TWN Info Service on Health Issues (Nov07/05)

28 November 2007

Published by SUNS #6374 dated 27 November 2007

200 of experts, social activists and patient network from all over the world have gathered in Bangkok, Thailand, (November 21 to 23, 2007) to discuss compulsory licensing, innovation, and access to medicines for all.

Please find below a news report on that event by IPS which was published in SUNS #6374 dated 27 November 2007 and is reproduced here with permission.

Attached as well below is the Bangkok Declaration that came out from the meeting.

Best Wishes
Sangeeta Shashikant
Third World Network



Published by SUNS #6374 dated 27 November 2007

Bangkok, 26 Nov (IPS/Marwaan Macan-Markar) -- Public health and HIV/AIDS activists from the developing world are seeking to break the monopoly over drugs held by pharmaceutical giants through a new global campaign designed to influence international debate over the issue.

Formulated at the end of a three-day meeting, last week, which brought some 200 participants from 20 countries to the Thai capital, the campaign seeks "a new way out of the current patent system; one that will encourage innovation of new drugs and access for all," says Kannikar Kijtiwatchakul, an organiser of the International Conference on Compulsory Licensing: Innovation and Access for All.

"What we have now is innovation controlled by the pharmaceutical industry that lets them have a monopoly on drugs."

The conference participants - who came from countries such as Brazil, India, Indonesia, Malaysia, China, Cambodia, the United States and hosts Thailand - have a meeting at the World Health Organisation (WHO) in January 2008 as the first target of the new campaign.

At that meeting, the Geneva-based health agency's executive board may receive a draft of a plan to find a compromise between the demands of big pharma, which produces patent-brand drugs, and the world's poor, who have little or no access to the available life-saving medication due to high prices.

The proposed plan is being drafted by the WHO's Intergovernmental Working Group on Public Health, Innovation and Intellectual Property (IGWG), which held a second round of discussions in early November.

"Our campaign wants to add to the IGWG's work, because we want to get our views heard at the January meeting," Kannikar told IPS.

"At the heart of the plan is finding an optimal way to boost research and development of affordable health-care products so people, particularly in the developing countries, can receive treatment for diseases, with an emphasis on neglected conditions including tuberculosis, malaria and HIV/AIDS," states a background note by Intellectual Property Watch, a Geneva-based on-line publication, distributed at the conference.

Papers presented at the conference justified the need for such a shift, given that the pharmaceutical multi-national corporations (MNCs) have contributed marginally towards developing new drugs to help the world's poor.

"Only 10% of the total global investment in pharmaceutical research was directed towards neglected diseases affecting 90% of the world's population," noted Jakkrit Kuanpoth, from the law faculty of the University of Wollongong in Sydney, Australia.

As revealing were the numbers presented in a paper by Dr. Mira Shiva, from the non-governmental Health Action International. Shiva said that between 1975 and 2004, there were 1,556 new active ingredients for drugs developed by the pharma giants but only 18 were for tropical diseases.

"The drug companies don't do some of the innovation that is most important to developing countries with respect to neglected tropical diseases," Brook Baker, professor of law at Northeastern University, in Boston, in the US, told IPS.

"They put their research where they make the most money, from rich people in rich countries. That is where they earn over 90% of their research and development dollars."

"There should be a new innovation reward system. Developing countries can and should pay something for innovation, but they should only be asked to pay for innovation that is most appropriate for themselves," he added.

The activists are bracing for a counter campaign from the pharmaceutical industry, which presides over an estimated $650 billion global market, of which all of southern Asia and south-east Asia account for only a 1.3% share.

Events in Thailand reflect this challenge, since the South-east Asian country has emerged as a leader in the developing world to take advantage of global trading rules to secure cheaper, generic drugs for public health emergencies such as HIV/AIDS.

Over the past year, Bangkok has used provisions available under the trade-related aspects of intellectual property rights (TRIPS) agreement to issue compulsory licences (CL) to break the patents for three drugs, two to prolong the life of people with HIV and a blood-thinner for heart patients.

The right for developing countries to grant CLs or pursue parallel imports of generic drugs were approved at a World Trade Organisation (WTO) ministerial meeting in Doha, in 2001.

It has consequently enabled some 10,000 Thais living with HIV who need second-line anti-retroviral (ARVs) drugs to live in hope of receiving affordable medication.

Currently, an estimated 140,000 Thais receive the first-line of ARVs. The country is one that has been among the worst hit since the pandemic began in the region, with over 600,000 infected with HIV at present and some 300,000 having died due to AIDS over the past two decades.

But as full-page advertisements that appeared in Thai and English-language newspapers on Friday made clear, the powerful pharmaceutical industry has other interests at heart.

"New drug discoveries help doctors save lives" announced one advertisement to justify why big pharma should continue to enjoy its monopoly in the drugs market.

The advertisement placed by the pro-pharma lobby is the latest in a string of measures aimed at forcing Thailand to give up its right to issue CLs.

The US pharma MNC Abbott Laboratories has also struck back by withdrawing seven new drugs it had introduced into the market, including a second-line ARV that can be easily stored in tropical climates.

Even the US government has retaliated against Bangkok, revealing Washington's interest in protecting its pharmaceutical industry.

The Office of the United States Trade Representative has placed Thailand on the Priority Watch List' for intellectual property violations and also terminated duty-free trade privileges that this country enjoyed.

"There is absolute double standards being applied here by the US. This is complete hypocrisy because there is no fuss made when compulsory licenses are issued in the US," Robert Weissman, director of Essential Action, a Washington DC-based corporate accountability organisation, told IPS.

"The US government has an automatic right to use any patent without any prior negotiations. There are many different ways in which we do compulsory licensing."

"It is very important that a country's behaviour be judged according to international law," adds Dr. William Aldis, coordinator for health policy and research at the WHO's South-east Asia regional office, located in New Delhi.

"Thailand's is within the provisions of TRIPS. It is not violating any laws." +



From November 21 to 23, 2007, 200 of experts, social activists and patient network from all over the world have gathered in Bangkok, Thailand, to discuss compulsory licensing, innovation, and access to medicines for all. This is our declaration.

1. We recognized and applauded Thailand's leadership in the use of compulsory licensing to overcome legal monopolies as well as decisions by Brazil and Indonesia. Thailand's continued leadership on compulsory licensing is important, but so too will be the actions of other countries. Because of economies of scale, it is important that the potential market in developing countries for generic products is large enough market to collectively justify entry by generic suppliers.

2. To achieve our optimal goal on innovation and access to medicines for all, we have created a new global network on compulsory licensing, innovation and access for all (I +a4a). This network will link together patients, NGOs, academic / public health experts, government officials, and generic drug manufactures to find ways to ensure that patients have access to medicines with acceptable quality.

3. We confirm that compulsory licensing of patents is a legitimate, important and effective tool to protect consumer and public interests. Thus every country should have the rights to systematically and routinely use compulsory licensing and other means under TRIPS flexibility similarly to wealthy countries. Governments all over the world use compulsory licensing in a variety of contexts and in many different fields. The right to use compulsory licensing is incorporated in international law and precedent, including WTO's TRIPS agreement and Doha Declaration.

4. Objections to the use of compulsory licensing in developing countries to ensure access to medicines for all patients are often based upon untruthful, misleading, unproven assertions and assumptions, and are designed to appeal to prejudices regarding the developing world. This should stop.

5. It is feasible to permit generic competition for products, dramatically expanding access to medicines, while ensuring sustainable sources of financing for needs driven research. Because we can promote both innovation and access, we must reject policies that force choices between the two, and accept the marginalization of low income and uninsured persons.

We applaud the May 2007 World Health Assembly resolution WHA60.30 which calls upon the WHO to consider new mechanisms that de-link R&D incentives and financing systems from the prices of drugs. We support the calls for a new global treaty on medical R&D, that does not force countries to embrace monopolies and high drug prices to financing medical innovation, and which boosts investments in needs driven essential R&D, including R&D needed to address the special health problems of developing countries.

Our cause is important for everyone. We are seeking global norms that ensure innovation and access for all. This is an achievable goal, if we collaborate and work together.

Bangkok, November 23, 2007

The International Conference on Compulsory Licensing: Innovation and Access for All, 21-23 November 2007 Bangkok, Thailand

1.Health Consumer Protection Program (HCP), Chulalongkorn University
2.Faculty of Pharmaceutical Sciences, Chulalongkorn University
3.Food and Drug Administration (FDA), Ministry of Public Health
4.Health & Development Foundation (H&DF)
5.Drug Study Group (DSG)
6.AIDS Access Foundation
7.Thai Network of People Living with HIV/AIDS (TNP+)
8.Social Pharmacy Research Unit, Chulalongkorn University
9.Pharmacy Network for Health Promotion (PNHP)
10.Foundation for Consumer (FFC)

Details about Compulsory Licensing