in conjunction with UNAIDS, UNDP, UNICEF, The World Bank and other partners to serve as a launching pad for a renewed commitment to more concerted action against HIV/AIDS in Africa.

At ADF 2000, More than 1,500 African leaders and policy makers, civil society organisations -- including people living with HIV/AIDS and academia -- private sector and development partner representatives addressed concrete roles and responsibilities for leaders at all levels, towards galvanizing an African-led response to the pandemic.

ADF 2000's Consensus and Plan of Action calls for a strong involvement by all stakeholders in the fight against HIV/AIDS in Africa, and articulates the commitments made by African governments, the international community, civil society and other stakeholders individuals to overcome the HIV/AIDS pandemic. Among other things, the Consensus stresses that:

  • Every individual must personally break the silence around the norms and practices that fuel the HIV/AIDS pandemic.
  • People living with HIV/AIDS stand at the centre of any community efforts to overcome the pandemic. Their rights must be respected in full and their leadership potential recognised.
  • National leaders have a responsibility to create the conditions for community mobilisation.
  • A continental strategy for the essential and comprehensive care and treatment of people living with HIV/AIDS is needed, including a determined pan-African approach to the affordability of drugs.
  • The international community should mobilise the necessary resources to enable Africa to overcome the pandemic. Wherever possible, assistance should be in the form of grants, not loans.

For more information on the African Summit, visit www.oau-oua.org/afrsummit/index.htm

To read the ADF 2000 Consensus and Plan of Action, and for all related theme papers, speeches, presentations, and other documents, visit www.uneca.org/adf2000 or contact:

The Communication Team
Economic Commission for Africa
P.O. Box 3001 Addis Ababa Ethiopia
Tel: +251-1-44 50 98 or +251-1-55 30 98
Fax: +251-1-51 03 65; Cell: +251-9-20 17 94
E-mail: [email protected]
Web: http://www.un.org/depts/eca


April 10, 2001

From: NYC UNGASS [UN General Assembly Special Session] Community Advocacy Treatment Working Group

[NOTE: THE NYC UNGASS Community Advocacy Treatment Working Group is an ad-hoc group of individuals living with HIV and AIDS, community advocates, HIV professionals, journalists, policy makers, and concerned citizens who represent a broad sector of the HIV/AIDS community.]

To: UNGASS Member States and Delegates

Re: Consensus Statement on Response to UNGASS Draft Declaration of Commitment

posted on http://www.egroups.com/group/breaking-the-silence, March 16, 2000
by Sharonann Lynch <[email protected]>

NOTE: The following consensus statement limits its comments to the section of the UNGASS Declaration of Commitment regarding Care and Support (reprinted below). It directly addresses the UNGASS Declaration's statement that prevention must be the mainstay of the global community's efforts to address the AIDS epidemic.

From the draft UNGASS Declaration of Commitment on HIV/AIDS (April 6, 2001) and the section dealing with care and support:

"Care and support are inseparable elements of an effective response"

"By 2003, ensure that comprehensive care strategies are developed to strengthen health care systems; provide access to affordable medicines and drugs for those who need time; support individuals, households and communities affected by HIV/AIDS; and address factors affecting the provision of essential drugs, including technical and system capacity, prices, international trade rules and intellectual property rights;

"By 2003, ensure that national strategies are developed in close collaboration with the international community and the private sector to increase substantially the availability of essential medicines for HIV, including antiretroviral therapy for people with symptomatic HIV infection."

Response of UNGASS Community Advocacy Treatment Working Group:

The world's HIV-infected and - affected populations cannot wait until 2003 for their countries to act. 1,300 people die of AIDS every day. In two years time, the epidemic will have claimed nearly 10 million lives. The UNGASS Declaration of Commitment overlooks many measures which are of the utmost importance to saving lives and preventing new infections.

