WTO, WHO & WIPO On Affordable Medicines

In case you missed it, there was an interesting event just held by the WTO on the thorny subject of third world access to important medicines. Many of which, of course, are developed by Western big pharma firms keen on generating revenues from strong patent protections. There, the respective principals of three organizations closely keyed to this debate--Pascal Lamy of the WTO, Margaret Chan of the WHO, and Francis Gurry of the WIPO--had some interesting things to say. Below are their key comments, although the rest is well worth reading for those following third world health issues in particular -

WTO Director-General Pascal Lamy requires no introduction:

No connection is planned or intended between this process and the ongoing policy and legal debates within the WTO about the scope and effect of TRIPS flexibilities, especially the work of the TRIPS Council. Since the Doha Declaration in 2001, WTO Members have rightly stressed the need for the effective use of the IP regime and of the flexibilities in the TRIPS Agreement. As discussed in Doha, TRIPS needs to be part of the wider national and international action to address public health problems. It was agreed that TRIPS does not and should not prevent members from taking measures to protect public health. So there is no doubt about the centrality of this element of the access equation. It has led to the first, and so far the only, amendment agreed to the entire package of WTO law since the ink dried in Marrakech over 16 years ago — the so-called paragraph 6 mechanism...

Global public health is a complex puzzle, Getting it right is a teasing challenge, involving effective use of the full set of applicable policy tools. But it is also a practical craft, rather than a theoretical excursion — meaning that we can and should learn from the actual experiences of others in their efforts to create and disseminate needed treatments. The full perspective needs to cover the international trade dimension, but also consider domestic policies and practices, and above all, the evolving state of the actual global disease burden, priority setting for front line treatments, and patterns of production and dissemination of medicines. I hope today’s program will help illuminate this far bigger picture, so that we can get on with our specific areas of work with the benefit of greater understanding about how all the elements interact, and what priority targets we should be aiming at — a task that can only be undertaken by our public health colleagues.

Meanwhile, here is Margaret Chan of the World Health Organization:

We face two bottom-line realities. First, the essence of the ethical argument is straightforward. People should not be denied access to life-saving or health-promoting medicines for unfair reasons, including those with economic causes. Yet the pharmaceutical industry operates in response to economic factors and market forces. This is a profit-driven industry, and not a philanthropist, not a humanitarian enterprise. What incentives does this industry have to fix prices according to their affordability among the poor?

Second, price has a decisive impact on access to medicines. Access is influenced by many other factors, like remoteness, lack of staff, poor procurement practices and delivery systems, and the absence of health insurance schemes. But price can be an absolute barrier to access for the poor. For the poor, access and affordability are usually one and the same.

WHO learned a great deal during the negotiations that eventually led to adoption of the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property. Some of the tensions between the motives of a profit-driven industry and ethically-driven public health can be circumvented, if not entirely overcome.

Finally, here is Francis Gurry of the World Intellectual Property Organization (WIPO):

Encouraging intellectual property plays a very important role in this regard. But we also know that there is no point in having new medicines unless they can benefit those who need them. And so there is the question of balance, which I think lies at the heart of all of intellectual property, whether we are talking about cultural creations or new medicines, a balance between, on the one hand, the incentive to create and, on other hand, the diffusion of the social benefit of the innovation or the new creation. Or a balance, otherwise said, between producers and consumers, whether they be individual producers and consumers, or country producers and country consumers.

This balance is an extremely complex matter and many things enter into the picture, including pricing and procurement policies. There is no simple legislative fix, which is not to say that legislation does not have a role. But there is a vast area of practical cooperation, which is very important in the achievement of this balance between creation, on the one hand, and diffusion of the social benefit of creation, on the other hand.