To enjoy the benefits of scientific progress is a human right
Please find below the MSF statement by Ellen 't Hoen, given during
a press briefing yesterday in Geneva.
Seco Gerard, MSF Amsterdam
Statement by Médecins Sans Frontières (MSF) on TRIPS and affordable
medicines press briefing at the occasion of the TRIPS Council session
on access to medicines.
Geneva, 19 June 2001
by Ellen 't Hoen
MSF is an independent humanitarian medical relief organisation
founded in 1971. MSF works in 400 projects in more than 80 countries.
In 1999 MSF started the Campaign for access to essential medicines in
response to the ever-growing access to medicines gap between the de-
veloping and developed world.
To enjoy the benefits of scientific progress is a human right. Yet in
the field of public health and particularly with regard to pharmaceu-
ticals access to innovations is unequally distributed in the world.
One third of the world population lacks access to the most basic es-
sential drugs and, in the poorest parts of Africa and Asia this fig-
ure rises to one-half. Developing countries where three-quarters of
the world population lives account for less than 10% of the global
pharmaceutical market. A number of new medicines that are vital for
the survival of millions are already too costly for the vast majority
of people in poor countries.
The implementation of the WTO Agreement on Trade Related Aspects of
Intellectual Property Rights (TRIPS), scheduled to be completed by
2006 by all member states may be expected to have further serious
consequences for the availability at affordable prices of new essen-
Essential medicines are not like any other commodities, yet under the
present WTO rules for intellectual property they are regulated very
much like any other product. But medicines are not CD-ROMs, they are
not Barbie dolls, they are not computer games. They are for millions
of people around the world a matter of life and death.
Today, there is a dire imbalance between the sanctity of patents and
the health of people. Access to essential medicines should not be a
luxury reserved for the wealthy, but should be reinforced as a criti-
cal component of the human right to health.
We therefore welcome the TRIPS Council session on affordable medi-
cines that will give the WTO member-states a forum to discuss ways to
ensure that intellectual property rights do not form barriers to ac-
cess to medicines.
Though there is a growing awareness among politicians of the faults
of the current patent system, pharmaceutical companies have declared
at numerous occasions that patents are not the problem and that
strong IP protection is needed to ensure new drugs for the future.
The experience of our doctors in the field shows differently:
- In South Africa we run an AIDS project in Khayelitsha, a township
with a population of 400.000 people. Around 25% of the population is
HIV positive and at this moment an estimated 5000 people need treat-
ment with antiretroviral drugs. These drugs are priced at more than
2300 $ for one year adult treatment. People in Khayelitsha cannot af-
ford this. We have started treatment with antiretroviral therapy in
the township, but we cannot make use of the offer of Indian generic
manufacturers of triple therapy for 300$ or less because of patents
held my multinationals.
- In Kenya people pay 6$ per unit of fluconazole an essential drug to
treat cryptococcal meningitis. This disorder affects around one in
ten people who have AIDS. In some countries, the prevalence is up to
25%. Without treatment, life expectancy is less than 1 month. Generic
versions of fluconazole are available for prices as low as 0.10 $ per
unit. Pfizer has just announced a donation but only least developed
countries - which excludes Kenya - are eligible.
- 8 million people get active tuberculosis (TB) each year. 2 million
people die of TB each year. Yet it has been over 30 years since the
last major new TB drug was developed. While pharmaceutical companies
argue that their patents must be sacrosanct for the sake of R&D, pri-
vate sector R&D neglects the need of the poor. Of the 1393 new chemi-
cal entities developed between 1975-1999, only 13 were for the treat-
ment of tropical diseases. The present patent system simply does not
provide incentives for R&D into diseases of the poor.
The medicines are in the North while the need is in the South. The
challenge for those meeting tomorrow is how to bridge this gap. Bra-
zil has made important steps to ensure that its HIV/AIDS population
can benefit from pharmaceutical advances. By offering universal ac-
cess Brazil has cut the death rate from AIDS with 50%, and saved 472
million $ in hospital expenditure. At the core of the successful Bra-
zilian programme is the ability to produce the medicines generically
and locally. Since Brazil began producing some AIDS drugs generi-
cally, the prices of equivalent products fell by 79%.
As from 2006 all WTO member states should have changed their national
IPR laws to be compliant with the TRIPS Agreement. Policies such as
those of Brazil, or prices for antiretroviral drugs as offered by In-
dian manufacturers will no longer be possible because the new drugs
will fall under a more stringent patent system required by the WTO
This leaves us with the question what will happen when sources of af-
fordable new medicine in the developing world have dried up and de-
veloping countries may be left at the mercy of Big Pharma.
MSF therefore strongly supports a pro- public health interpretation
of the TRIPS Agreement. Our demands to Member-States include:
- To let developing and least developing countries benefit from a
wide scope of interpretation of TRIPS Article 31, and in particular
to support fast track administrative compulsory licensing procedures,
especially when they relate to public health.
- To further support compulsory licensing for export to address pub-
lic health needs.
- To consider humanitarian and health exceptions to patent rights un-
der article 30.
- Ongoing assessment of the effects of the TRIPS Agreement on access
MSF is not against patents and not against patent legislation. True
innovation deserves to be protected and to be awarded. We advocate a
balanced IP regulation that takes into account the specific needs and
priorities of developing countries and that follows the principles
that are outlined in the TRIPS: patents should benefit the innovator
and those who need access to the innovation. Should it not be possi-
ble to achieve this balance under the present international agree-
ments it will be necessary in the TRIPS review process to strengthen
the public interest further by providing explicit exceptions for key
health care technologies. Innovation and technological development is
not a goal in itself but should be a means to a better life and a
more just and humane society. Human life and dignity should count for
more than the interest of the commercial sector.
[reproduced with thanks from E-Drug -- sorry there is currently no
[Note: It is interesting that Ellen chose to use an analogy with two
Information Communication and Technology products (CD-ROM, computer
games) since these products fall in most countries under the copy-
right regime, except in Japan and the USA where patents on software
are allowed (Europe is contemplating it as well, but authors of free
and/or open software are afraid that this would limit their freedom,
e.g. the horizontal scroll bar which you perhaps see under this mes-
sage is patented in the US, such patent could make it difficult for
Linux to include important software features). With this analogy
Ellen opens up a larger debate whether it would be more fair and just
that patents may be issued on software instead of on drugs and medi-
cines. But for a lot of young persons, the ability to program, to
write software is a bit like growing plants in a garden or caring for
animals in a farm; sharing programmes has become an important social
tissue (world-wide); many find in this activity a meaningful reason
of living, which as we know does positively impact onto health (it
would be most urgent to study the impact of unemployment on the im-
mune system). Computer programmes may sound like a product but for
these young persons it is similar to singing or dancing, which also
fall under the regime of copyright. If dance could be patented what
would happen to the creativity and innovation of young persons, and
how could young generations express themselves? Programming brings
enjoyment, satisfaction, a sense of achievement; something that young
generations desperately need as the increase in deadly violence at
schools facilities cruelly reminds it.
However Ellen is quite correct to ask questions on this status quo.
This will generate more exchange of ideas between the persons follow-
ing these two questions, especially because both HIV/AIDS and free
software are things that affect young generations, kids, teen-agers,
young unemployed adults. I'll try to make a timid contribution in
that direction at the Linux Tag 15 Seminar on July 5th, 2001: "15
years of software patent practise at the European Patent Office --
The concept of technical character in 1986, today and in the future":
If you have some material that may pertain to aspects of patents and
would wish that it is quoted during this seminar, please kindly for-
ward me the URL with a short title.
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