The degree and pace of liberalisation necessary for a free-trade agreement (FTA) to comply with World Trade Organization (WTO) rules (especially Article XXIV of GATT) remains an important discussion point in EPA (economic partnership agreement) negotiations. This article helps clarify the different interpretations of Article XXIV by analysing some 40 free-trade agreements notified to the WTO, including interim EPAs. Developing countries can make proposals for flexibilities in the FTAs they negotiate with developed countries. The concept of asymmetry justifies this approach, and these flexibilities are an important means for adjusting to liberalisation that goes beyond WTO requirements. Two WTO legal texts can be used as a basis: on the one hand, the enabling clause which states that ‘contracting parties may accord differential and more favourable treatment to developing countries, without according such treatment to other contracting parties’, and, on the other hand, the General Agreement on Trade in Services (GATS), which allows some flexibility to developing countries depending on their global and sectorial and subsectorial development level. At a time when the West Africa and Central Africa EPA negotiations have stalled over provisions that would provide more flexibility, the analysis of the FTAs notified to the WTO reveals that there is room to manoeuvre. Indeed, the precedent set in some FTAs is a basis for understanding and accepting the ACP’s request to liberalise 60% – and not 80% – of their market or to benefit from a 25-year transition period.
Health equity in economic and trade policies
In this report, the authors allege relief for Indian generic drug manufacturers, as five East African countries – Uganda, Tanzania, Rwanda, Burundi and Sudan – refused in a health meeting to endorse a proposal by the East African Community (EAC) to introduce an anti-counterfeit products law. The law, which could have potentially blocked exports of generic drugs from India because of a lack of clarity on what is counterfeit, had worried the Indian drug industry ever since the 2007 draft proposal by the EAC. East African countries together contribute almost one-fifth of India's Rs40,000 core drug exports. Kenya passed a similar law in 2008 that Uganda had used as a model for its own draft Bill last year, and which was due for implementation this year. The Ugandan Bill has been sent back for review. The members of the East African states present at this regional health meeting refused to endorse the draft proposal and demanded that the definition of generics be what WHO [the World Health Organization] stipulates. The views of trade ministers are, however, not made clear in the report.
This fact sheet contains vital information on counterfeit medicines, especially regarding identification of these medicines. Counterfeit medicines are medicines that are deliberately and fraudulently mislabelled with respect to identity and/or source. Use of counterfeit medicines can result in treatment failure or even death. Public confidence in health-delivery systems may be eroded following use and/or detection of counterfeit medicines. Both branded and generic products are subject to counterfeiting. All kinds of medicines have been counterfeited, from medicines for the treatment of life-threatening conditions to inexpensive generic versions of painkillers and antihistamines. Counterfeit medicines may include products with the correct ingredients or with the wrong ingredients, without active ingredients, with insufficient or too much active ingredient, or with fake packaging.
A member of the European Parliament is reported to have argued that trade agreements must not contain clauses on intellectual property rights that could imperil poor people's access to affordable medicines. A veteran member of the European Parliament (MEP), David Martin, is reported to have expressed concern about ‘data exclusivity’ requirements, whereby major pharmaceutical companies would be able to block India’s generic medicines industry from using the formulae with which new drugs are developed for a period of several years. This is because India is a leading exporter of low-priced generic medicines to other developing countries, and such provisions have repercussions for those countries to which generic medicines from India are provided, including African countries.
In this article, the author states that affordability through reduced pricing is only one part of enhancing access to treatment in public health emergencies: supply security and the guarantee of supply consistency is the other. To the extent that patent pooling is able to create regional African manufacturing capability, Africans will support the concept. However, if it further decentralises manufacture away from the continent and increases Africa’s dependence on imports, it can potentially weaken supply security and will continue to relegate Africa a continent of dependency, rather than one that invests in its own capability. The author cautions that patent pooling should be viewed guardedly on the African continent and only be embraced if it is consistent with the AU Heads of State’s call for an African manufacturing plan. Africa must aspire to move from ‘converting charity dollars into sustainable, long term investment dollars’.
