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Ensure International Agreements Support Public Health, says HRC

by Chakravarthi Raghavan

Geneva, 23 Apr 2001 -- The UN Commission on Human Rights sent out a message of powerful political support of the international community for affordable access to medicines in the context of pandemics like HIV/AIDS, asking all States “to ensure that application of international agreements is supportive of public health policies which promote broad access to safe, effective and affordable preventive, curative or palliative pharmaceuticals and medical technologies.”

The subject of HIV/AIDS and the issues of human rights of the patients involved, including affordable treatment was introduced in the Human Rights Commission by Brazil. The resoloution ended up with 56 cosponsors (including some EU members and Norway). It was adopted on a roll-call vote by 52 votes against nil with one abstention, the United States. Though it will not directly affect the US dusute against Brazil at the World Trade Organization, the US abstention, and the indications at the WTO that it is going slow at the WTO for the moment in having panellists named, indicates the extent of growing political pressures on the US, the WTO and the transnational pharmaceutical corporations pursuing their profit above all policies.

The resolution recognizes that access to medication in the context of pandemics such as HIV/AIDS is “one fundamental element” for achieving progressively the full realization of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

States were called upon to pursue policies to promote availability in sufficient quantities of pharmaceuticals and medical technologies to treat pandemics such as HIV/AIDS, ensure affordable access of these to all, including the most vulnerable sections of population, without discrimination. They were also called upon to ensure that their actions, as members of international organizations, “promote broad access to safe, effective and affordable preventive, curative or palliative pharmaceuticals and medical technologies.”

The call to states to pursue these policies was hedged in with references to international and international agreements, but the political thrust of the resolution and its message of support to public interest groups and governments of developing countries against the pharmaceutical companies pushing their patent rights to extract unconscionable prices for medicines came through clear and loud.

Though the subject has been brought up at the HRC in the context of HIV/AIDS pandemic, and the call for affordable access to the medicines for the poor, speeches and statements of the sponsors and supporters like Norway made clear that the issue went beyond the question of HIV/AIDS, but other pandemics too.

The resolution in its operative paragraph “ Recognizes that access to medication in the context of pandemics such as HIV/AIDS is one fundamental element for achieving progressively the full realization of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.”

It calls upon States to pursue policies, in accordance with applicable international law, including international agreements acceded to, which would promote:

·        availability in sufficient quantities of pharmaceuticals and medical technologies used to treat pandemics such as HIV/AIDS or the most common opportunistic infections that accompany them,

·        accessibility to all without discrimination, including the most vulnerable sections of the population, of such pharmaceuticals or medical technologies and their affordability for all, including socially disadvantaged groups,

·        assurance that these pharmaceuticals or medical technologies, irrespective of their sources or countries of origin, are scientifically and medically appropriate and of good quality.

In terms of national actions, States were called upon, at national level and on a non-discriminatory basis:

·        to refrain from taking measures that would deny or limit equal access for all persons for such pharmaceuticals and medical technologies,

·        to adopt legislation or other measures, in accordance with international law, including international agreements acceded to, to safeguard access to such preventive, curative or palliative pharmaceuticals or medical technologies from any limitations by third parties,

·        to adopt all appropriate positive measures to the maximum of resources allocated for this purpose, to promote effective access to such preventive, curative or palliative pharmaceuticals or medical technologies.

In terms of international action, the resolution, called upon all States to take steps individually and/or through international cooperation, in accordance with applicable international law and agreements acceded to facilitate access in other countries to essential preventive, curative or palliative pharmaceuticals or medical technologies used to treat pandemics such as HIV/AIDS or most common opportunistic infections that accompany them, as well as to extend necessary cooperation wherever possible, especially in times of emergency.

States were also called upon to ensure that their actions as members of international organizations take due account of right of everyone to the enjoyment of the highest attainable standards of physical and mental health and that “the application of international agreements is supportive of public health policies which promote broad access to safe, effective and affordable preventive, curative or palliative pharmaceuticals and medical technologies.”

Developed countries were also called upon to assist developing countries in their fight against pandemics like HIV/AIDS through financial and technical support as well as training of personnel.

The UN Committee on Economic, Social and Cultural rights was called upon, when considering the human rights dimensions of combatting pandemics such as HIV/AIDS to give attention to the issue of access to medication, and invited States to include appropriate information on this in their reports to the Committee.

The UN Secretary-General was asked to solicit comments from Governments, UN organs, programmes and specialized agencies and international and non-governmental organizations on the steps taken to promote and implement the resolution, and report to the next session of the Human Rights Commission.

In general comments on the resolution, the EU said there was no doubt about the positive effect of increased access to medication to cure people who are ill, or where is no cure, to provide relief and increase possibilities of longer life in dignity.

“However,” said the EU, “medication still constitutes only a limited part of the actions needed to improve lives of people living with pandemics, such as HIV/AIDS. The importance of prevention and health care infrastructures as well as sustainable leadership cannot be emphasized enough. Success can be attained only through a multi-sectoral approach.”

Norway said that universal access to essential drugs was far from a new debate.  Neither was the stakeholder dialogue on this new nor the heated arguments and divergent views of interest groups.

Access to drugs carry features of “global public goods”, but they are largely manufactured and marketed as “global private goods” through large transnational corporations, “accessible anywhere, but only for those with purchasing power, and largely unaffordable to many public health care systems and - in most countries - unavailable for the poor.”

The issue was being discussed in the context of “heavy challenge to global economic systems and institutions by people in the street and in neighbours of the whole global community.”

It is not enough to note or analyse the inequities and imperfections in the global market, nor repeat phrases about the heavy odds sustaining poverty, marginalisation and disempowerment internationally and nationally.

“Governments and international institutions are challenged in terms of accountability and transparency, and asked to produce results that matter for the poor.”

The AIDS pandemic, Norway added, was a global emergency and had given a momentum to this debate, and cannot be met with a single set of responses. It was linked to other diseases, which also require vaccines and essential drugs and a working health system. New major efforts were under way to stop tuberculosis, rollback malaria, strengthen vaccine delivery and make nations more able to cope with the double burden o disease. “The path ahead calls for an ethical framework to guide this process of change and to establish parameters for policy choice and accountability.”

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

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