World Health Organisation's Director General Margaret Chan has sought to send some conciliatory signals to the drug industry, affirming its interests should not be compromised in the pursuit of cheap drugs.
The second session of the Intergovernmental Working Group on Public Health, Innovation and Intellectual Property opened Monday in Geneva. This group is charged with preparing a global strategy and plan of action, which is scheduled to be presented to the World Health Assembly in May 2008.
Welcoming the delegates, Margaret Chan did say that she was fully committed to equitable access to healthcare and that people should not be denied access to life-saving and health-promoting interventions for 'unfair reasons.'
She also noted eloquently, 'The rise of chronic diseases, which now impose their greatest burden on low- and middle-income countries, makes the need for effective and affordable medicines all the more critical. When people need to take medicines for a lifetime, the costs increase enormously for households, health services, and government budgets.'
WHO itself has said in the past that 74 percent of AIDS medicines are still under monopoly, and that 77 percent of Africans still lack any access to AIDS treatment.
But even while hinting at such a disturbing scenario, Dr.Chan sought to reassure the drug industry that its interests too would be protected by saying, "Public health cannot move forward without innovation. I am fully aware that for some diseases that disproportionately affect the poor, we will not see breakthrough progress until we have better tools. Many diseases of the poor do not have good therapeutic drugs, or the prices are out of reach. Or diagnostic tools are outdated or too complicated for point-of-care use close to people's homes.
'The need for innovation is constant. Resistance develops and drugs fail, creating an urgent need for second- and third-line medicines. We have seen this problem most acutely with HIV/AIDS. We are seeing it again with the spread of extensively drug-resistant tuberculosis, which is far more costly and difficult to treat. For some diseases, we know our greatest hope rests with the development of vaccines.'
The World Health Organization's 193 member states are hoping to forge a global strategy on the highly divisive issues of drug development, patenting and pricing by the end of the week.
Under rules agreed by the World Trade Organization, countries can issue so-called 'compulsory licenses' to disregard patent rights, but only after negotiating with the patent owners and paying them adequate compensation. If they declare a public health emergency, governments can skip the negotiating.
Brazil and Thailand have invoked the procedure to import cheap generic versions of American AIDS drugs, among other medicines, to treat patients who developed resistance to older anti-retrovirals and needed more expensive, second-line drugs.
The moves by Brazil and Thailand were praised by health campaigners but criticized by industry groups. The United States later placed Thailand on a copyright watch list of nations where American companies face problems protecting intellectual property rights. Countries on the list are under extra scrutiny and can face trade sanctions if alleged violations worsen.
Dr. Chan told the delegates, 'You are concerned about appropriate funding and incentive mechanisms for the creation of new and affordable medicines and other products for diseases that disproportionately affect developing countries. You are working to secure an enhanced and sustainable basis for needs-driven, essential health research and development relevant to diseases that - again - disproportionately affect developing countries.
'In essence, you are concerned about fairness, and fairness has long been a concern of public health.
The challenge is to work on multiple fronts: to meet the immediate need for equitable access to quality, affordable medicines, while also, at the same time, working to stimulate innovation.'