Africa: Treatment Access Update, 1/2, 04/19/01

Africa: Treatment Access Update, 1/2, 04/19/01

Africa: Treatment Access Update, 1 Date distributed (ymd): 010419 Document reposted by APIC

Africa Policy Electronic Distribution List: an information service provided by AFRICA ACTION (incorporating the Africa Policy Information Center, The Africa Fund, and the American Committee on Africa). Find more information for action for Africa at

+++++++++++++++++++++Document Profile+++++++++++++++++++++

Region: Continent-Wide Issue Areas: +economy/development+ +health+


This posting contains a brief Africa Action commentary by director Salih Booker on the withdrawal of the drug company law suit against South Africa. It also includes two documents from the workshop on drug pricing held on April 8-11, 2001 in Hosbjor, Norway, organized by the World Health Organization, the World Trade Organization, the Norwegian Foreign Ministry, and the Global Health Council. The documents included are a statement by five non-governmental organizations after the workshop and the official press release from the workshop.

Additional background on the Norway workshop can be found at:

An extensive analysis of the current status of drug-pricing by Jamie Love of the Consumer Project on Technology, entitled 'How to Help the Poor, Really (and how not to), prepared for the Norway workshop, can be found at: April/000923.html [put URL on one line}

For documentation on the South African court case, see the web site of the Treatment Access Campaign

An additional posting today has a press release on next week's OAU summit, an NGO commentary on the proposed UN statement of position on treatment for the UN Special Session, and a brief update on new World Trade Organization discussions on intellectual property rights and drug patents.

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March 19, 2001

The decision by multinational drug companies to withdraw their suit against South Africa is a major victory for Africans and people around the world who support Africans' equal rights to health. Coordinated worldwide protests have had a profound impact.

At the same time, this victory does not yet bring treatment to those in need. International agencies as well as African governments are moving to recognize that treatment is necessary and not optional. But meetings in the weeks since the South African case opened on March 5 still reveal pervasive ambivalence about what needs to be done, reluctance to open the doors widely for lowest-cost generic production, and a false dichotomy between treatment and prevention.

The Organization of African Unity hosts a summit on HIV/AIDS and other diseases next week. The United Nations is in the last stages of preparation for the UN Special Assembly Session on HIV/AIDS in June. These meetings will set the tone for governmental and inter- governmental policies over the next year. It is essential that they avoid vague language and clearly affirm the universal right to health, the legitimacy of low-cost generic medications, and the global obligation to fund both treatment and prevention for HIV/AIDS as part of a strategy to prioritize public health as a fundamental human right.

Once the principles are established, the real tests will come in practice. Are the funds quickly appropriated and spent not only for drugs (at the lowest possible cost) but also for infrastructure to address treatment, prevention and the underlying social injustices that are fueling the AIDS pandemic?

Let's celebrate the victory. And let's keep the pressure on.

Salih Booker Director, Africa Action


Joint Statement of Consumer Project on Technology (CPT), Health Action International (HAI), Medecins sans Frontieres (MSF), Oxfam and Treatment Action Group (TAG) on the WTO/WHO on Differential Pricing & Financing of Essential Drugs

April 11, 2001

Hosbjor, Norway - Representatives of the five non-governmental organizations (NGOs) who participated in the three day WHO / WTO Workshop on Differential Pricing & Financing of Essential Drugs issued the following joint statement on the goals, proceedings, and outcome of the workshop.

The WHO/WTO workshop provided a new forum for health and trade experts to come together to work on eliminating trade barriers to long-term, affordable drug access. However NGOs expressed disappointment about the fact that no real progress was made to bring drug prices for essential drugs in developing countries down.

NGOs present at the meeting stressed that one proven effective way to bring prices down is to increase competition by encouraging generic competition.

In June following an initiative of a group of African countries a special session of the WTO TRIPS Council will be devoted to health. For the first time countries will discuss how the requirements of the TRIPS Agreement can be reconciled with health needs in developing countries. NGOs will work together to ensure that their proposals voiced at this workshop in Norway are addressed at the upcoming WTO TRIPS Council meeting in June 2001 in Geneva. These proposals include a call on the TRIPS Council to extend the deadline for the least developed countries to comply with the TRIPS Agreement and to design mechanisms to ensure R&D for neglected diseases in developing countries.

