E-DRUG: Brundtland on WHO's role in trade agreements
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[copy of Brundtland speech in Amsterdam meeting]
International Trade Agreements and Public Health: WHO's Role
Presented by video at the Conference on Increasing Access to Essential
Drugs in Globalised Economy, Amsterdam, 25-26 November 1999
Ladies and Gentleman,
I send my greetings to all participants at this very timely gathering
of so many key stakeholders in the quest for health and progress.
Access to essential drugs - this is a key priority for the World
Health Organization. Our longstanding aim is to help ensure equity of
access to essential drugs, rational use, and quality. This is simply
part of the fundamental right to health care. Our work in WHO is built
on this premise.
We have come some way towards securing this right in the last decades.
But there is still a long way to go when one-third of the world
population still lacks access to essential drugs. In the poorest parts
of Africa and Asia, over 50% of the population are deprived of it.
This is the situation in a world of considerable surplus - in a world,
which leaves a century marked by the most spectacular scientific
innovations benefiting people's health. This is simply not acceptable.
We must take action and we are taking action.
Over the last twenty years considerable progress has been made to
expand access to essential drugs. WHO is working with all its
partners to ensure that access continues to expand and to keep this
issue on the agenda as the new international trade agreements
affecting the pharmaceutical sector are being implemented.
Three factors are critical for securing access: adequate financing,
affordable prices, and reliable supply systems. Dr Michael Scholtz,
Executive Director in charge of health technology and pharmaceuticals,
will cover these factors in his presentation.
My message is that addressing the problem of access to essential drugs
requires having all three critical factors in place. That is no small
task and solutions cannot be brought about by just a few. Making a
difference requires the often painful work to build consensus among
stakeholders that can move things in the right direction. Contributing
to that process is WHO's responsibility.
Speaking out for those who are denied access to essential drugs -
continuously searching for practical solutions which can enhance the
access - and building consensus to reach these goals - this is, in
short, what WHO will do.
In a few days delegations gather in Seattle to initiate a new round of
trade negotiations. WHO will be present - not as a participant - but
as an active and vocal observer. Why is this important to us?
Because health products and health services are tradable. Health
products such as pharmaceuticals are produced, marketed and sold
across the globe - benefiting some but failing to reach too many. So
the rules that regulate this trade are key.
Because disease is tradable. As goods and people travel across
continents health is affected. Food-borne disease, contaminated water
and even transport of mosquitoes in aeroplanes represent new risks.
And because health is opportunity. In few fields are the potential
scientific innovations more striking than in health. The bottom line
for every regulatory activity in the international system - including
the trade system - should be to contribute to the enhancement of
people's health and well being.
On international trade agreements and pharmaceuticals, WHO has five
public key health messages. Let me share them with you:
First, patent protection is a necessary and effective incentive for
research and development for needed new drugs. Essential drugs are a
public good and not simply just another commodity. Patents must
therefore be managed in an impartial way to benefit both the patent
holders and the public.
Protectionism has never benefited public health. WHO supports
governments to enact national legislation which can draw advantage
from more open trade and a better regulated international system. And
we support governments in incorporating the safeguards that have been
built into the WTO TRIPS agreement to protect the rights of the
public.
Second, priority-setting for research and development in the
pharmaceutical market is imperfect. There are also striking market
failures when here is such desperate demand for products that are
available - but not within reach of those in need.
WHO has initiated with other partners innovative mechanisms to
stimulate research and development in areas of high public health need
such as malaria and tuberculosis. Through its Medicines for Malaria
Venture (MMV), the Global Alliance for Vaccines and Immunication
(GAVI) and other initiatives WHO is actively encouraging public sector
financing for critical public health problems and neglected tropical
diseases.
Third, WHO strongly supports development of mechanisms for
preferential low prices for essential drugs in lower income countries.
Lower-income countries simply cannot be expected to pay the same
price for essential drugs as the wealthier countries.
For governments, industry, and other stakeholders, there is a range of
measures which might be used to achieve preferential pricing. But
where there is an abuse of patent rights, where patented essential
drugs are not on the market, or where a national emergency exists,
recourse to compulsory licensing is a legitimate measure consistent
with the TRIPS Agreement.
Fourth, WHO supports implementation of the TRIPS agreement to ensure
prompt availability of generic drugs upon patent expiration. WHO has
long promoted use of generic drugs of assured quality. Experience from
countries with "generic-friendly" policies clearly demonstrates that
the market competition created by these policies increases
affordability of medicines, stimulates true innovation within the
research-based industry, and encourages increased production
efficiency by the generic industry.
Finally, trade agreements should not create barriers to trade. An
important WTO principle is that technical regulations, standards and
assessment procedures should be based on international standards,
guides and recommendations. In the areas of pharmaceuticals, WHO
norms, standards and guidelines represent such international
consensus. So we will actively promote these guidelines.
In conclusion, I would like to say how pleased we are that WHO is not
alone in our efforts. We have important partners, including
governments, the research community, bilateral donors, the private
sector, the public interest NGOs, many of whom are represented at this
meeting.
We look forward to working closely with you as we strive together to
improve universal access to essential drugs. I wish you well in your
discussions over the next two days.
Thank you.
Dr Gro Harlem Brundtland
Director-General
World Health Organization
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