Trade Talks at Doha

1. Health and DevelopmentNovartis Symposium4/14/01Access to Medicine – The Role of Patent RulesSophia Tickell- Oxfam GB

2. Trade Talks at Doha • Test of legitimacy of WTO & multilateral trading system. • Patents/Medicines by far the biggest single issue

3. Outcome: Declaration “We Agree That the TRIPS Agreement Does Not and Should Not Prevent Members From Taking Measures to Protect Public Health”

4. What is at issue? • Privileged access of pharmaceutical industry led to imbalance between public & private interests in global trade rules, including: • TRIPS agreement – All WTO member states to offer a minimum of 20 year patent protection on all products and processes

5. Why does it matter?1. The Health context • 37,000 people each day dying of treatable/preventable diseases • 1 million die each year from malaria • 2 million die each year from T.B. • 3 million die each year from HIV/AIDS

6. TRIPS raises prices Poor people buy medicines & struggle to do so in LDCs and DCs Luweero, Uganda – ¾ poor families sell food crops to buy medicines Colombia – 1 in 5 on/below poverty line – medicines = greatest household health expenditure. Poor governments do too 61 DCs average medicine spend = S$10 2. Why does it matter? – Poor people can barely afford medicines

7. 3. Why does it matter? • Extending scope and duration of patent protection = extending scope and duration of high prices: • Combivir (GSK) US$7,000 in US, Cipla version US$275 • Thailand recent visit - indinavir = 37 baht from company (Roche), from India = 13 baht

8. 2001 – Increased familiarity with industry’s pro-TRIPS arguments: • problem of access = lack of infrastructure, transport, health personnel, training education • takes US$500m to bring a new drug to market • patents as incentive for research (including for poverty diseases) and reward for innovation

9. 2001 – Increased familiarity with industry’s pro-TRIPS argumentscont.: • public private partnerships as adequate response to developing country needs • need for uniform system to prevent undercutting of prices in North

10. 2001 – Growing recognition of social function of generics: • Early entry of generics = earlier price falls for the poor (rule of fives) • Low prices extremely significant poor individuals – little state health coverage/few insurance schemes

11. Low prices important for poor governments – save foreign exchange - WB report that TRIPS will = net outflow of US$20bn in technology payments & admin costs Local generics industry allows governments to negotiate over prices: Nelfinavir & Indinavir – Brazil Cipro – US$1.77 per tab to US$0.95 – US 2001 – Growing recognition of social function of generics

12. Unlike to recur: South Africa - Nelson Mandela in the dock for attempting to get cheap drugs for 4.2m AIDS sufferers Dominican Republic threat to textiles Brazil - Successful HIV/AIDS programme under threat 50% mortality cut • 2001 – Declaration = concerted developing country determination to ensure trade rules more balanced

13. 2002 – TRIPS not yet resolved: • Issue of compulsory licensing for export needs early & unconditional resolution • Review needed to access impact of length and scope of pharmaceutical patenting and amend TRIPS to ensure access