Comments on the Meeting - Progress & Frustration

A diverse group of stakeholders including rich and poor country governments, multilateral UN agencies, multinational pharmaceutical companies and generic drug companies, and NGO representatives gathered to discuss whether differential pricing of essential drugs could be used as a tool to expand access in developing countries while preserving incentives for future drug development.

The meeting focused on differential pricing, which the NGOs feel can be a crucial tool to help broaden access to affordable medicines in developing countries. But differential pricing mechanisms cannot come with onerous conditions attached, such as forcing poor countries to surrender their rights guaranteed under the TRIPS agreement.

Besides differential pricing, other tools -- such as voluntary licensing, compulsory licensing, and parallel importing - are available to help broaden access to affordable medicines.

After 2 + days of discussion not a single company disclosed plans to actually implement differential pricing for their drugs. Current offers for AIDS drugs are ad hoc, inadequate, and still far below the prices that can be obtained from generic manufacturers. CPT's Jamie Love said, "It's ironic that in a meeting organized to help the poor, the main drug company proposals were to increase intellectual property protection and ask for the elimination of national price controls. At one point, Oxfam actually offered to give the industry a grant, since they were pleading poverty."

The Way Forward -- Global Access to Essential Medicines

The NGOs issued a series of recommendations to enhance research and development (R&D) and to ensure that intellectual property (IP) protection, serves public health needs rather than the reverse. The NGOs stressed that there is no single solution; rather, a mix of mutually supportive strategies will be required to assure dramatically reduced drug prices in developing countries. Policies to achieve this goal should:

-- be sustainable and not be solely based on charity or donations

-- strengthen developing countries' autonomy

-- attract donor funding

-- include all essential medicines and should not be limited to drugs for HIV/AIDS and related conditions only.

Greater Competitiveness Helps Lower Drug Prices

MSF's Ellen 't Hoen made the following proposals at the meeting:

Equity pricing strategies should not depend solely on voluntary offers by the multinational drug firms. Hitherto, most drug companies have preferred low-volume-high price strategies. Equity or differential pricing should be combined with mechanisms to increase competition and encourage sustainable approaches. For example, it should not have a negative effect on the development of a generic industry in the South.

One proven effective way to decrease drugs prices is to increase competitiveness:

-- In Brazil, antiretroviral prices for certain anti-HIV drugs came down by 82% within five years after Brazil initiated local production and provided universal free HIV treatment to Brazilians who needed it.

-- Recent offers from generic producers have sparked a price war for antiretrovirals and have brought the annual price for triple therapy down from $10,000 to $350 in a single year.

The need for competitive markets will require flexibility in implementation and a pro public health interpretation of the TRIPS agreement. The NGOs welcome a special TRIPS Council meeting as proposed by a group of African countries and which will take place in June 2001.

Global procurement strategies and funding should include measures to increase and upgrade generic production in the south.

Voluntary licensing and compulsory licensing can help increase the number of generic producers in the market.

Voluntary licensing agreements have the added advantage that they would effectively deal with the companies' fear that low-priced drugs in developing countries might flow back into high income country markets.

Research & Development

The NGOs called for a new global Convention on research & development, designed to strengthen both public- and private-sector research. At every gathering to discuss access to medicines, the big pharma companies raise the specter that any effort to help the poor will harm R&D. Some claim proposals to lower drug prices in developing countries, including the use of compulsory licensing of patents on essential medicines, may lower their profits. The idea of the Convention is to create new mechanisms to boost global R&D funding in ways consistent with access to medicines and health needs by encouraging research on neglected diseases. Country support for R&D funding could take a variety of forms, including publicly funded R&D, mandatory R&D requirements for companies, or the big pharma solution, which is high levels of patent protection and high prices.

The NGOs will ask the World Health Assembly in May to request the WHO to convene the negotiations by the end of the year.

The NGOs noted with interest the proposal by Jeffrey Sachs of Harvard University, who addressed the workshop by video uplink, for a global infectious disease prevention and treatment fund which would pool resources from rich countries to provide access to low-cost drugs for HIV/AIDS, tuberculosis, and malaria. However, they opposed any effort to link the endowment of such a fund to conditions such as the surrender by developing countries of their rights under TRIPS to utilize compulsory licensing, parallel imports, and other mechanisms to assure sustainable access to low priced, high quality essential medicines.

