Health: Assembly adopts new revised drug strategy

by Chakravarthi Raghavan

Geneva, 24 May -- The World Health Assembly at its current 52nd session has adopted a revised drug strategy giving a new mandate to the WHO on policies to ensure improved access to essential drugs, and tackling the interface between health, trade and intellectual property issues.

The new resolution supplements the 1986 Revised Drug Strategy, to take account of the public health perspectives on trade issues and the World Trade Organization's Agreement on Trade Related Aspects of Intellectual Property Issues (TRIPS).

The resolution asks member states to:

* reaffirm their commitment to develop, implement and monitor national drug policies and take all necessary concrete measures to ensure equitable access to essential drugs,

* ensure that public health interests are paramount in pharmaceutical and health policies,

* and explore and review their options under relevant international agreements, including trade agreements, to safeguard access to essential drugs.

Last year a resolution on this issue, recommended by the Executive Board, that came before the Assembly was strenuously opposed by the US and many European governments and the transnational pharmaceutical lobby, and was sent back for further study and consultations.

The adoption of the new resolution this year was welcomed by a number of non-government organizations including the Health Action International, Medicins Sans Frontires and the Consumer Project on Technology.

In their statement, they quoted Dr. Ian Roberts Special Advisor to the Minister of Health of South Africa (which has taken a prominent role in this debate and discussions at the WHO) as saying that "the main importance of the new resolution is that health now has a role in all international trade and finance agreements.. We will be collaborating closely with the WHO to ensure that we get affordable medicines to our people."

HAI said that the resolution was a "timely addition" to the WHO's mandate in the pharmaceutical area, and governments should be "encouraged to use the safeguards (against monopoly and higher prices charged by the patent owners) that exist within the TRIPS including parallel imports and compulsory licensing."

James Love, Director of the US-based Consumer Project on Technology noted that last year the concepts in the resolution had been bitterly opposed by the US and many European governments on the ground that they undermined the intellectual property rights of large pharmaceutical companies. "Now that the resolution has been adopted, we need to take the next step and focus on implementation, which will make treatment more available to people in poor countries."

The new resolution in its preambular paragraphs notes that trade issues require a public health perspective and recognizes that the TRIPS Agreement provides scope for the protection of public health - presumably a reference to the ability of governments even under TRIPS to issue compulsory licenses for production of essential drugs and regulating the price of essential drugs.

The resolution that had been recommended by the Executive Board to last year's health assembly, in a preambular paragraph had expressed concern "about the situation in which one-third of the world's population has no guaranteed access to essential drugs, in new world trade agreements may have a negative impact on local manufacturing capacity and the access to and prices of pharmaceuticals in developing countries, and in which poor quality pharmaceutical raw materials and finished products continue to move in international trade;"

The resolution adopted by the Assembly now tones this down and in three separate preambular paras expressed concern over lack of guaranteed access to essential drugs and the poor quality of pharmaceutical raw materials and finished moving in international trade.

However deleted from this year's resolution are the references in last year's draft to the negative impact of new world trade agreements on local manufacturing capacity in developing countries and the issue of access to and prices of pharmaceuticals in developing countries.

In operative paragraphs, last year the Assembly among other actions, was asked to urge member States to reaffirm their commitment to develop, implement and monitor national drug policies to ensure equitable access to essential drugs and "to ensure that public health rather than commercial interests have primacy in pharmaceutical and health policies and to review their options under the Agreement on Trade-Related Aspects of Intellectual Property Rights to safeguard access to essential drugs;"

The resolution adopted this year among others also asks governments:

* to enact and enforce legislation or regulation in accordance with the principles of the WHO Ethical Criteria for medicinal Drug Promotion, encourage the pharmaceutical industry and the health community to establish an ethical code, monitor drug promotion in collaboration with interested parties,

* develop or maintain national guidelines governing drug donations,

* promote rational use of drugs through independent, up-to-date and comparative drug information and integrate rational use of drugs and information about commercial marketing strategies into training for health practitioners.

Last year, in another operative paragraph the Assembly would have asked the WHO Director-General, "to assist Member States to analyze the pharmaceutical and public health implications of agreements overseen by the World Trade Organization and to develop appropriate policies and regulatory measures;"

This too was toned down this year into: "to cooperate with Member-States, at their request, and without international organizations in monitoring and analysing the pharmaceutical and public health implications of relevant international agreements, including trade agreements, so that Member States can effectively assess the subsequently develop pharmaceutical and health policies and regulatory measures that address their concerns and priorities, and are able to minimize the positive and mitigate the negative impact of those agreements."

The WHO Director-General has also been asked to report to the Health Assembly next year on the progress achieved resolution and the problems encountered in implementation and the renewal of the WHO's revised drug strategy, along with recommendations for action. (SUNS4441)

The above article first appeared in the South-North Development Monitor (SUNS) of which Chakravarthi Raghavan is the Chief Editor.

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