German Marshall Fund of the United States: 19 November 2009
This document is a collection of seventeen essays on economic partnership agreements (EPAs) authored by recognised trade experts and senior policy-makers. Their responses constitute a mix of positive and negative elements, reflecting the complexity of the EPA processes. The negative message here is that EPAs are not useful or, at least, that these agreements are not necessarily relevant in light of the challenges faced by poor and vulnerable states, such as the African, Caribbean and Pacific (ACP) countries. The positive message is that all stakeholders continue to strongly believe that the EPAs should and can make a positive difference and that it is therefore possible to shape them for a truly positive outcome. The views expressed here reflect great convergence over the fact that there continues to be a huge trust gap in the negotiations. Whether perceived or observed, there is a persistent impression among ACP negotiators that EPAs are about European interests. Without trust among negotiating parties, chances are scant that negotiations will actually lead to genuine partnerships, as implied by the term ‘economic partnership agreement’.
A waiver to World Trade Organization (WTO) rules intended to aid people in poor countries in gaining access to medicines is reported to have remained essentially unused in the over six-and-a-half years since it was put in place. Member states of the WTO will be holding an informal meeting to discuss this situation and see what, if anything, needs be done. The 2003 waiver was made an amendment in 2005 within the WTO Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement to allow for increased export of medicines made under compulsory licences. This was intended to give a helping hand to nations without a domestic pharmaceutical industry, who might have public health needs for a patented and unaffordable medicine they are unable to produce themselves.
Under TRIPS, compulsory licences are meant to primarily serve a national market, but the TRIPS public health amendment (often referred to as the ‘paragraph 6’ solution referring to the Doha Declaration on TRIPS and Public Health) allows countries with pharmaceutical industries to manufacture and export more medicines under a compulsory licence to countries without them, provided certain conditions are met.
Kenya and Tanzania have recently passed anti-counterfeit laws and regulations that risk blocking legitimate generic medicines instead of fake products, which is the purported purpose of these laws. Uganda is now considering a similar bill. Like the other East African legal provisions, Uganda's draft bill defines counterfeiting in such a way as to criminalise manufacturers and importers of safe, high-quality generic medication. Critics say Uganda already has adequate legislation against fake products. To explain what is spurring the adoption of these new laws on intellectual property rights, intellectual property rights expert, Sisule Musungu, points to the politics of global trade. In this interview, he notes: '…Intellectual property rights don't guarantee quality or certification of quality. And that is why talking about quality and intellectual property does not add up because they are two different things: the latter confers rights to intellectual property owners and has nothing to do with the quality of products.'
Access to medicines in developing countries continues to be a significant problem due to lack of insurance and lack of affordability. Chronic myeloid leukemia (CML), a rare disease, can be treated effectively, but the pharmaceutical treatment available (imatinib) is costly and unaffordable for most patients. GIPAP is a programme set up between a manufacturer and a non-governmental organisation to provide free treatment to eligible CML patients in 80 countries worldwide. In this study, data for 13,568 patients across 15 countries, available quarterly, were analysed over the 2005-2007 period. Four waves of patients entering quarterly in 2005 were used to evaluate patient survival over the sample period. Having controlled for age, location and occupation, the analysis showed that patients were significantly more likely to move towards a better health state after receiving treatment irrespective of their disease stage at the point of entry to the programme.
According to this book, the first certain trade between Africa and China may be dated from the fourteenth century, but east African city-states may have been trading with southern China even earlier. In the mid-twentieth century, Maoist China funded and educated sub-Saharan African anticolonial liberation movements and leaders, and China then assisted new sub-Saharan nations. Africa and China are now immersed in their third and most transformative era of heavy engagement, one that this book believes will promise to do more for economic growth and poverty alleviation than anything attempted by Western colonialism or international aid programs. Robert Rotberg and his Chinese, African and other colleagues discuss this important trend and specify its likely implications. Among the specific topics tackled here are China’s interest in African oil; military and security relations; the influx and goals of Chinese aid to sub-Saharan Africa; human rights issues; and China’s overall strategy in the region. China’s insatiable demand for energy and raw materials responds to sub-Saharan Africa’s relatively abundant supplies of unprocessed metals, diamonds, and gold, while offering a growing market for Africa’s agriculture and light manufactures. As the book illustrates, this evolving symbiosis could be the making of Africa, the poorest and most troubled continent, while it further powers China’s expansive economic machine.