The NGOs will continue working to support the development of an effective, long-term, sustainable, global strategy and a drug procurement and distribution system to provide affordable drugs for people with HIV/AIDS in developing countries.

For additional information please contact:

CPT - James Love: + 1 202 3613040 (mobile) HAI - K. Balasubramaniam (Malaysia) - + 603 77261599 MSF - Ellen 't Hoen: + 33 6 22375871 (mobile) Oxfam - Phil Bloomer: + 44 186 5312251 mobile: + 44 7720259769 TAG - Mark Harrington: + 33 1 43267246


11 April 2001

Joint WTO-WHO-Norwegian Foreign Ministry-Global Health Council press release

Hosbjor, NORWAY - Making life-saving medicines more affordable for poor countries is vital for improving public health. More importantly, it is realistic, experts said in a three-day workshop that ended today (11 April 2001).

In particular, 'differential pricing' - companies charging different prices in different markets according to purchasing power - is a feasible means of achieving this, provided certain conditions are met.

That was a widely held view among a diverse group of 80 experts from 21 countries and a wide range of professional backgrounds, participating in a workshop organized jointly by the World Health Organization, World Trade Organization, Norwegian Foreign Ministry and Global Health Council, a broad-based US organization in the healthcare field.

The workshop examined in detail ways to reduce pharmaceutical prices in low-income countries and how to increase financing so that the world's poorest people can obtain necessary medicines and healthcare. HIV/AIDS, malaria and tuberculosis featured prominently, but a wide range of other diseases that affect poor people were also discussed.

WHO Director-General Gro Harlem Brundtland said the meeting had been constructive and helpful.

'It is clear that the price of medicines does matter - especially for people in poor countries,' she said.

'We heard from the experts that much lower prices can be achieved for the poorest countries. Equally important is strengthening health systems, and, for the poorest countries, securing additional international financing,' Dr Brundtland said.

Participants attended as experts in their own right. They came from: developed and developing country governments; international research-based companies; generic pharmaceutical companies from Asia, Africa and Latin America; non-governmental organizations; consumer and treatment groups; universities; and international organizations.

'Although participants clearly approached the issues from different points of view, there was broad recognition that differential pricing could play an important role in ensuring access to existing drugs at affordable prices, particularly in the poorest countries, while the patent system would be allowed to continue to play its role in providing incentives for research and development into new drugs,' said Adrian Otten, director of the WTO's Intellectual Property Division.

Two of the organizers, the WHO and WTO, will each report on the outcome to forthcoming meetings in their organizations to be held in the next few months. In May, the WHO holds its World Health Assembly, and in June the WTO's Council on Trade-Related Aspects of Intellectual Property Rights (TRIPS) will hold a special discussion on intellectual property and access to drugs.

All participants will be able draw on the ideas and experiences exchanged in the workshop, for use in their own work, together or separately.

Differential pricing has already been achieved for commodities such as vaccines, contraceptives and condoms through a combination of high-volume purchasing, reliable and adequate financing, advocacy, corporate responsibility and market forces.

The challenge is to find ways to expand this to life-saving medicines. The participants accepted that there is no single formula to achieve this. A wide mix of options is needed, they said.

'Intellectual property rights stimulate development of new medicines, but must be implemented in an impartial way that safeguards public health. We also need to ensure that there are additional incentives for the development of the drugs needed to address the health problems of people in poor countries,' Dr Brundtland said.

Among the ideas emerging from the meeting were:

Differential prices

Differential pricing would allow companies that make patented drugs to recover most of the costs of research and development in richer markets and at the same time to sell or license production at lower prices in lower-income countries. Advocates said this could be a win-win solution if consumers in richer countries do not face higher prices as a result.

Critical to the success of this would be methods of preventing lower priced drugs from finding their way into rich country markets. A number of speakers were also concerned that lower prices in development countries should not be used as reference points for price controls in industrialized countries.

