Many people in developing countries lack access to health technologies. This paper presents seven findings about processes that shape access, based on analysis of six case histories: praziquantel to treat schistosomiasis (a parasitic worm disease), hepatitis B vaccine, the Norplant contraceptive, malaria rapid diagnostic tests, vaccine vial monitors and the female condom. Each case study is assessed with a comprehensive framework that examines the effects of architecture, availability, affordability and adoption on creating access. The analysis shows that access to health technology in poor countries is difficult to achieve because of multiple obstacles, but it can be created under certain conditions.
Health equity in economic and trade policies
Creating access to health technologies in poor countries
Frost LJ and Reich MR: Health Affairs 28(4): 962–973, 2009
Developing nations respond to ECOSOC report
Saez C: Intellectual Property Watch, 16 July 2009
In response to the report by the United Nations Economic and Social Council (ECOSOC) on their high-level meeting held from 6–9 July in Geneva, Lumumba Di-Aping of Sudan, who spoke on behalf of the Group of 77 and China, said the international community should not let the patent holders deny the right to health. Patent holders should not ‘seek to restrain and unreasonably impose measures that affect the supply chain of medicines and transfer of technology relating to health products.’ Mike Boyd, acting director general of the International Federation of Pharmaceutical Manufacturers and Associations, asserted that pharmaceutical industry made a very significant contribution to helping achieve the health-related UN Millennium Development Goals. International cooperation should be improved in order to ensure access to affordable, good quality and effective medicines, said Maria Nazareth Farani Azevedo of Brazil. Intellectual property rights play a determinant role in the access, affordability, innovation, local production, and trade, she said, adding that member states should resolve the intellectual property agenda.
Empty promises: What happened to ‘development’ in the WTO’s Doha Round?
Oxfam Briefing Paper 131: 16 July 2009
The World Trade Organization’s (WTO) Doha Development Round was meant to rebalance decades of unfair rules in agriculture and address the needs of developing countries. Instead, the negotiations have betrayed this promise. It has become a ‘market access’ negotiation, in which developing countries are expected to give disproportionately more and will receive little but stale promises of the general benefits of liberalisation. In order to put the Doha Round back on the ‘development’ track, Oxfam recommends that WTO members take actions to: improve the process of negotiations to make them more transparent and inclusive; ensure special and differential treatment for developing countries; promote development by enabling the realization of rights, such as the right to food, ensuring that trade rules respond to the needs of the most vulnerable people first; and strengthen the WTO as an institution to build greater confidence in its ability to achieve fairer trade rules for developing countries.
EU Finds anti-competitive abuse of pharmaceutical patents and launches antitrust action
Mara K: Intellectual Property Watch, 8 July 2009
Pharmaceutical companies are manipulating the intellectual property rights system and are ‘actively trying to delay the entry of generic medicines onto their markets,’ a top EU official has said. As a result, there has been a decline in the number of innovative medicines getting to the market. The European Commissioner for Competition, Neelie Kroes, has announced that the first antitrust case resulting from the inquiry is now open. It alleges breaches of European rules on ‘restrictive business practices’ and ‘abuse of a dominant market position,’ and is filed against French company Les Laboratoires Servier and five generics with which it had made deals, according to a separate press release. The slowdown in novel medicines entering the market – 27 annually since 2000 as compared to 40 annually between 1995 and 1999 – was a systemic problem and the causes need to be identified.
Kenya pressured to implement anti-counterfeit law despite access fears
Wadhams N: Intellectual Property Watch, 2 July 2009
An influential manufacturers’ lobbying group in Kenya is pushing the government to start enforcing an anti-counterfeiting law, despite fears from public health advocates that the new rules will impede access to generic drugs and set an unwanted precedent in East Africa. The Kenya Association of Manufacturers (KAM) says it wants the Anti-Counterfeit Act to be implemented as soon as possible and has been in talks with the government to make sure that happens. The law was passed last year but has not yet taken effect because of budgeting and procedural delays. The association claims that counterfeits cost companies 50 billion shillings (US$650 million) and the government 19 billion shillings (US$250 million) in taxes in 2008. Yet public health advocates argue that the Act’s definition of what constitutes a counterfeit product is too vague and could be used to block the import and local manufacture of generic drugs. Civil society organisations also want the two issues of counterfeiting and patent rights to remain separate.
