Agenda Item 13.8 Revised Drug Strategy

Statement by Consumers International/Health Action International
to the 54th World Health Assembly

I am speaking on behalf of Consumers International and Health Action International. This statement is also endorsed by Medecins Sans Frontieres and the World Council of Churches.

During her speech to this Assembly the Director General stated that action is needed now and that the window of opportunity to improve global health may close at any time. We agree that urgent action is needed not only for keeping that window open but expanding it. We also believe that WHO must take a central role in this action. Dr. Brundtland mentioned that WHO's role is not to take advocacy positions and sides in all debates about crucial health issues being raised by civil society today. However, we think that the issue of access to essential drugs is one where WHO cannot and should not be neutral. It has to take sides, visibly and loudly, with the poor who are being denied access to essential health care. WHO has to take a lead in taking and coordinating intensified global action to meet the unmet treatment needs of the billions of poor. It is an ongoing public health emergency which bring into question the credibility of the present global market system.

Access to basic health care is a fundamental human right and unhindered access to needed medicines is a most important component of this right. This has been highlighted in the recent General Comment on Health by the UN High Commission on Human Rights.

The Director General talks of the health divide. But to bridge this health divide we need sustainable, not ad-hoc, solutions. In the case of access to medicines we need to rely on serious implementation of national health policies and national drug policies based on the essential drugs concept and public health sensitive patent laws with in-built safeguards like compulsory licensing, parallel importing and early introduction of generics. We also need to rethink the sufficiency of these safeguards. We need to move away from the country-by-country, company-by-company and drug-by-drug negotiated solutions for drug price discounts, witnessed in recent months, to more reliable, sustainable, policy-based measures by the national governments. The international community has a moral obligation and WHO has even a constitutional responsibility to support such national efforts, which are the only guarantee for bridging the current health divide.

Developing countries face immense overt and covert pressures from rich countries when they try to protect public health in their national patent laws. We are pleased to hear that the current US Administration has publicly reaffirmed the decision to end trade sanctions pressures on developing countries and that the European Parliament has publicly supported countries' right to use the safeguards.

In this statement I specifically want to highlight the following three points:

1. The adoption of the Revised Drug Strategy resolution by the WHA in 1999 (WHA52.19) marked a major turning point in WHO's work on access to medicines. Through this resolution Member States explicitly expanded the Organization's mandate to include monitoring and analysing the public health implications of trade agreements, specifically TRIPs, and supporting Member States in addressing concerns about the effects of these agreements on access to medicines. In the Revised Drug Strategy report prepared for this Assembly, WHO describes the progress it has made in addressing this crisis. We think that such WHO reporting should be a regular agenda item at every WHA. The time has come for WHO to take on a much more proactive and visible role in this crucial area. Much more technical assistance needs to be provided by WHO to the poor countries. WHO must strongly advocate for public health concerns at the upcoming WTO TRIPs Council meeting and try to rise above the level of being just an observer in this important public health debate. WHO also needs to be strengthened in its capacity so that it can support countries in a much more active and effective way.
2. The discussion about differential pricing needs a broader perspective. Recently, WHO and WTO jointly hosted a meeting in Norway to discuss differential pricing and how differential pricing can lead to affordable prices. We think that this meeting has failed to achieve any concrete results as yet. .Moreover, we think that the differential pricing system will not be enough to achieve the goal of equity pricing. Yes, differential pricing is important but only as a part of a more comprehensive system that includes generic competition, pooled procurement and distribution, local production through voluntary licensing, technology transfer, and donor support. In short, medicines will not be made affordable through one single strategy. Rather, a combination of mutually supportive measures is required. Drug prices is another area requiring WHO's clear leadership and support to the member countries.
3. We applaud WHO's effort to strengthen the essential drugs list by reviewing and revising the procedures involved in its development. The Essential Drugs List remains one of the most important public health tools. We welcome this initiative to make the Essential Drugs List more inclusive, transparent, and to ensure that safe and effective drugs are not excluded on the basis of their cost alone.

In closing, to repeat the Director General's words, action is needed NOW. As we speak, Mr. Chairman, thousands of patients are dying in the developing countries for want of treatment. In many cases the treatments are available. People are dying not because they are sick but simply because they are poor and cannot buy life-saving medicines. States are not able to serve them well and the private sector is not sensitive to their needs. They do not benefit from the advances of medical science. This is the greatest tragedy of our times and a collective "action is needed now".

Thank you.