Options for appropriate strategies suggested in the workshop included: creating the right conditions so that the market determines differential pricing; discounts negotiated bilaterally between companies and purchasers (which could include bulk purchasing on behalf of many customers); licences agreed voluntarily between patent owners and generic manufacturers; and global procurement and distribution systems.

Competition and generic drugs

Several speakers also felt that generic drug manufacturers play an important role in bringing competition to pharmaceutical markets and improving production efficiency, which would reduce prices further.

Intellectual property and TRIPS safeguards

Participants acknowledged that intellectual property protection is an important incentive for research and development into new drugs. Some said there are also other ways to encourage research and development.

At the same time, countries need to be able to make use of the public health safeguards built into the TRIPS Agreement - including compulsory licensing (governments allowing others to produce a patented invention without the patent owner's permission) and 'parallel' imports (i.e. imports of products supplied by the patent owner or a licensee at a lower price in another country).


When drug prices fall - and many low priced essential drugs are already available - there is still no guarantee that poor communities can afford them. This is particularly true for HIV/AIDS drugs. Even with costs coming down to $500 per patient per year, this is well beyond the reach of the many countries whose total health expenditure is less than $10 to $20 per year. In these cases, significant amounts of external financing is needed.

Many of the participants also said financing for drugs should not be considered in isolation. They called for massive increases in finance to develop effective healthcare systems in general, including training, education and delivery, as well as for buying the drugs.


Africa: Treatment Access Update, 2 Date distributed (ymd): 010419 Document reposted by APIC

Africa Policy Electronic Distribution List: an information service provided by AFRICA ACTION (incorporating the Africa Policy Information Center, The Africa Fund, and the American Committee on Africa). Find more information for action for Africa at

+++++++++++++++++++++Document Profile+++++++++++++++++++++

Region: Continent-Wide Issue Areas: +economy/development+ +health+


This posting contains a press release on next week's OAU summit on HIV/AIDS, Tuberculosis and other related infectuous diseases, a commentary from the NY Commanity Advocacy Treatment Working Group on the proposed UN statement of position on treatment for the UN Special Session, and a brief update from BRIDGES Trade newsletter on new World Trade Organization discussions on intellectual property rights and drug patents.

An additional posting today has a brief Africa Action commentary by director Salih Booker on the withdrawal of the drug company law suit against South Africa. It also includes two documents from the workshop on drug pricing held on April 8-11, 2001 in Hosbjor, Norway.

+++++++++++++++++end profile++++++++++++++++++++++++++++++

ECA Press Release No. 01/2001(ENGLISH)


Addis Ababa, 18 April 2001 (ECA) -- The African Development Forum (ADF) Consensus and Plan of Action agreed in Addis Ababa in December 2000 is to be endorsed by Africa's leaders next week, when they convene in Abuja, Nigeria for the African Summit on HIV/AIDS, Tuberculosis and other related infectious diseases (26 - 27 April).

More than 20 Heads of State are expected at the Summit, to be held at the Abuja International Conference Centre. The Summit, to be preceded by a Ministerial Technical meeting (24 - 25 April), is being organised by the Organization of African Unity (OAU) in collaboration with the Government of the Federal Republic of Nigeria, the Economic Commission for Africa (ECA), UNAIDS and other key partners.

The Summit, first proposed by President Olusegun Obasanjo of Nigeria, is being convened to focus Africa's leadership on reversing the alarming rate of infection of HIV/AIDS, Tuberculosis and other related infectious diseases on the continent. Unlike ordinary summits of the OAU, this gathering will include participation from different stakeholder groups, including People Living with HIV/AIDS, TB and other diseases. Africa's development partners will also be represented at the Summit.

The Summit's objectives are to: translate the commitments made by African leaders into social and domestic and external resource mobilisation for prevention, care and treatment of the diseases and sustainable programming of primary health care; and develop strategies aimed at preventing and controlling the impact of the pandemic on socio-economic development in Africa.

Among dignitaries attending the Summit will be Kofi Annan, the UN Secretary-General, who has been at the forefront of the global fight against HIV/AIDS, and who is placing a special emphasis on Africa. Mr. Annan is scheduled to deliver an opening statement at the Summit of Heads of State and Government on 25 April.

