by Someshwar Singh

Geneva,20 Oct 99 -- The advances made by the essential drug policies
in many third world countries are threatened by the World Trade
Organization's agreement on Trade Related Intellectual Property Rights
(TRIPs) as well as certain policies of the World Health Organization,
says a research study.

Published in the October issue of 'Corner House', a research and
solidarity group based in the U.K., the study titled 'Diseases,
Drugs and Donors in the Third World' states that TRIPS has 'grave
implications' for many developing countries.

Pharmaceutical expenditure accounts for a substantial part of the
health budgets of most developing countries. So far, the prices
of essential drugs have been kept under control by implementing
national drug policies or by manufacturing the drugs themselves.

But all that is going to change, the study says. The WTO's TRIPs
agreement requires member countries to introduce "product"
patents instead of "process" patents.

Until now, many developing countries have been able to
manufacture a patented drug legally by a process different from
that originally used.

But for developing countries, implementing the TRIPs "is an
invitation to a lethal cocktail of 'higher consumer prices of
pharmaceutical drugs; larger foreign exchange outflow as a result
of more imports and fewer exports; and fewer people employed as
a result of lower domestic production."

The study also notes that predictably, the remedies proposed by
the Global Forum for Health Research, a WHO-pharmaceutical-aid
agency industry collaboration, are state subsidies, guaranteed
markets and "streamlined regulatory requirements" for private
sector corporations - which would only entrench their power

Economic globalization, meanwhile, has contributed to the
resurgence of some infectious diseases and the emergence of new
ones, according to the study.

After Thailand's economic collapse, for instance, dengue fever
increased because pools of water collected as construction
projects were left unfinished, providing a breeding ground for
disease-carrying mosquitoes.

Malaria's comeback has been helped by the building of large dams
and irrigation schemes which increase areas of stagnant waters,
and by the movements of migrant workers who bring the pathogen
into regions where it previously did not exist.

Use of pesticides and synthetic drugs has led to the evolution
of resistant strains of mosquitoes and pathogens: far more people
die from malaria today than did three decades ago.

The study maintains that today's medical research is highly
skewed in favour of heart diseases and cancer as compared to
other diseases like malaria, cholera, dengue fever and AIDs which
kill many more people.

Just four per cent of drug research money is devoted to
developing new pharmaceuticals specifically for diseases endemic
in the South anyway, the study notes.

To put it another way, less than 10% of the $56 billion spent
each year globally on medical research is aimed at the health
problems affecting 90% of the world's population.

While pneumonia, diarrhoea, TB and malaria account for more than
20% of the disease burden of the world, they receive less than
one per cent of the funds devoted to health research.

Even with extended and enforced patent protection in the
countries of the South, it is unlikely that Western companies
will devote much effort to research which might benefit
"financially non-solvent populations".

The WHO estimates that between 1,300 and 2,500 million people -
more than one-third of the world's population - have little or
no access to "essential drugs" -- defined by WHO as those
"indispensable" drugs which "should be available at all times,
in the proper dosage forms, to all segments of society".

What drugs are available are often unsafe, ineffective, or of low
quality, the study points out. Many of them have been dumped on
the South because they remain unapproved in the West.

Some drugs developed in the 1950s and 1960s to treat tropical
diseases, on the other hand, have begun to disappear from the
market altogether because they are seldom or never used in the
developed world.

Perhaps the study's most disheartening note is its observation
with regard to the on-going controversies in the field of genetic
engineering and health.

"The role for people in the South in a globalized medical system
involving genetic engineering is perhaps less as health
beneficiaries than as donors of body parts and cell lines," it

Organs of both dead and live children are already widely sold in
Brazil, with the justification that this market alleviates

In Thailand, meanwhile, recent scandals involved the alleged
trading in organs of patients who were deliberately allowed to
die or were operated on without the consent of relatives, the
study adds. (SUNS4534)

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