Sunday, May 23, 2010

Quito Declaration


DECLARATION


Quito, Ecuador 22 - 24 April 2010



Organizations of the Latin American and Caribbean (LAC) - Global Alliance for Access to Medicines reaffirm their commitment to work to ensure universal access to medicines, in the belief that medicines are enabling factors for the full exercise of the right to life. The LAC –Global Alliance has identified old and new policies and processes, some of which enable access to medicines, while others sustain commercial privileges that become obstacles to the achievement of public interest outcomes. Access to medicines should not be subordinated to commercial interests.


1. The LAC-Global Alliance welcomes and supports the new initiatives of the governments of Ecuador and Colombia which are aimed at promoting competition and regulating the pharmaceutical market, as effective means to reduce medicine prices. The Ecuadorian government has issued a compulsory license for lopinavir-ritonavir (Kaletra), a medicine for the treatment of HIV that was previously sold under monopoly. The compulsory license offers significant savings that make it possible to expand treatment coverage and use capacity to attend to other health priorities. The Colombian government has issued Decree 1313, which authorizes parallel imports to overcome the high medicine prices being imposed by pharmaceutical companies. Both initiatives are legitimate and the sovereign application of flexibilities enshrined in the WTO’s Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). They should be regarded as examples for countries of the region to follow, in order to improve access to medicines in accordance with governments' efforts to achieve the Millennium Development Goals.


2. The LAC-Global Alliance rejects attempts to enact the so-called Anti Counterfeiting Trade Agreement (ACTA) , which, led by the governments of the United States, Japan, Switzerland and the EU, aims to set new global norms using a biased and malicious interpretation of the concept of counterfeiting. Implementation of ACTA would limit the production and free movement of legitimate generic products. This new agreement has been negotiated in secret since 2008, and only under the pressure of civil society organizations did the parties recently make the draft agreement public. ACTA presents a serious threat to access to medicines that could exceed even the current restrictions countries face under TRIPS and bilateral Free Trade Agreements (FTA’s). This agreement is being negotiated without the participation of countries in the region, even though they will inevitably affect them.


3. The LAC–Global Alliance expresses grave concern about ,and rejects the advancement of, trade agreements that include TRIPS-plus and TRIPS-extra provisions, including trade agreements with the United States and the European Union (EU). The Alliance also rejects pressures related to implementation of these agreements which are intended to impose greater restrictions on national laws and regulations. The Alliance is particularly concerned with the initiation of negotiations on the Trans Pacific Partnership Agreement (TPPA) as well as the EU negotiations with Central American countries. Both risk negative effects on public health and patients’ rights. The LAC-Global Alliance calls on governments, civil society and private companies in Central American countries to be alert to avoid the imposition of new provisions for intellectual property protection such as patent extensions, longer periods of data exclusivity, and enforcement measures, that could affect public health and access to medicines. Similarly, the LAC-Global Alliance calls on all governments in the LAC region not to accept any imposition on their national legislation that could further damage the public interest, particularly the right to health.


4. The failures of the Expert Working Group on Research and Development Financing established by the World Health Organization (WHO) are evident and unfortunate. This is a step backwards in implementing The Global Strategy and Plan of Action on Public Health Innovation and Intellectual Property. We are disappointed and dismayed with the way that WHO has handled this issue. The LAC-Global Alliance is convinced that mechanisms to encourage innovation that de-link the cost of research and development (R&D) from the final price of products should be explored. Monopoly incentives cannot meet the needs for R&D of medicines, particularly for diseases that primarily affect developing countries. Therefore, we call on civil society organizations and governments to engage in a process aimed at setting international norms and standards for innovation, based on the health needs of the majority of the world's population, including hitherto neglected diseases, to reach a global treaty on biomedical research and development. This should be put on the table for discussion at multilateral agencies such as WHO.


5. The LAC-Global Alliance calls on public and private agencies in countries of the region and multilateral agencies to develop initiatives to measure the impact of intellectual property protection on access to medicines, whether this impact is a result of the TRIPS Agreement, or of bilateral / regional and national laws arising from TRIPS, including the protection of clinical trial data. In particular we call upon the governments of the region to improve their procedures on patenting and protection of clinical trial data, in order to avoid granting undue exclusivity. Moreover, we encourage governments to explore initiatives to avoid any monopoly over medicines that are included in their essential medicines list or formularies.


6. The LAC-Global Alliance welcomes regional and sub-regional initiatives that seek new ways to protect, promote and defend the right to health. These should include innovative solutions that commit countries to put their pharmaceutical production and innovation capacity to work for the needs of regional populations, and provide real impetus to a true pro-innovation and development agenda, founded on and responsive to regional needs.


7. The Alliance notes that in the case of biotechnological health products, there is pressure on our governments to increase exclusivity and monopoly protection, with controversial regulatory requirements and the extension of intellectual property and data protection regimes that will limit market entry of competing medicines. We recommend governments approach any regulatory or intellectual property-related decisions on this matter with the utmost seriousness and independence, including through the participation of civil society to represent the interests of public health.


The LAC-Global Alliance urges governments of the region and political forces in its countries to remain vigilant toward attempts to establish new mechanisms that impede access to medicines. At the same time, the LAC-Global Alliance hereby offers its assistance and puts its technical knowledge at the service of relevant stakeholders toward developing initiatives that contribute to improving the health of populations.


