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Rich Countries Betraying their Obligations to Help Poor Countries Protect Public Health

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Poor people in developing countries are still being denied cheaper life-saving medicines five years after world leaders signed a formal trade declaration to put health before profits, according to international aid and relief organization, Oxfam America. In a report published today marking the fifth anniversary of the Doha Declaration "Patents vs. Patients Five Years After the Doha Declaration." Oxfam asserts that rich countries are taking little or no action towards their obligations and are in some cases actually undermining the declaration.  

The declaration states that developing countries must be able to use public health safeguards written into the World Trade Organization's (WTO) intellectual property rules (called TRIPS) in order to access cheaper generic versions of patented medicines. Generic competition is the most sustainable way to keep the price of medicines down, according to Oxfam.

"Rich countries have broken the spirit of the Doha Declaration," said Celine Charveriat, head of Oxfam's Make Trade Fair campaign. "The declaration said the right things but needed political action to work. That hasn't happened. We've gone backwards. People are still suffering or dying needlessly."

Since 2001 things have become worse for sick people in developing countries:

  • More than 4 million people were newly infected by HIV in 2005,
  • Cancer - once considered a "burden of the rich" - is increasingly affecting people in developing countries, with the rate of disease expected to double by 2020 and 60 percent of new cases occurring in the developing world, and
  • Diabetes has risen from 30 million to 230 million people in the past 20 years with most new cases now reported in poorer countries.

According to the World Health Organization, 74 percent of AIDS medicines are still under monopoly, 77 percent of Africans still have no access to AIDS treatment, and 30 percent of the world's population still does not have regular access to essential medicines.

At the same time, rich countries, especially the US, are bullying developing countries to impose stricter intellectual property rules in order to preserve pharmaceutical monopolies. This is restricting generic competition and keeping prices high.

"Global health statistics are grim but the US continues to negotiate trade deals with stricter rules that limit how a country can use public health safeguards," said Charveriat. If implemented, these deals will result in Colombia having to pay an additional $940 million per year by 2020 to cover the increased cost of medicines, affecting nearly 6 million patients. Similarly in Peru, the price of medicines could increase by 100 percent in 10 years and 162 percent in 18 years.

Other rich countries, particularly those among the European Union, have quietly consented to US actions. Pharmaceutical companies have gone even further by directly challenging countries such as India and in Philippines that have sought to use the safeguards.

In 2005, cancer patient groups in India used Indian intellectual property law to stop a patent application by the Swiss company Novartis for its anti-cancer drug, Glivec. This allowed Indian companies to continue making generic versions at $2,700 per patient a year, as opposed to Novartis having a monopoly priced version for sale at $27,000 per patient a year.

However Novartis recently appealed the court's decision in a direct challenge to India's right to interpret the TRIPS Agreement to protect public health. If Novartis is successful, it could jeopardize India's generic export industry. India is the world's leading exporter of generic medicines, with 67 percent of its exports going to developing countries.

"Novartis has told Oxfam that there is no commercial market for Glivec in India and that it is challenging India in order to align Indian intellectual property law with TRIPS," Charveriat says. "However, India is only trying to use the flexibilities rightfully available to it under TRIPS and Novartis is seeking to block that right."

Meanwhile in the Philippines, the government has conducted tests and issued regulatory approval for a cheaper patented version of Norvasc, a heart disease drug now under patent to the US company Pfizer. The government is doing this to ensure that a cheaper patented version of Norvasc that costs almost 90% less will be available immediately from when the patent expires in June 2007.

Oxfam believes that the government's action is consistent with the TRIPS Agreement and with the Philippines intellectual property law. However, Pfizer is now suing the government. If Pfizer is successful, it will severely limit the government's ability to access cheaper medicines and assert its right to enforce TRIPS safeguards.

"Developing countries have a responsibility to use the public health safeguards but when they try to do so they are put under huge pressure," Charveriat said.

In order to make the Doha Declaration work, Oxfam is calling for:

  • The WTO to review the impact of the TRIPS Agreement to ensure that all members can protect public health.
  • The US to stop pressuring countries to adopt stricter intellectual property rules, especially through its FTA negotiations;
  • The EU to clarify that it will not push for TRIPS-plus measures within Economic Partnership Agreements, and that it gives developing countries the policy space to freely use TRIPS flexibilities;
  • Rich countries to give political and technical support to developing countries to use the safeguards under TRIPS to ensure access to affordable medicines;
  • Political will on the part of developing countries to implement the public health safeguards;
  • An end to lawsuits currently pursued by Novartis and Pfizer against developing countries.

"Rich countries must live up to their commitments and stop undermining the Doha Declaration with their selfish actions," Charveriat said. "Now more than ever we need a global trading system that puts health before profit and makes medicines affordable for all." 

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