As it stands, the United Nations Declaration of Commitment is wholly inadequate with respect to treatment and care. Taking immediate measures to improve access to care, treatment and support should be of equal priority to prevention efforts in the global response TO HIV/AIDS. The Declaration should be altered to reflect the following:

TREATMENT IS PREVENTION

The Declaration of Commitment presents a false dichotomy between prevention and treatment. Treatment and care services are known to enhance prevention efforts and are efficient routes to many prevention goals, including uptake of voluntary counseling and testing, treatment of STDs, and condom use. The Declaration should reflect that treatment and prevention are inextricably linked and that:

  • Treatment strengthens prevention efforts, expands local health infrastructure, and improves overall delivery of care and support.
  • Access to treatment is a known incentive for HIV testing, and helps address stigma and discrimination against individuals living with HIV, as well as denial associated with HIV.
  • Effective treatment of HIV and sexually transmitted diseases, as well as opportunistic infections in HIV-infected individuals helps reduce their risk of HIV transmission. Member countries must commit to developing programs which reflect the immense public health impact - including reductions in new infections - of basic treatment interventions such as treatment for STDs and opportunistic infections.
    • The Declaration must clearly state that access to care and treatment are basic human rights, and must provide an expanded definition of treatment and an outline of immediate steps that every member country can take and will commit to taking to improve care, treatment and support for those already infected with HIV.

The Declaration should set a specific timetable and specific numeric targets for providing immediate access to antiretroviral and OI therapy to the neediest individuals with HIV now, not in 2003, and should address criteria for selection of those who are most likely to benefit. Priority must be given to individuals with symptomatic HIV illness and late-stage AIDS. Since HIV treatment is an incentive to HIV testing, any treatment initiatives will also facilitate the identification of newly-exposed or recently seroconverted individuals who are known to be at high risk of transmitting HIV to others and could potentially benefit from early access to short-course antiretroviral therapy that would in turn represent an important prevention strategy.

AN EXPANDED DEFINITION OF TREATMENT

Treatment and care have many components. The current wording is too broad and gives inadequate direction to member countries. As the Health GAP Coalition has stated with regard to the Declaration: "Generality is an excuse for inaction; abstraction is a foreshadowing of failure."

The many interrelated aspects of disease management include: treatment for STDs and opportunistic infections; palliative care; nutrition; diagnostics (including HIV antibody tests, viral load and CD4 T-cell counts), "best practice" clinical management of HIV disease; education of communities about HIV treatment through culturally-appropriate treatment literacy materials; and training of physicians and health-care professionals. Many of these aspects can be translated into concrete goals which member countries can and should begin to pursue immediately, and not in 2003.

The Declaration should state that:

  • Member states commit to outlining and implementing immediate and clear action steps for increasing access to treatment and care, with clear standards for action.
  • While they recognize that access to antiretrovirals remains a difficult challenge, member states must immediately begin to: train physicians, health-care professionals and community advocates in appropriate strategies for managing HIV/AIDS; identify and take concrete steps to enhance the existing health infrastructure of their countries for the introduction and delivery of HIV-related medicines and care; identify and establish national programs and successful community-based models of HIV treatment; immediately establish mechanisms that will prioritize the care and support individuals with sympomatic HIV or late-stage AIDS and their families.

COMMUNITY REPRESENTATION

These goals cannot be met without the involvement and guidance of the diverse communities of people with HIV and AIDS and other members of Civil Society. It is imperative that people with HIV/AIDS be offered representation at all levels of decision-making with regards to access to care and treatment. This includes full participation in the administration of any proposed "global AIDS fund," participation member state UNGASS delegations; and decisions by member states about resource allocation.

The Declaration should state that:

  • Governments of member states must commit to work in equal partnership with people with HIV/AIDS and Civil Society with respect to the allocation of funds, financial and technical resources for HIV prevention, treatment and care.
  • Governments of member states must commit to transparency and accountability in these partnerships.

AN END TO ECONOMIC AND TRADE BARRIERS

Allocation of new funds and resources for treatment and care is a priority for all member countries. For developing nations crippled by the burden of debt, this can only be accomplished by debt cancellation and reallocation of these funds to programs for HIV/AIDS prevention, treatment and care. The use of funds freed up by debt cancellation can become an essential element in the ability of developing countries to address the AIDS pandemic, since it will free up needed internal national resources and make it more possible for them to increase the effectiveness of their response to AIDS and other health, education and civil issues. We wish to emphasize the need for government transparency and civil society participation in any reallocation of funds freed up by debt cancellation.

