DEVELOPMENT: WTO and WHO Agree – Health over Trade

By Gustavo Capdevila Reprint | | Print |

Gustavo Capdevila

GENEVA, Aug 22 2002 (IPS) - The principle that public health concerns should take priority over trade interests was publicly accepted Thursday by the international organisations entrusted with regulating these two areas, which are often the source of discord.

The World Health Organisation (WHO) and the World Trade Organisation (WTO) recognise the right of each country to adopt measures restricting imports or exports when they are considered necessary to protect the health and lives of people or to preserve national animal and plant life.

“WTO jurisprudence has clearly established that its members have the undisputed right to determine the level of health protection they deem appropriate,” says Miguel Rodríguez Mendoza, one of the trade institution’s four deputy director-generals.

The tensions between the right to health services and the existing multilateral trade rules have troubled the WTO since it was created in 1995, and have been a stumbling block in its relations with civil society.

Since then, non-governmental organisations (NGOs) specialising in health and development, like Doctors without Borders, Oxfam International and the Third World Network, have waged a campaign to ensure that trade in medicines is subject to universal rights and values, and not to the rules of the market.

That principle was ultimately ratified in a declaration approved last November in Doha, Qatar, by the WTO ministerial conference.

A joint study released Thursday by the WHO and WTO refers to the Doha Declaration as a “landmark” because it “affirms that the TRIPS (Agreement on Trade-Related Intellectual Property Rights) should be interpreted and implemented so as to protect public health and promote access to medicines for all.”

Germán Velásquez, coordinator of the WHO’s pharmaceuticals action programme, pointed out that the WTO has accepted the interpretation of the Doha Declaration that consecrates the right of member states “to make full use of the safeguard provisions of the TRIPS Agreement in order to protect public health and promote access to medicines.”

Officials from the WHO underscored the importance of achieving such recognition from the WTO, particularly given that the debate on the relationship between public health policy and trade is to be reopened in the coming weeks.

The WTO’s council on the TRIPS Agreement is slated to meet Sep 17 to discuss pending matters related to the protection of medical patents when there are urgent public health needs to be addressed.

TRIPS provides for a certain level of flexibility in implementing the accord in that it permits countries, under certain conditions, to limit patent holders’ exclusive rights. For example, a government may grant what are known as compulsory licenses and allow parallel imports of patented medical products.

According to the Doha Declaration, the TRIPS council must find a solution before year’s end to the problem of the use of compulsory licensing in countries “with little or no manufacturing capacity or insufficient market demand” for the medical product needed.

In these discussions, the delegations from the United States and Switzerland — which defend the intellectual property rights of their big pharmaceutical companies — generally clash with the delegations for developing countries, particularly those from Africa, which have the support of health-related NGOs.

The new WTO and WHO study covers all trade accords related to health and health policies, in addition to intellectual property rights (TRIPS).

The treaties include the agreements on Technical Barriers to Trade (TBT), Sanitary and Phytosanitary Measures (SPS), and Trade in Services (GATS).

All of these accords involve articles that have come under fire from the NGOs and developing countries due to their negative impact on health policies.

In the case of GATS, which is currently in its review stage at the WTO, critics have warned of the risk that liberalisation of trade in services would lead to market-based provision of water, education and health services.

The study drawn up by the WTO and WHO states that the liberalisation of health services offers new opportunities if appropriate regulations are in place, resulting in improved quality and efficiency and increasing revenues.

In some countries, such as Thailand and Jordan, the health industry operates as a regional centre, attending to foreign patients, thus increasing national income and creating employment.

Other developing countries, including Cuba, India and the Philippines, export their doctors and nurses, generating cash remittances sent to their families remaining in the home country, says the study.

However, the liberalisation of health services also has its risks, acknowledge the WTO and WHO. In some cases, problems of access and equality, in the areas of medical services and financing, have been exacerbated, especially for poor populations in developing countries.

South Africa alone has lost tens of millions of dollars as a result of the emigration of its doctors. Poor countries that treat foreign patients may be shifting resources away from services meant to meet domestic demand, notes the report.

The two multilateral organisations state that the GATS only imposes very limited general obligations upon member nations, which are free to decide which services sectors they will open to foreign competition, and how they will do so.

The WHO said it would closely follow the deliberations on GATS and the proposals made by WTO members. The health agency will also study the implications of those proposals for health rights and make such information public.