E-DRUG: Access, PPI and other news from Geneva
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[crossposted from DRUGINFO with thanks. NN]
Dear Friends,
Things are moving at the 54th World Health Assembly. A few important
things to report:
On Monday, the DG addressed the plenary and spoke about "wide spread
relief after the settlement of a very controversial struggle involving
people's lives and futures". (This was a reference to the withdrawal of
the pharmaceutical manufacturers case recently withdrawn in South Africa.)
In response, a number of countries, including South Africa, have made
excellent speeches about the access issue and the need for action. At the
end of this message you will find the complete text of the South African
Minister's statement.
The DG's full speech can be accessed from the WHO website. The English
language link is:
http://www.who.int/director-general/speeches/2001/english/20010514_wha54.html.
In her speech, she also made continual references to WHO's increasing
reliance on 'partnerships' as the way forward. HAI will criticise this
strategy in its upcoming briefing session on WHO's increasing dependence
on the private sector which will be held on Thursday afternoon. HAI has
already released a briefing paper highlighting its concerns which can be
found at: http://wwww.haiweb.org/news/news.html
On the Revised Drug Strategy:
Brazil has introduced two resolutions related to access. One is on
HIV/AIDS, the other is on the Revised Drug Strategy. The latter one has
received strong support from the developing world and now has a
substantial list of co-sponsors. However, the US and parts of the EU are
apparently opposed. There is a chance that the debate will start later
this afternoon.
Will keep you posted+
Lisa Hayes and Andy Gray
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STATEMENT TO THE WORLD HEALTH ASSEMBLY BY THE HONORABLE DR MANTO
TSHABALALA-MSIMANG, MINISTER OF HEALTH OF SOUTH AFRICA ON BEHALF OF
THE SADC HEALTH MINISTERS
GENEVA, SWITZERLAND
MAY 2001
On behalf of the Southern African Development Community member-countries,
SADC, I am honored to be able to give this year!s SADC statement to the
World Health Assembly.
The SADC region is afflicted by ill-health in the form of HIV/AIDS, TB,
malaria, cholera and other communicable diseases. In addition, we have
more than our fair share of non-communicable diseases including tobacco
and alcohol-related diseases. High maternal and child mortality rates
continue to be a prominent feature in our statistics. The floods which hit
parts of Mozambique very severely, and ongoing armed conflicts in our
region and elsewhere in the world, exacerbate these and other health
related and social problems.
On an annual basis, 13 million cases of malaria are reported in the
region. In some countries up to 40% of the population has suffered from
malaria at some point during any year. For this reason, we welcome the
recent decisions to allow limited use of DDT for malaria control.
At least 3 million cases of diarrhea are reported each year. These
include the recent and ongoing cholera epidemics in 7 of our 14 countries.
This emphasises the need for development to provide basic infrastructure
in our region.
These health-related problems are exacerbated by poverty, poorly-resourced
health systems and general underdevelopment. It is only the overall
development of our countries and people that will solve the problems at
their source. Furthermore, we urge the WHO to work towards the
identification and implementation of durable, development orientated
solutions to alleviate external debt and to solve the debt-servicing
problems of our developing countries.
As a region our fundamental goal is to build health systems that are based
on the twin foundations of equity and justice. In pursuit of our goals we
are fully aware that there will be no easy victories and that there will
be many obstacles in our path. However, we remain committed to our vision
and its practical implementation because for us, access to health care is
above-all, a basic human right.
Mental health poses a major challenge to our underdeveloped services. We
welcome the emphasis and prominence that the WHA has given to this
problem. We believe better integration of mental health with other health
services will contribute to dealing with the stigma associated with mental
and neurological illnesses. We also look forward to the discussions on
infant and child nutrition. We hope that we will address this matter with
due regard also to how we can support the mothers to better cope with the
challenges of prolonged and exclusive breastfeeding.
HIV/AIDS is a major challenge in our region. In the past year we
undertook a number of initiatives at the regional level to complement the
many activities taking place at the country level.
(a) The SADC HIV/AIDS Strategic Framework and Programme of Action for 2000-
2004 was approved by the SADC Summit of Heads of State and Government in
August 2000.
(b) The Principles to Guide Negotiations with Pharmaceutical Companies on
provision of Drugs for the Treatment of HIV/AIDS Related Conditions in
SADC Countries were developed by the SADC Health Ministers, and approved
by the SADC Council in August 2000.
(c) Council approved the inclusion of the SADC economic sectors in the
regional HIV/AIDS response.
