E-drug: New York Times WHA
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May 18, 2000
Patent Holders Fight Proposal on Generic AIDS Drugs for Poor
By DONALD G. McNEIL Jr.
PARIS, May 17 -- Brazil caught world health authorities by surprise today
by asking them to set up a database of prices of all anti-AIDS drugs, a
move that would allow poor countries to shop for the best deal worldwide.
The proposal has upset the world's large pharmaceutical companies because
the database would have to include drugs made in countries like Brazil,
India and Thailand, whose laws disregard many drug patents.
Companies in those countries, and some others, make generic versions of the
most important -- and most expensive -- AIDS drugs and sell
them for pennies per dose.
The issue is at the heart of the debate over drug prices. The major
American and European drug makers argue that they alone should have the
right to manufacture and sell the drugs they invented, and that any
decision to offer lower prices to poor countries should be theirs, as five
companies did last week in a landmark agreement with the World Health
Organization.
But a coalition of public health advocates, advocates for those with AIDS,
third world governments and third world pharmaceutical industries argue
that poor nations should be allowed to use clauses in world trade treaties
that let countries facing health emergencies void the patents on
life-saving drugs and make their own low-cost generic versions.
For the rest of the world's poor nations -- the vast majority of which lack
their own drug industries -- the database would make it easier to import
cheap remedies.
Brazil made its request as a surprise amendment to a resolution before the
World Health Assembly, the annual meeting of all the world's health
ministers at the United Nations convention center in Geneva. Today it
seemed to be getting wide support.
"I think the reason Brazil got so much support is that its proposal got to
the heart of the matter: that countries want to be able to shop around the
world for the best deals," said Ellen 't Hoen, a health policy consultant
to Doctors Without Borders, the medical aid agency. "That's scary to the
pharmaceutical companies, because it will show that their expensive drugs
are sold elsewhere at tiny fractions of their prices."
Observers from Doctors Without Borders and from Act Up, an American
advocacy group for people with AIDS, both of which strongly support the
Brazilian initiative, said the United States delegation initially fought
it, though the Americans denied that.
This evening in Geneva, it was agreed that a committee would meet on Friday
to draft new amendments based on Brazil's proposal and some offered later
by other countries on blood banks, traditional medicine and other issues.
The committee will include representatives from countries with large
pharmaceutical industries, as well as countries hit hard by AIDS.
Beyond opposition from major drug companies, creating and maintaining such
a database presents problems of its own. If the Brazilian amendment passed,
it could put a huge burden on the organization, said Dr. Daniel Tarantola,
senior policy adviser to the World Health Organization's director general,
Gro Harlem Brundtland. Drug prices change constantly, so a large monitoring
staff would be needed.
More important, a database under the aegis of the World Health
Organization, a United Nations agency, could be taken as an endorsement
that all the drugs in it were safe, a representative of the international
pharmaceutical industry said. The World Health Organization does not now
have the money to test them.
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