Coherence between health and trade: accessing medicines
5 February 2013
Lamy: Coherence between health, intellectual property and trade key to access to medicines
Director-General Pascal Lamy, at the launch of the joint WTO-WHO-WIPO study “Promoting Access to Medical Technologies and Innovation” on 5 February 2013, said that “coherence between health policies, intellectual property rules and trade policy is key to finding sustainable solutions to access to medicines and medical technologies.” He added that “this study is one of the many bridges WTO has constructed with other international organizations during my tenure.” This is what he said:
I offer a warm welcome to you all. We are delighted at the range and numbers of those who have registered for this event, and thank you for your interest in the study which we are launching today.
Above all, I thank my colleagues Margaret Chan and Francis Gurry and the hardworking, highly capable teams within the Secretariats they lead. They have shown collegiality, openness to collaboration and dialogue, energy, leadership and enthusiasm for progressing the objectives and values that we share — a world in which innovation yields ever more solutions to global challenges.
I have the honour to introduce the Chair for this launch, Mme Ruth Dreifuss. She is well known to you all — not only as a long-standing member of the Swiss Federal Council representing Geneva and President of the Confederation, but also for her distinguished role as chair of the WHO Commission on Intellectual Property Rights, Innovation and Public Health (CIPIH) which produced an important forerunner to today’s publication, the 2006 report “Public health, innovation and intellectual property rights”.
Launch of the publication
Today marks the launch of a landmark publication which exemplifies the active programme of technical co-operation and dialogue between the three partners. Let me begin by retracing some of the steps that led us to today’s event.
In 2001, trade ministers did something entirely unprecedented. The dimensions had become clear of the catastrophic impact of the HIV/AIDS pandemic which was ravaging the world’s poorest populations. WTO ministers turned to the question of public health, and its interplay with intellectual property law and policy — producing the “Doha Declaration on the TRIPS Agreement and Public Health”.
This was a major turning point. Neither public health nor even the area of intellectual property (IP) had been among the traditional preoccupations or core competences of trade ministers. They had typically focused on matters such as tariffs and subsidies.
The logic of the Doha Declaration remains compelling today. Ministers recognized that the IP system is not an isolated specialist domain, nor yet a monolithic barrier to public health. Instead, they saw IP as an element of the complex set of policy tools required to solve global problems. The emphasis was laid on how different policy measures work together coherently and to mutual benefit — the policy ’intersections’ that give this report its title. The Declaration provided a blueprint for the coherence agenda that has culminated in the study we launch today.
The Doha Declaration helped catalyse the growing understanding that access to medicines requires the right mix of health policies, intellectual property rules and trade policy settings, and involves the judicious and informed use of a range of measures including competition policy, procurement strategies, attention to tariffs and other trade related drivers of cost, and choices within the IP system. Coherence between these is key to finding sustainable solutions. And this is exactly the spirit behind the joint study that we launch today.
The report emphasises that innovation and access must be seen holistically — innovation without effective access offers scant public health benefit; yet simply to leverage access to an existing pharmacopeia without encouraging the development of new medicines and new medical technologies would diminish health outcomes.
The study points out the importance of the patent system for the pharmaceutical sector, while also identifying alternative incentive mechanisms that seek to enable much needed new products in neglected diseases.
The study also looks at measures such as differential pricing as a practical way of reconciling innovation and access in medical technologies. It draws together, in a relatively brief and accessible manner, a diverse array of current information on access and innovation, enabling an overview of how diverse policy measures can fit together coherently.
It highlights the important trends in trade in health-related products and shows how tariffs remain high in some countries, with direct implications for access. Tariffs, taxes and other charges on pharmaceuticals and other health-related products have been described as a “tax on health”. Trade in health-related products has been dominated by a few developed countries but the study highlights the growing presence of some emerging countries. A review of the economics literature on medical innovation and the history of the business models in the pharmaceutical sector illustrates how economics offers guidance for health policy, and spotlights the factors that are currently driving historic change in the pharmaceutical sector.
A preliminary overview of preferential trade agreements shows their significance for access to and innovation in medical technologies, but equally demonstrates the need for more systematic analysis of this complex area.
The discussion of access to medical technologies recalls that access is often a function of public procurement programmes, and underscores the importance of sound procurement policy, effective safeguards for legitimate competition, and the relevance of the principles of the WTO Government Procurement Agreement.
In exploring the interface between health, trade and IP, the trilateral study also illustrates mutually reinforcing and complementary roles of the cooperating agencies. For example, effective use of TRIPS flexibilities for public health entails improved access to patent information, a core WIPO function, and is guided by detailed information on disease burdens, medicine prices and patterns of access, data which is a particular focus of the WHO.
My colleagues have told me that one of the greatest challenges in preparing this study was not in gathering material — information is incredibly abundant in each of the three fields it covers. Rather, the challenge was to work out what to exclude, what details and empirical data to leave out.
But we need to understand that the function of the study is not to pronounce the final or authoritative word on the issues it addresses. It is to provide a stronger shared platform of objective information to build the capacity of policymakers and to serve as the basis for informed policy discussions. I commend the study to you as a practical resource, not as a doctrinal treatise. We expect it will catalyse the cross-disciplinary dialogue, pooling of resources and coordination of technical assistance that has been the hallmark of our work on public health with our colleagues in the WHO and WIPO, and with our many other partners working in this field, many of whom have honoured us with their presence today.
To conclude, this study is one of the many bridges the WTO has constructed with other international organizations during my tenure. The WTO is not an island in the international system. Opening trade is not an objective in itself. It serves the purpose of enhancing welfare. We have worked with ILO on trade and jobs. We have worked with UNEP on trade and environment. And as we are demonstrating today, the WTO, WHO and WIPO have teamed up on the issue of health. Jobs, the environment and health are issues people across the world care about, which is why they are also essential for us.
We look forward to a vibrant, informed, active dialogue with you all.
It only remains for me to thank you all again for joining us for the launch of this landmark publication, and to invite you to continue the broad based dialogue on these issues which remain of fundamental concern to us all. This publication is meant to be a springboard for further dialogue and policy analysis, not as the final word.
I welcome especially the close, cordial and productive partnership with my colleagues Margaret Chan and Francis Gurry, and pledge our continuing commitment to this partnership. I also would like to thank Mme Dreifuss for having chaired this event and for her longstanding and continuing engagement in what is such an important matter to us all.