Amsterdam, 25 November 1999

Ladies and Gentlemen

It is my very great pleasure to welcome you all here today. We are here for the next 2 days to work on an issue of international significance for our future.

Amsterdam is a fitting setting for this conference - as the Dutch are a peculiarly internationalist people - an instinct developed through a long and rich history of international trade. The Dutch have learned from many centuries of involvement in global trade that in order to benefit socially and economically you must develop relationships of mutual sustained interest - not exploitation.

This conference is hosted by:

Each of these organisations has an entirely different history, mission and activities - but we have all converged upon this increasingly important issue.

1. 10 years ago we were told that the age of infectious disease was almost over - and we faced a future of chronic diseases of ‘affluence’. I am not sure if that future was the future for only a small proportion of the world or for all of us - BUT, it is clearly no longer to be considered true for any area of the world. Communicable diseases (such as measles, diarrhoea, Respiratory Tract Infections, Tuberculosis, AIDS and Malaria) are still the Number 1 cause of death in the world today.
2. MSF sends medical volunteers to 84 countries around the world. But our volunteers are just some of the thousands of Drs and nurses in the world who struggle every day, month after month, year after year - working to improve people’s health.

MSF works in countries, torn apart by conflict or disaster - facing huge populations displaced from their homes, separated from their families, deprived of the means to earn their own living and weakened by hunger. In these settings communicable diseases cut through populations leaving massive casualties. But medical staff working in many areas of the world face a daily chronic crisis.

Together we have witnessed the development of a new problem. The basic and cheap essential medicines and vaccines used to prevent or treat simple communicable diseases are increasingly ineffective in the face of growing resistance. Furthermore there is either no pharmaceutical research and development for the near future - nor is there any likelihood!!

ACCESS TO ESSENTIAL DRUGS AND VACCINES ARE WOEFULLY INADEQUATE.

This is a problem that we all face - it is a major problem for the Ministries of Health and the health care services of the developing world and for large numbers of economically excluded people from the supposedly ‘developed’ world.

3)

• IT MUST BE A PRIORITY TO STIMULATE THE RESEARCH AND DEVELOPMENT OF ESSENTIAL MEDICINES;

• IT MUST BE A PRIORITY TO ENSURE THE AVAILABILITY AND AFFORDABILITY OF SUCH MEDICINES
• WE MUST CHANNEL OUR COLLECTIVE CAPACITIES TO THE DEVELOPMENT OF HEALTH CARE TECHNOLOGIES BASED ON HUMAN NEED - NOT SIMPLY MARKET DEMAND.

4. All rankings of countries by health status show countries afflicted by recurrent crisis at the bottom of the health league tables. Health and human development have been clearly demonstrated to be a major element in sustainable economic and social development. For these areas - stability and investment in people is a critical human priority.

And it is from these areas of the world where infectious diseases are re-emerging.

• The global pandemics such as TB, AIDS and malaria increasingly pose a major threat to all of us.
• Health economists all recognise that market failure often occurs due to the under-evaluation of public goods - OF WHICH HEALTH AND HEALTH CARE ARE UNIVERSALLY RECOGNISED PUBLIC GOODS.
• But apart from enlightened self-interest, surely technological advancement needs to be put to the service of humanity. Humankind has collectively made huge technological advances in the last centuries. Increasingly, some of us are able to distance ourselves from the ravages of nature. But technology is becoming the most significant determination of who has and has not who is and who is not. It is increasingly an act of imagination for someone living in Amsterdam to understand the life of a person in the great swamps of south Sudan. The huge advancements in technology must be put to the benefit of human social development - and not to the development of a technological apartheid.

We are not questioning the usefulness of patents as a motor of research and development fundding. But a balance between protecting intellectual property and the right of individuals to good health must be found. This will help ensure that the working international regulatory framework on trade does not neglect public health or commercial interests.

The argument that profit is required to drive the wheel of invention may sound compelling - but we must realise that the world’s treasures are not equally divided and not everyone has a choice. Good health cannot be relegated to a luxury commodity for the rich. Ultimately people have rights, products dont.

There are about 350 people expected here today from governments, the UN, NGOs, the media and industry. People have travelled from over 50 countries (and we would like to extend our very special welcome to those who were unable to travel here directly but had to go via other European countries to get entry visas).

It is clear that we will not all agree on every issue. That is not the purpose of this conference. The challenge is to generate an agenda for active collective responsibility - and this is by no means impossible. I am inspired by this unique coalition of people and opportunity to make a difference. I look forward to working with you and for us to take these very important issues to Seattle and beyond. Have a good meeting and lets get to work. But before we do so I am handing over to Ellen t’Hoen.

I very much hope that you are all here for the next 2 days not simply to listen - but to participate and to work towards an agenda for action and engagement.

I wish you luck in this endeavour.

Thank you.