A number of UN senior UN officials are also expected in Abuja, among them UNAIDS Executive Director Peter Piot, WHO Director-General Gro-Harlem Bruntland, ECA Executive Secretary K.Y. Amoako, and UNICEF Executive Director Carol Bellamy. These officials will participate in a panel on the 'Way Forward' (25 April).

ECA has been working closely with the OAU, UNAIDS and other members of the Technical and Steering committees to ensure that the Summit builds on previous efforts to develop a strong African response to HIV/AIDS.

In particular, ECA has sought to mainstream the outcomes of ADF 2000, which the Commission organized around the theme "AIDS: The Greatest Leadership Challenge", in conjunction with UNAIDS, UNDP, UNICEF, The World Bank and other partners to serve as a launching pad for a renewed commitment to more concerted action against HIV/AIDS in Africa.

At ADF 2000, More than 1,500 African leaders and policy makers, civil society organisations -- including people living with HIV/AIDS and academia -- private sector and development partner representatives addressed concrete roles and responsibilities for leaders at all levels, towards galvanizing an African-led response to the pandemic.

ADF 2000's Consensus and Plan of Action calls for a strong involvement by all stakeholders in the fight against HIV/AIDS in Africa, and articulates the commitments made by African governments, the international community, civil society and other stakeholders individuals to overcome the HIV/AIDS pandemic. Among other things, the Consensus stresses that:

- Every individual must personally break the silence around the norms and practices that fuel the HIV/AIDS pandemic.

- People living with HIV/AIDS stand at the centre of any community efforts to overcome the pandemic. Their rights must be respected in full and their leadership potential recognised.

- National leaders have a responsibility to create the conditions for community mobilisation.

- A continental strategy for the essential and comprehensive care and treatment of people living with HIV/AIDS is needed, including a determined pan-African approach to the affordability of drugs.

- The international community should mobilise the necessary resources to enable Africa to overcome the pandemic. Wherever possible, assistance should be in the form of grants, not loans.


For more information on the African Summit, visit

To read the ADF 2000 Consensus and Plan of Action, and for all related theme papers, speeches, presentations, and other documents, visit or contact:

The Communication Team Economic Commission for Africa P.O. Box 3001 Addis Ababa Ethiopia Tel: +251-1-44 50 98 or +251-1-55 30 98 Fax: +251-1-51 03 65; Cell: +251-9-20 17 94 E-mail: Web:


April 10, 2001

From: NYC UNGASS [UN General Assembly Special Session] Community Advocacy Treatment Working Group

[NOTE: THE NYC UNGASS Community Advocacy Treatment Working Group is an ad-hoc group of individuals living with HIV and AIDS, community advocates, HIV professionals, journalists, policy makers, and concerned citizens who represent a broad sector of the HIV/AIDS community.]

To: UNGASS Member States and Delegates

Re: Consensus Statement on Response to UNGASS Draft Declaration of Commitment

posted on, March 16, 2000 by Sharonann Lynch <>

NOTE: The following consensus statement limits its comments to the section of the UNGASS Declaration of Commitment regarding Care and Support (reprinted below). It directly addresses the UNGASS Declaration's statement that prevention must be the mainstay of the global community's efforts to address the AIDS epidemic.

>From the draft UNGASS Declaration of Commitment on HIV/AIDS (April 6, 2001) and the section dealing with care and support:

"Care and support are inseparable elements of an effective response"

"By 2003, ensure that comprehensive care strategies are developed to strengthen health care systems; provide access to affordable medicines and drugs for those who need time; support individuals, households and communities affected by HIV/AIDS; and address factors affecting the provision of essential drugs, including technical and system capacity, prices, international trade rules and intellectual property rights;

"By 2003, ensure that national strategies are developed in close collaboration with the international community and the private sector to increase substantially the availability of essential medicines for HIV, including antiretroviral therapy for people with symptomatic HIV infection."

Response of UNGASS Community Advocacy Treatment Working Group:

The world's HIV-infected and - affected populations cannot wait until 2003 for their countries to act. 1,300 people die of AIDS every day. In two years time, the epidemic will have claimed nearly 10 million lives. The UNGASS Declaration of Commitment overlooks many measures which are of the utmost importance to saving lives and preventing new infections.