We remain firm in the view that what we need to fight HIV/AIDS are a
complex set of interventions, each occupying a special place and which
together constitute a comprehensive and multi-sectoral approach and
response that is fundamental for success. We have identified as:
* Socio-economic upliftment,
* The strengthening of health systems,
* Strong preventive programmes,
* Robust and aggressive treatment of opportunistic infections,
* Strong mitigation programmes for those infected and affected,
* Targeted and appropriate use of antiretrovirals.
Such an approach will also ensure that we do not make the mistake of
developing a vertical response to this epidemic.
As regards antiretroviral medicines, let us reiterate that at current
prices our public health sector budgets remain inadequate. In addition,
in most of our health systems, the infrastructure including human
resources remains incapable of wide-scale provision of these drugs. Even
if providing antiretrovirals is cost effective in the long term, they
nevertheless remain unaffordable at the present time.
Chairperson, during the past twelve months we have been caught up, as a
region, in protracted interactions with the five multinational
pharmaceutical companies who appeared to be making offers around
affordable access to medicines. The experience has been frustrating and
confusing. But because Africa is a hopeful continent we trust that there
is wisdom to be gleaned from this experience. As we move towards
discussions around the Global Trust Fund for Health we hope that we will
be able to build upon the valuable lessons learned.
SADC appreciates that during this session of the WHA we will be given an
initial opportunity for engagement on the form and shape of the Fund.
Nevertheless, we would like to urge the Assembly to consider the following
aspects:
- We believe that the fund should be open to all developing countries;
- Developing countries should have a say at all levels of political
decision-making;
- The Fund must support only those plans, many of which already exist,
that are approved by member states;
- It must support an overall strengthening of health systems generally, as
opposed to a narrow focus on the purchase of medicines;
- Where it does focus on the purchase of medicines, the Fund must be open
to bids from companies that manufacture generic equivalents of medicines;
and finally,
- The Fund must be operated on a fast track basis and with the leanest
possible administrative and governance structures.
As many of you are already aware, the African Presidents have tasked the
Presidents of Algeria, Nigeria and South Africa to drive the Millennium
Africa Programme, commonly known as MAP. We believe that the Global Trust
Fund for Health should also be able to provide funding for some of the
public health initiatives under MAP.
Let me take this opportunity to thank all those member states and
organisations, including the SADC and NAM Ministers of Health for the
support given to my country in our battle against the pharmaceutical
companies. We hope that this victory has made a small contribution to
our common pursuit for affordable access to medicines.
Regarding the court case, let me briefly set the record straight. Firstly,
there was no out of court settlement. What we have is an unequivocal
withdrawal in a public court of law of all elements of the legal
challenge. In addition, the pharmaceutical companies will pay all costs
incurred by the South African government since the inception of the case.
Secondly, the issue of the court case has been portrayed persistently as a
battle only for affordable access to anti-retroviral medication. This is
erroneous. The case really concerned affordable access to medicines of all
kinds.
Whilst we welcome the withdrawal from the legal action by the
pharmaceutical industry, we realise that there is still a long way to go
before all of us can be secure in the knowledge that the battle for
affordable medicines has been won. This, is a matter that affects most,
if not all of the member states of WHO, and it therefore imposes an
obligation on the WHO to unequivocally and firmly take the lead in what is
clearly a key element in the struggle for better health for all.
As SADC, we would like to make the following earnest appeals to the WHO as
important elements that will take us in the direction of achieving just
and equitable health systems for all our peoples:
- That the WHO reviews its linguistic system, in an effort to promote
gender equality by ensuring the use in all it documents, publications and
meetings, of gender sensitive and inclusive language.
- That the WHO gives serious consideration to its representivity both from
the gender perspective and the perspective of developing versus developed
countries. It is a matter of grave concern to us that the developing
world is barely represented in the recent appointments.
- That the WHO acts in a more transparent manner with regard to both the
process and substance of a document that aims to deal with a campaign
against the diseases of poverty.
Let me conclude by thanking the Director General, Dr Brundtland, for her
stewardship of our organisation. My colleagues in SADC and I also wish to
reiterate our commitment to work alongside Dr Samba as he endeavours to
restore the dignity and respect of our regional organisation, AFRO. Of
course, we will continue to be critical of both of you when we believe
that it is appropriate, but we trust that you will not doubt our respect
and support for your overall leadership. You can count on us to work
together with you for the advancement of public health as a basic human
right.
Let us be strong and soldier on!
I thank you.
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