Pathways of health technology diffusion: The United States and low-income countries
Nandakumar AK, Beswick J, Thomas CP, Wallack SS and Kress D: Health Affairs 28(4): 986–995, 2009
In the United States, the complex process of getting health care technologies into practice takes place in a competitive health system that is driven by technological innovation. Federal, state and local governments’ roles in the diffusion process are limited. In low-income countries, where competitive markets are not as prominent, diffusing medical innovations requires an alternative understanding of how new technologies are adopted. This paper describes how, in low-income countries, the lack of functioning markets serves as a barrier to the transfer of necessary health technologies and why governments must act as stewards in promoting technologies there.
Report of discussions: G8 Intellectual Property Experts Group meeting
G8 IP Expert Group (IPEG): 9 July 2009
Leaders at the G8 conference in Italy have made very cautious commitments with regard to the top issue, climate change, but views on intellectual property rights enforcement began to become clear on the second day. Leaders called for a firm push for the Anti-Counterfeiting Trade Agreement (ACTA), which is unchanged from the past. The G8 IP Expert Group (IPEG) reaffirmed the 2000 Okinawa Charter commitment on use of software in full compliance with intellectual property rights that addresses public authorities. It also called on all states to step up consideration about how to combat digital piracy on the internet, which the IPEG sees as growing problem. And it presented the ‘G8 Model Arrangement on Bilateral Information Sharing for Fighting Counterfeiting and Piracy’ to allow the exchange of information between national authorities. Leaders also urged completion of the round of negotiations at the World Trade Organization’s meeting later this year.
Agreement on Trade-related Aspects of Intellectual Property Rights (TRIPS) and free trade agreements have adverse impact on access to drugs
Raja K: Third World Network, 15 June 2009
The World Trade Organization’s TRIPS Agreement and the TRIPS-plus provisions in free trade agreements (FTAs) have had an adverse impact on prices and availability of medicines, making it difficult for developing countries (DCs) and least-developed countries (LDCs) to meet their obligations to fulfill the right to health, the UN Special Rapporteur on the right to health, Anand Grover, has said. Similarly, lack of capacity coupled with external pressures from developed countries has made it difficult for DCs and LDCs to use TRIPS flexibilities to promote access to medicines. He recommended that DCs and LDCs should not introduce TRIPS-plus standards in their national laws, nor should they enter into TRIPS-plus FTAs that may infringe upon the right to health. He recommended that they should review their laws and policies and consider whether they have made full use of TRIPS flexibilities or included TRIPS-plus measures and, if necessary, amend their laws and policies to make full use of the flexibilities.
Concerns voiced at Agreement on Trade-related Aspects of Intellectual Property Rights (TRIPS) Council over seizure of drugs
Shashikant S: Third World Network, 16 June 2009
The repeated practice of European Community (EC) customs officials seizing shipments of medicines while in transit to developing countries on grounds of alleged intellectual property violations has once again come under sharp criticism in the World Trade Organization (WTO). Protest by developing countries came at a formal session of the TRIPS Council on 8 June. The developing countries expressed concern over the European Union's (EU) commitment to the Doha Declaration on TRIPS and Public Health and the flexibilities inscribed in the TRIPS Agreement. They said that the EU was confusing legitimate generic medicines with counterfeit fakes. Furthermore, the EU was also undermining poor countries' ability to obtain cheaper generic medicines. India called upon the EC to urgently review their legislation and the actions of their national authorities and bring them in conformity with the letter and spirit of the TRIPS Agreement, the rules-based WTO system and the Doha Ministerial Declaration on Public Health.
Counterfeit medical products: Need for caution against co-opting public health concerns for intellectual property protection and enforcement
Center for International Environmental Law and South Centre: IP Quarterly Update, 1st Quarter, June 2009
The World Health Organization’s report and draft resolution, Principles and Elements of National Legislation against Counterfeit Medical Products, presented at their annual meeting in January emphasises counterfeit medical products as the central health problem pertaining to quality, safety and efficacy of medicines, while paying scant attention to equally significant public health problems of falsely labelled, spurious and substandard drugs. This article discusses the ramifications of the International Medical Products Anti-Counterfeiting Taskforce (IMPACT), which wrote the report and resolution, and concludes that all role players should consider the negative implications of anti-counterfeiting actions, such as how the seizure of suspected intellectual property-infringing medicines in transit will affect access to medicines and the right to health, plus anti-counterfeiting legislation in various countries.