The Declaration should also commit member states to:

  • clearly address and, where necessary, remove trade barriers that negatively impact on access to essential medicines for HIV, including antiretroviral drugs;
  • support the highest possible protection of public health in international, regional, and national trade, patent, and intellectual property laws, including TRIPS-compliant safeguards.
  • support developing countries to provide the most affordable, highest quality health care for their HIV-affected populations as possible, using such mechanisms as generic production, compulsory licensing and parallel importing of HIV medicines.
  • develop patent legislation in accordance with these principles and with a view to fulfilling the basic human right of each citizen to health care.
  • avoid using litigation or other pressures, particularly bilateral ones, to prevent another country from measures designed to implement the fundamental human right to health.

FOLLOW UP MEASURES & INDEPENDENT MONITOR

  • The Declaration should address follow-up plans and steps that member states will be required to take to fulfill their stated commitment to this document of action, along with a timetable for action.
  • The Declaration should establish a clear mechanism for review of the follow-up actions of member states, with clear standards for evaluating their commitment to providing access to HIV treatment and care for HIV-positive individuals.
  • UN member states should establish an independent monitoring body that would include HIV-positive individuals and other members of Civil Society, to review the UNGASS Plan of Action and the immediate, mid-and longer-term strategies of member states to provide access to treatment to HIV-positive citizens and other steps outlined in this document of commitment to action. Funding and administration for this independent monitoring body should be provided by the UN body and member states with a clear timetable for action, clear standards and a clear mechanism for review.

BRIDGES Weekly Trade News Digest

BRIDGES Weekly Trade News Digest is published by the International Centre for Trade and Sustainable Development (ICTSD), http://www.ictsd.org, with technical support from the Institute for Agriculture and Trade Policy (IATP). ICTSD is an independent, not-for-profit organisation based at: 13, ch. des AnTmones, 1219 Geneva, Switzerland, tel: (41-22) 917-8492; fax: 917-8093.

Vol. 5, Number 13 10 April, 2001

TRIPS COUNCIL TO HOLD DISCUSSION ON ESSENTIAL MEDICINES

Following a request by Zimbabwe on behalf of the African Group at the WTO, the WTO Council on Trade-related Aspects of Intellectual Property Rights (TRIPs) in its meeting on 2-6 April agreed to hold special discussions on essential medicines during the next Council meeting in June. The decision came in the wake of recent accusations that the WTO impedes developing countries' access to cheap drugs by protecting pharmaceutical patents (see BRIDGES, 20 February 2001;
http://www.ictsd.org/html/weekly/story5.20-02-01.htm).

Africa's request for special discussions on drugs

In its statement to the TRIPs Council, the African Group called for a Special Session of the Council to address issues relating to TRIPs, patents and access to medicines. In particular, the paper said, the Session should aim to "provide legal clarity in the interpretation and application of the relevant TRIPs provisions which allow the adoption of certain measures to enable the protection of health." The outcomes of the Session could feed into the preparatory process of the fourth Ministerial Conference in Qatar. The statement also stressed that the African Members were not aiming to undermine or discourage investment into research and development for new drugs. "Our challenge is to address the question of affordable access to drugs in a manner that is fair and equitable to all stakeholders," it said. The African Group also acknowledged that the question of affordable drugs goes beyond patenting and pricing and includes other issues, such as government purchasing power and infrastructure, which lie outside the mandate of the Council.

The TRIPs Council agreed to devote a full day to a special discussion of intellectual property issues relevant to access to medicines during the course of the next TRIPs Council meeting on 18-20 June. Furthermore, the WTO is co-sponsoring a workshop on "Differential Pricing and Financing of Essential Drugs" with the World Health Organization, which is currently being held in Norway from 8 to 11 April. The workshop brings together representatives from research-based and generic manufacturers, governments, intergovernmental organisations, non-governmental organisations, academics and consultants to provide an opportunity to exchange views on these issues. BRIDGES Weekly will report on the outcomes of this meeting in a forthcoming issue. In addition, the WTO has released a fact sheet on TRIPS and pharmaceuticals, which outlines the exceptions to patent rights under TRIPs of relevance to the drugs issue (available at
http://www.wto.org/english/tratop_e/trips_e/trips_e.htm).


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.

URL for this file: http://www.africafocus.org/docs01/acc0104b.php