Quito, Ecuador 22 - 24 April 2010


Acción Internacional por la Salud (HAI) Latin America and the Caribbean


Acción Internacional por la Salud (HAI) Bolivia


Acción Internacional por la Salud (HAI) Ecuador


Acción Internacional por la Salud (HAI) Peru


Federación Médica de Colombia - OBSERVAMED


FarmaMundi - Spain


IFARMA Foundation - Colombia


Health Action International (HAI) Europe


Knowledge Ecology International (KEI), United States


Mision Salud, Colombia


Medicines Sans Frontieres(MSF)-Brazil


Public Citizen, United States


Peruvian Network for Fair Globalisation-RedGE


Red Brasilera por la Integración de los Pueblos-REBRIP Brasil






Thursday, May 20, 2010

EU Global Health Council Conclusions presented at WHA

At the World Health Assembly the European Commission and the Spanish Presidency presented the Council Conclusions on Global Health that were agreed to on May 10th by the EU member states.

http://www.consilium.europa.eu/uedocs/cms_Data/docs/pressdata/EN/foraff/114352.pdf


The Conclusions, which are an official EU position on behalf of the member states, are very relevant to discussions taking place this week at the World Health Assembly, especially regarding the discussion on the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property and the discussion on counterfeits, IMPACT and IP enforcement. However the EU does not seem to have entirely absorbed the significance and implications of these conclusions for their policy in these discussions when we hear their positions at the WHA this week.


The Conclusions stress the need for policy coherence, including on trade and health.

Some elements of the conclusions relating to the discussions on access & innovation:


15. In line with the commitments made on policy coherence for development (PCD) and in the framework of the PCD Work Programme, the Council calls on the Commission and the Member States to address the major aspects that influence global health in the five priority areas of trade and financing, migration, security, food security and climate change.


16. In this regard the EU should :

a. support third countries, in particular LDCs, in the effective implementation of flexibilities for the protection of public health provided for in TRIPs agreements, in order to promote access to medicines for all, and ensure that EU bilateral trade agreements are fully supportive of this objective;.

18. As regards to research and evidence based dialogue and action, the Council calls on the EU and its Member States to promote effective and fair financing of research that benefits the health of all. Towards that aim the EU will ensure that innovations and interventions produce products and services that are accessible and affordable.


This should be achieved by the EU and its Member States through:

a. working towards a global framework for research and development that addresses the priority health needs of developing countries and prioritises pertinent research actions to tackle global health challenges in accordance with the WHO Global Research Strategy.

b. increasing research capacities in public health and health systems in partner countries and strengthening cooperation between the EU and partner countries in this respect.

c. exploring models that dissociate the cost of Research and Development and the prices of medicines in relation to the Global Strategy and Plan of Action on Public Health, innovation and intellectual property, including the opportunities for EU technology transfer to developing countries.

d. ensuring that EU public investments in health research secure access to the knowledge and tools generated as a global public good and help generate socially essential medical products at affordable prices, to be used through rational use.

e. strengthening and balancing the complete health research process of innovation, implementation, access, monitoring and evaluation. International cooperation, common platforms of knowledge sharing and exchange of good practices are essential in this field.

Tuesday, May 11, 2010

EU Ombudsman: Transparency rules apply to all documents held by EMA

In 2008, an Irish citizen asked the European Medicines Agency for access to reports on suspected adverse reactions to a drug used to treat severe forms of acne. The EMA refused this request and the citizen turned to the EU Ombudsman, Mr. P. Nikiforos Diamandouros.

Diamandouros has concluded that:


"Since its work has a direct impact on the health of European citizens, its is of utmost importance for EMA to give the widest possible access to docuents and also to pursue a pro-active information policy for the benifit of citizens." Continue reading the Ombudsman's full recommendation...


What does this mean for public access to EMA documents? The Ombudsman cautions that adverse reaction reports won't automatically be open book. But, exceptions to the rule need to be made.

It's striking that information about medicines safety, particularly the data generated by citizens, is actually held out of their reach. The EU Ombudsman's added support only strengthens our repeated requests for access to information that can affect our health.

See HAI, MiEF and ISDB joint response to September 2009 consultation "EMEA transparency policy falls short" (pdf)

Katrina Perehudoff

Monday, May 10, 2010

Patient groups not only for sick people's interests - says Portuguese sociologist

Patient organisations are instrumental to social movements, but they can also be a vehicle for commercial interests, cautions Portuguese sociologist Noemia Lopes of the Instituto Superior de Ciencias de Saude Egas Moniz.

Drawing on several examples from Portugal, Lopes and others cite disclosure policies, donor-recipient interaction guidelines and maintaining a variety of income sources as strategies that could diffuse any dependency on corporate cash.

Read the full article in Diario de Leiria in Portuguese (20 April 2010)

Katrina Perehudoff

Thursday, May 6, 2010

Citizens call for inquiry into EU response to H1N1 outbreak

Swine flu season has passed and many countries still hold millions of unused flu vaccine doses. Did the health threat warrent such mass-spending on these medicines? What influence did any ties with the pharmaceutical industry have on decisions at the national level?

HAI Europe is questioning how this health 'crisis' was handled. We support an official inquiry by a (European) Parliamentary committee into how the H1N1 outbreak was handled by the European Union and member states. Given the significant public resources involved, it is vital that European citizens have the opportunity to scrutinise the decisions made on their behalf.

Read HAI Europe's Letter of Support (link to come) for the creation of a parliamentary committee to examine this issue further.

Katrina Perehudoff