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HEALTH: WHO Assembly to Face Controversies Over Patents, Taiwan

Gustavo Capdevila

GENEVA, May 19 2006 (IPS) - The most controversial debates at the 59th World Health Assembly will involve the question of intellectual property rights and health, and Taiwan’s request to participate as an observer.

During its May 22-27 session, the Assembly – the decision-making body of the World Health Organisation (WHO) – will also discuss questions like the eradication of poliomyelitis, the destruction of the smallpox virus stocks, the spread of avian flu, and the international migration of health personnel.

Denis Aitken, adviser to WHO Director-General Lee Jong-wook, acknowledged the difficulty presented by the debate on intellectual property rights and health, an issue that has been the focus in recent months of a report commissioned by the WHO itself, and of a proposal set forth by the governments of Brazil and Kenya.

The report by the independent Commission on Intellectual Property Rights, Innovation and Public Health recommended, for example, that governments avoid any stipulation in bilateral free trade treaties that could reduce access to medicines on the part of developing countries.

The conclusions reached by the Commission, which was headed by former Swiss president Ruth Dreifuss, revealed the differences between its members, which were outlined in an annex to the report signed by experts who adhered to positions taken by the pharmaceutical industry or by different developing countries.

The 59th Assembly of health ministers from WHO’s 192 member states will discuss the Commission’s recommendations as well as the proposal drafted by Brazil and Kenya, which suggests the creation of a working group to study the establishment of a global framework for supporting R&D on medicines consistent with public interest needs.

The “Global Framework on Essential Health Research and Development” proposed by Brasilia and Nairobi has to do with criticism by scientific and humanitarian groups of global health R&D as backed by the pharmaceutical industry and industrialised countries, which dedicate 90 percent of investment to address the medical needs of 10 percent of the world population.

The initiative submitted by Brazil and Kenya calls for the new working group to propose to the WHO the adoption of intellectual property protection systems that would increase access by developing countries to health innovations and medicines.

“You would expect that the WHO, responsible for improving health in the world, would be the organisation that would be the leader in this field,” said Rowan Gillies, president of the International Council of Médecins Sans Frontières’ (MSF). But “today that’s not the case.”

For that reason, the MSF and other international humanitarian organisations launched the Drugs for Neglected Diseases Initiative (DNDI).

Former MSF president Bernard Pécoul, who now heads the DNDI, told IPS that the initiative was pressing for significant efforts and resources to go towards R&D of medicines and treatment for “forgotten” diseases like trypanosomiasis, leishmaniosis and malaria.

The DNDI currently involves five public sector institutions – the Oswaldo Cruz Foundation of Brazil, the Indian Council for Medical Research, the Kenya Medical Research Institute, the Malaysian Ministry of Health and France’s Pasteur Institute – as well as the MSF and the UNDP/World Bank/WHO’s Special Programme for Research and Training in Tropical Diseases (TDR), as a permanent observer.

The initiative is similar to the movement led by Brazil and South Africa in the late 1990s in favour of the primacy of health over trade.

MSF and other independent humanitarian organisations like Oxfam and Focus on the Global South joined that effort, which achieved the adoption of the Declaration on the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and Public Health at the November 2001 World Trade Organisation (WTO) ministerial conference in Doha.

The document, considered an important step forward in the campaign for affordable medicines, affirmed the primacy of public health over intellectual property rights, and the rights of governments to make full use of the public health safeguards in TRIPS.

Brazilian representative Guilherme Patriota said “it would be interesting to see a similar process” now.

“That is what we are trying to do,” Pedro Saldanha, another official with the Brazilian mission in Geneva, told IPS. “It depends on the outcome of the Assembly, but that’s the idea.”

Governments, and in this particular case WHO, must define R&D priorities, argued Pécoul. “Today setting priorities for research is not a key activity of WHO, except when they are under pressure as is now the case with the avian flu,” added the executive director of DNDI.

Of the 105 billion dollars dedicated to global health R&D annually, 90 percent focuses on diseases that affect just 10 percent of the world population, said Pécoul.

“There is a lack of leadership, a lack of investments in terms of funding from major governments,” he added.

Gillies complained that there is currently no “useful diagnosis test for tuberculosis, especially for people with HIV/AIDS. It’s an incredible situation because that’s the disease that kills most people with AIDS in the world.”

In the meantime, the international pharmaceutical industry continues to do more and more business in the industrialised world. The global market for pharmaceutical products grew seven percent in 2005, to 602 billion dollars.

Of that total, some 265 billion dollars in drugs went to North America, nearly 170 billion to Europe, 60.3 billion to Japan, 46.4 billion to the countries of Africa, Asia (except for Japan and China) and the Pacific, 24 billion to Latin America, and the rest to China.

Patriota said changes to international treaties promoted by the private sector, through bilateral agreements and other means, have led to increasing standards of protection of intellectual property rights.

In these conditions, “governments of developing countries have their hands tied,” said the Brazilian diplomat.

The pharmaceutical companies “are very strong politically and they can actually manoeuvre weaker governments in developing countries and pressure them against taking any real effective action that may threaten their interests,” such as attempting to control the prices of access to medicines or producing generic drugs.

Another touchy issue, Taiwan’s request for observer status in the World Health Assembly, is unlikely to see any change from previous years, when it was turned down, said Aitken.

A resolution adopted by the United Nations General Assembly in 1971 recognised only China as a member of the world body, thus expelling Taiwan.

Since then, Taiwan’s petitions to take part in the World Health Assembly as an observer have failed to prosper.

Only 25 countries – 24 of which are WHO members – recognise Taiwan as an independent state. The remaining 147 members of the global health body only recognise China. “So the balance of the member states is very clearly in favour of the Chinese position, which is that ‘there is one China’,” said Aitken.

Chao-chin Huang, secretary of the Taipei Representative Office in Belgium, pointed out to IPS that “the WHO constitution enshrines the principle that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being.”

“Under this principle, the 23 million people in Taiwan should have the same rights as all other human beings to normal and regular access to the WHO system,” argued the official, on a visit this week to Geneva.

The International Federation of Journalists (IFJ) also expressed concern that WHO had refused to accredit Taiwanese journalists at the Assembly.

According to IFJ president Christopher Warren, the refusal “is discriminatory and is undermining the ability of the Taiwanese media to cover world affairs.”

“Journalists are independent individuals and should not be seen as representatives of their country of origin,” argued the IFJ in a statement.