As it stands, the United Nations Declaration of Commitment is wholly inadequate with respect to treatment and care. Taking immediate measures to improve access to care, treatment and support should be of equal priority to prevention efforts in the global response TO HIV/AIDS. The Declaration should be altered to reflect the following:


The Declaration of Commitment presents a false dichotomy between prevention and treatment. Treatment and care services are known to enhance prevention efforts and are efficient routes to many prevention goals, including uptake of voluntary counseling and testing, treatment of STDs, and condom use. The Declaration should reflect that treatment and prevention are inextricably linked and that:

- Treatment strengthens prevention efforts, expands local health infrastructure, and improves overall delivery of care and support.

- Access to treatment is a known incentive for HIV testing, and helps address stigma and discrimination against individuals living with HIV, as well as denial associated with HIV.

- Effective treatment of HIV and sexually transmitted diseases, as well as opportunistic infections in HIV-infected individuals helps reduce their risk of HIV transmission. Member countries must commit to developing programs which reflect the immense public health impact - including reductions in new infections - of basic treatment interventions such as treatment for STDs and opportunistic infections.

* The Declaration must clearly state that access to care and treatment are basic human rights, and must provide an expanded definition of treatment and an outline of immediate steps that every member country can take and will commit to taking to improve care, treatment and support for those already infected with HIV.

The Declaration should set a specific timetable and specific numeric targets for providing immediate access to antiretroviral and OI therapy to the neediest individuals with HIV now, not in 2003, and should address criteria for selection of those who are most likely to benefit. Priority must be given to individuals with symptomatic HIV illness and late-stage AIDS. Since HIV treatment is an incentive to HIV testing, any treatment initiatives will also facilitate the identification of newly-exposed or recently seroconverted individuals who are known to be at high risk of transmitting HIV to others and could potentially benefit from early access to short-course antiretroviral therapy that would in turn represent an important prevention strategy.


Treatment and care have many components. The current wording is too broad and gives inadequate direction to member countries. As the Health GAP Coalition has stated with regard to the Declaration: "Generality is an excuse for inaction; abstraction is a foreshadowing of failure."

The many interrelated aspects of disease management include: treatment for STDs and opportunistic infections; palliative care; nutrition; diagnostics (including HIV antibody tests, viral load and CD4 T-cell counts), "best practice" clinical management of HIV disease; education of communities about HIV treatment through culturally-appropriate treatment literacy materials; and training of physicians and health-care professionals. Many of these aspects can be translated into concrete goals which member countries can and should begin to pursue immediately, and not in 2003.

The Declaration should state that:

- Member states commit to outlining and implementing immediate and clear action steps for increasing access to treatment and care, with clear standards for action.

- While they recognize that access to antiretrovirals remains a difficult challenge, member states must immediately begin to: train physicians, health-care professionals and community advocates in appropriate strategies for managing HIV/AIDS; identify and take concrete steps to enhance the existing health infrastructure of their countries for the introduction and delivery of HIV-related medicines and care; identify and establish national programs and successful community-based models of HIV treatment; immediately establish mechanisms that will prioritize the care and support individuals with sympomatic HIV or late-stage AIDS and their families.


These goals cannot be met without the involvement and guidance of the diverse communities of people with HIV and AIDS and other members of Civil Society. It is imperative that people with HIV/AIDS be offered representation at all levels of decision-making with regards to access to care and treatment. This includes full participation in the administration of any proposed "global AIDS fund," participation member state UNGASS delegations; and decisions by member states about resource allocation.

The Declaration should state that:

- Governments of member states must commit to work in equal partnership with people with HIV/AIDS and Civil Society with respect to the allocation of funds, financial and technical resources for HIV prevention, treatment and care.

- Governments of member states must commit to transparency and accountability in these partnerships.


Allocation of new funds and resources for treatment and care is a priority for all member countries. For developing nations crippled by the burden of debt, this can only be accomplished by debt cancellation and reallocation of these funds to programs for HIV/AIDS prevention, treatment and care. The use of funds freed up by debt cancellation can become an essential element in the ability of developing countries to address the AIDS pandemic, since it will free up needed internal national resources and make it more possible for them to increase the effectiveness of their response to AIDS and other health, education and civil issues. We wish to emphasize the need for government transparency and civil society participation in any reallocation of funds freed up by debt cancellation.

