The author of this paper argues for public-private partnerships to help deliver locally produced generics in Africa, and against protectionism in favour of open market access. He points to promising developments, such as experienced Indian and Western pharmaceutical firms undertaking original research and development and partnering with firms in African countries. He believes this investment by reputable companies should help ensure quality drugs are produced by furnishing the technical expertise that overcomes capacity constraints. Local production enterprises in Africa will allow international companies to diversify their supply sources, the author argues, guarding against potentially disastrous shocks such as a natural disaster that would destroy an Artemisia crop and send the price of artemisinin-based malaria drugs skyrocketing. Local production partnerships could encourage trade, especially because the bulk active ingredients needed to produce them still come most efficiently from abroad. Partnerships between foreign pharmaceutical firms and African companies may also help train a pool of skilled workers, improving a country’s long-term development prospects.
Health equity in economic and trade policies
In this study, the authors argue that an optimal drug registration approach for Africa should reliably evaluate safety, efficacy, and quality of drugs for African use. It should include African expertise, contribute to building African regulatory capacity, and, ultimately, expedite African access by reducing duplicative and sequential reviews by different regulators. However they present an overview of the current situation that shows the present system of drug approval to be far from achieving these goals, with inefficiencies in the use of regulatory resources and in the uptake of capacity-building opportunities for African regulators. As a result regulatory processes and decisions may not meet current needs. The authors recommend that countries institute formal twinned regulatory reviews, fund Centres of Regulatory Excellence in each of Africa’s main regions and conduct a strategic review of WHO drug pre-qualification disease and product priorities.
Despite the successes in using competition law to reduce drug prices in South Africa, the prospects of other countries in the region being able to utilise competition law and policy to attain similar objectives are not high, due to a lack of institutional capacity (in some cases) and a lack of expertise, the authors of this paper argue. By taking an initial focus on domestic legislation, SADC countries may ultimately pave the way for a form of regional harmonisation for competition policy. As developments in South Africa have shown, national competition policy can ensure that national markets function efficiently, assure consumers of competitive prices and product choices, and promote other such efficiency-plus objectives. However, it is true that market developments tend to outstrip policy and regulatory developments. This region demonstrates perhaps one of the most confusing and complex arrays of overlapping membership of regional trade organisations with various countries being members either of SACU, SADC or COMESA. Given the mix of multiple memberships of regional trading organisations in the region, it is suggested that the two most viable (but by no means exclusive) options to explore for a regional competition policy are COMESA and SACU.
This article looks at the main challenges to European Union-Africa relations in light of the EU-Africa summit held in Tripoli, Libya from 29-30 November 2010. The Tripoli meeting marked the third Africa-EU Summit since 2000. In 2007, both parties to the JAES pledged to work together to implement the Africa Health Strategy, the EU Project on Human Resources for Health, the Abuja commitment to dedicate 15% of government financing for health, and the European Programme for Action to Tackle the Shortage of Health Workers in Developing Countries. President Jacob Zuma of South Africa openly expressed his concern that after ten years of the partnership, there was still too little to show in terms of tangible implementation of the undertakings made in previous summits. He cautioned the summit against committing to another action plan when commitments made in the past have not been implemented. The author noted that for example the ongoing Economic Partnership Agreement (EPA) negotiations, have become a contentious issue in EU-Africa relations, with clauses that may negatively impact on the production of affordable generic medicines for developing countries by rigorously protecting patent holders in developed countries.
In this report, the author found that proprietary rights on “influenza genetic sequences and the proteins they encode, used in vaccines,” get in the way of developing countries’ access to medicines. The study shows a sharp rise in patent applications in this area since 2006, shortly after the outbreak of H5N1 in late 2005. The study lists a series of examples of patent applications, such as Baxter International, for the production of influenza vaccines, published in July 2010. This patent application includes animal and human H5N1 types from China, Vietnam, