HEALTH, HUMAN RIGHTS, GLOBAL TRADE AND ACCESS TO ESSENTIAL MEDICINES

The issue of access to life-saving, life-prolonging drugs by poor countries has recently been at the center of international financial news. On one side, developing countries, particularly in sub-Saharan Africa, desperately need cheaper sources of drugs to treat HIV/AIDS and other diseases such as malaria and tuber culosis. On the other side are transnational pharmaceutical companies, claiming trade-related intellectual property rights (TRIPS) to secure patents and control prices under the rules currently governing global trade. This position is backed by the United States, European governments and the World Trade Organization.
As a result, African countries are still priced out of the market in essential medicines. For example, they cannot afford the drug AZT, which is known to cut mother to child transmission rates during and after pregnancy by at least half. More prosperous Southern countries like Brazil, India and Thailand have ignored TRIPS and US patent laws and import or manufacture cheaper, generic versions of these drugs. But these options are not available to much poorer African countries.
In the past year, there has been some positive movement. After political pressures from groups like Act Up and anti-globalization protests, the US president retracted the threat of sanctions against countries that ignore TRIPS. The U. S. And the World Bank offered $1.5 billion in loans related to AIDS. Some drug companies reduced their prices on HIV/AIDS drugs to meet the huge crisis of the epidemic in Africa. These were offered as "humanitarian" gestures, not as admissions of an obligation under international human rights principles. They leave intact the free market credo of health as a commodity and drug companies as the last authority on prices.
At the center of the controversy has been South Africa. It has the fastest-growing HIV rate of any country in the world (20 percent of its population now infected) , and a strong voice in the region. Many international health advocates expressed disappointment when the Mbeki government dropped previous defiance of US opposition to licensing of local manufacturers; then questioned the value of AZT as a treatment for pregnant HIV-infected women in South Africa; and finally became involved in debates about whether HIV causes AIDS. While these issues were still brewing, South Africa took the lead during the year 2000 in negotiating groundbreaking provisions regarding global trade, human rights and access to essential, affordable medicines. It took this role around the June 2000 Special Session of the UN General Assembly to review the results of the 1995 World Summit on Social Development five years later (OFTEN CALLED WSSD+5). During the April preparatory committee for the Session, the Women's Caucus proposed adding language to paragraph 80, which dealt with TRIPS, in the draft document for WSSD+5;
"Recognize that intellectual property rights under the TRIPS Agreement must not take precedence over the fundamental human right to the highest attainable standard of health care, as provided in many international human rights and other multilateral instruments, nor the ethical responsibility to provide life-saving medication at affordable cost to developing countries and people living in poverty."
The aim was to raise the awareness of governments and development NGOs of the connections among health, human rights and global trade. The issue also has important gender implications, because of the plight of HIV-infected pregnant women in poor countries and the greater susceptibility of women and girls to HIV infection generally.
Before the WSSD+5 conference, the South African delegation introduced this point in meetings of the Group of 77 developing countries and China, which adopted it. At the June conference, the issue generated much debate. Northern countries held that intellectual property rights and profits from them are necessary "to promote further research" on drugs and to advance technological knowledge. Some NGOs called this a fallacy as regards drugs for AIDS and other life Threatening illnesses that ravage African populations. The NGOs pointed out that most research on drugs for tropical diseases has been done by public agencies, not corporations. They also noted that most research to find treatments and a vaccine for AIDS is geared to an American and European market, not the 50 million HIV-infected people who live in Africa.
After opposition by the U. S. And lobbying by pharmaceutical corporations, the outcome at the Special Session was a text which does not challenge the WTO rules concerning intellectual property rights, but still affirms the link between human rights, health and access to affordable essential medicines:
Recognize the right of everyone to the enjoyment of the highest attainable standards of physical and mental health as contained in relevant international human rights instruments, as well as in the WHO Constitution. Further recognize the critical importance of access to essential medicines at affordable prices. Acknowledge the contribution of intellectual property rights to promote further research, development and distribution of drugs, and that these intellectual property rights should contribute to the mutual advantage of producers and users of technological knowledge, and in a manner conducive to social and economic welfare. Agree that Member States may freely exercise, consistent with national laws and international agreements acceded to, in an unrestricted manner, the options available to them under international agreements to protect and advance access to lifesaving,

This article is based on reporting by Rosalind P. Ptetchesky.

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