BRICS Ministers Join Forces For Access To MedicinesPublished on Tuesday, 20 May 2014 10:56
By Julia Fraser for Intellectual Property Watch At a side event to the opening of the 2014 World Health Assembly, strong statements were made by BRICS (Brazil, Russia, India, China and South Africa) country ministers and representatives to assume leadership and cooperate to tackle the issue of inaccessibility to affordable medicines in theirs and developing countries.
Countries shared national experiences and showed mutual support for the continued use of local production, compulsory licensing and parallel importations and other mechanisms to push down prices and increase accessibility. The side event on “Access to medicines: challenges and opportunities for developing countries” was organised the BRICS countries on 19 May alongside the 67th World Health Assembly (WHA) taking place on 19-24 May. Event moderator Luis Loures, UNAIDS deputy executive director and assistant UN secretary-general, said this discussion is “timely and topical.” Loures referred to “renewed interest on TRIPS” [the World Trade Organization Agreement on Trade-Related Aspects of Intellectual Property Rights] and the development of the BRICS group as a “new power in terms of global governance,” with a “built in capacity for innovation.” The BRICS countries account for about 40 percent of the global population, he said, and their responsibility arises not only from political leadership “but also the size of the populations of these countries,” he said. Arthur Chioro, Brazil’s minister of health, drew attention to the fact that this is the first meeting between the BRICS countries taking place at ministerial level during a WHA. In Brazil, the focus has been on “investing in domestic manufacturing and technology transfer” to tackle the issue of access and technological imbalances, he said. This has been supported by national health systems strengthening, public-private partnerships and consolidating the power of public purchasing. Brazil has been advocating at the international level, Chioro said, for reforms of the “essential” role of regulatory authorities, the adoption of new mechanisms of research and development, and the Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG) process. Brazil has also implemented a “centralised national public purchasing of medicines program” which, in 2011, included the distribution of medicines for chronic and non-communicable diseases to more than 18 million people through 29,000 pharmacies. Brazil is working on a “poverty reduction scheme,” which Chioro believes is “striking the right balance between prevention and access to medicines at affordable prices.” Chioro hoped that this event would consolidate cooperation between BRICS and other developing countries, “with a view to developing a unified stance andin order to move forward towards universal access.” South Africa Health Minister Aaron Motsoaledi highlighted key reforms in its health policy to promote access to medicines including: regulation of prices throughout the supply chain; centralised purchasing of medicine; monitoring of distribution systems; and the introduction of parallel importation. Speaking of TRIPS flexibilities, he referred to the UN Development Programme (UNDP) report on “HIV and the Law risks, rights and health,” which concludes “where laws do not enhance human well being, and where laws do not respond to contemporary realities they must be repealed and replaced by those that do” (IPW, Development, 19 May 2014). “It is clear that the current laws do not adequately promote access and foster innovation,” said Motsoaledi. South Africa is currently revising its IP laws, initiated by South Africa’s Minister of Trade and Industry. “It was meant for agriculture software, sports, culture and indeed pharmaceuticals,” he said. “Of all this, it was the minister of health in South Africa who was put under severe attack and accused of fighting pharmaceutical companies. All I was doing was to ask for a better deal for the sick.” South Africa’s initiative to use innovative approaches to lower prices by persuading patent holders to licence patents to encourage generic competition in the case of antiretrovirals for HIV/AIDS, represents “lessons to be learned in South Africa,” he said. He also said he supports the innovative work of UNITAID and the Medicines Patent Pool. Oleg Salagai, deputy director at the Russian Ministry of Health, presented Russia’s strategy of access. Key items include the rational use of medicines and appropriate prescription of medicines. Since 2011, doctors are legally liable for informing their patients as to what medicines are available for their condition and what possibilities exist for obtaining required medication free of charge with the government covering costs, said Salagai. They are also promoting national production of medicines that comply with national standards of quality consistent with international standards, he said. Other key efforts in Russia highlighted by Salagai include: a system of monitoring the costs of medicines and recommended retail prices; improvements in the training of medical workers; increasing the number of rural pharmacies; and controlling the quality of medicines. Salagai stressed the importance of innovation to increase accessibility, for which its national pharmaceutical industry will play a key role, but which also requires “joint generation of knowledge and joint scientific research in order to obtain new products.” Shri C. K. Mishra, additionalsecretary of the Ministry of Health of India, commented on the popularity of the eventsaying, “We are in a packed room because this is a cause everybody is worried about.” Accessibility has been the “driving force” of health policy, and reducing costs a priority for India, he said, with initiatives for the distribution of free drugs and promotion of generic production. Mishra stressed the need to maintain balance between the use of IP to incentivise the development of new healthcare products, and the interests of the consumer. He gave examples of countries’ TRIPS-compliant use of flexibilities and safeguards including compulsory licences, parallel imports, provisions allowing for early entry of generics, and the adoption of strict patentability criteria, quoting India’s Section 3(c) of the Patent Act. Mishra urged “developing countries should consider revising national IP legislation” to include these flexibilities. He also warned against countermeasures adopted in “TRIPS-plus” bilateral trade agreements and investor states disputes, and asked international organisations and civil society to “actively advocate much more in support of national governments in use of all these flexibilities.” Referring to the Glivec case decided in India in 2013, Mishra said, “any attempt at subverting the patent regime or ever-greening of the product or process can be effectively checked in thepublic health interest to restrict the patent regime.” The Deputy Director of the Chinese Ministry of Health said China adopted health reforms in 2009 that included funding of essential medicines by basic health insurers, the development of a national essential drugs list, centralised procurement and the promotion of rational use of medicines. China has put forward two proposals on the agenda items of Access to Essential Medicines and Traditional Medicines for this year’s WHA. The deputy director highlighted give key propositions for international action: to formulate national policies based on essential medicines; encourage investment in research and development focussing on quality, safety and effectiveness; establishing national essential medicines lists; enhancing multilateral cooperation through joint research projects, ad hoc working groups and information exchange; and leveraging the role of WHO and other international organisations in this issue. WHO, UNITAID, MSF Views WHO Director General Margaret Chan also made an appearance at the event and thanked the BRICS countries for their leadership. She referenced ongoing activities by international organisations to support local production of medicines by BRICS and other countries; the need to look at how national drug regulators can strengthen their capacity to address substandard and counterfeit medicines; and the importance of the health information system. “The data gap is very glaring,” she said. “Without knowing the data, we cannot make the right investment in health.” Philippe Douste-Blazy, chair of the UNITAID Executive Board, highlighted UNITAID’s contribution to the issue of access to drugs in middle-income countries in convening partners and providing grants to lawyers in India to “remove unjustified patent barriers for key medicines.” Douste-Blazy also pointed to the Medicines Patent Pool’s recent licencing agreement with the drug company ViiV, which included middle-income countries for a higher royalty fee. “Such tiered royalties are the future for access to medicines in MICS,” he said. Rohit Malpani, director of policy for Médecins Sans Frontières (MSF), brought up concerns over a joint access initiative led by the Global Fund for AIDS, Tuberculosis and Malaria and other global health agencies that relies on tiered pricing and market segmentation, without participation of BRICS and other governments that will be affected. Chioro said Brazil shared these concerns, and pointed out that under current development classifications, many countries do not classify for donations from health initiatives despite large amounts of their populations still living in poverty.
Source: Intellectual Property Watch