The Declaration should also commit member states to:

- clearly address and, where necessary, remove trade barriers that negatively impact on access to essential medicines for HIV, including antiretroviral drugs;

- support the highest possible protection of public health in international, regional, and national trade, patent, and intellectual property laws, including TRIPS-compliant safeguards.

- support developing countries to provide the most affordable, highest quality health care for their HIV-affected populations as possible, using such mechanisms as generic production, compulsory licensing and parallel importing of HIV medicines.

- develop patent legislation in accordance with these principles and with a view to fulfilling the basic human right of each citizen to health care.

- avoid using litigation or other pressures, particularly bilateral ones, to prevent another country from measures designed to implement the fundamental human right to health.


- The Declaration should address follow-up plans and steps that member states will be required to take to fulfill their stated commitment to this document of action, along with a timetable for action.

- The Declaration should establish a clear mechanism for review of the follow-up actions of member states, with clear standards for evaluating their commitment to providing access to HIV treatment and care for HIV-positive individuals.

- UN member states should establish an independent monitoring body that would include HIV-positive individuals and other members of Civil Society, to review the UNGASS Plan of Action and the immediate, mid-and longer-term strategies of member states to provide access to treatment to HIV-positive citizens and other steps outlined in this document of commitment to action. Funding and administration for this independent monitoring body should be provided by the UN body and member states with a clear timetable for action, clear standards and a clear mechanism for review.


BRIDGES Weekly Trade News Digest

BRIDGES Weekly Trade News Digest is published by the International Centre for Trade and Sustainable Development (ICTSD),, with technical support from the Institute for Agriculture and Trade Policy (IATP). ICTSD is an independent, not-for-profit organisation based at: 13, ch. des AnTmones, 1219 Geneva, Switzerland, tel: (41-22) 917-8492; fax: 917-8093.

Vol. 5, Number 13 10 April, 2001


Following a request by Zimbabwe on behalf of the African Group at the WTO, the WTO Council on Trade-related Aspects of Intellectual Property Rights (TRIPs) in its meeting on 2-6 April agreed to hold special discussions on essential medicines during the next Council meeting in June. The decision came in the wake of recent accusations that the WTO impedes developing countries' access to cheap drugs by protecting pharmaceutical patents (see BRIDGES, 20 February 2001;

Africa's request for special discussions on drugs

In its statement to the TRIPs Council, the African Group called for a Special Session of the Council to address issues relating to TRIPs, patents and access to medicines. In particular, the paper said, the Session should aim to "provide legal clarity in the interpretation and application of the relevant TRIPs provisions which allow the adoption of certain measures to enable the protection of health." The outcomes of the Session could feed into the preparatory process of the fourth Ministerial Conference in Qatar. The statement also stressed that the African Members were not aiming to undermine or discourage investment into research and development for new drugs. "Our challenge is to address the question of affordable access to drugs in a manner that is fair and equitable to all stakeholders," it said. The African Group also acknowledged that the question of affordable drugs goes beyond patenting and pricing and includes other issues, such as government purchasing power and infrastructure, which lie outside the mandate of the Council.

The TRIPs Council agreed to devote a full day to a special discussion of intellectual property issues relevant to access to medicines during the course of the next TRIPs Council meeting on 18-20 June. Furthermore, the WTO is co-sponsoring a workshop on "Differential Pricing and Financing of Essential Drugs" with the World Health Organization, which is currently being held in Norway from 8 to 11 April. The workshop brings together representatives from research-based and generic manufacturers, governments, intergovernmental organisations, non-governmental organisations, academics and consultants to provide an opportunity to exchange views on these issues. BRIDGES Weekly will report on the outcomes of this meeting in a forthcoming issue. In addition, the WTO has released a fact sheet on TRIPS and pharmaceuticals, which outlines the exceptions to patent rights under TRIPs of relevance to the drugs issue (available at

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Message-Id: <> From: "APIC" <> Date: Thu, 19 Apr 2001 11:34:21 -0500 Subject: Africa: Treatment Access Update, 1

Editor: Ali B. Ali-Dinar

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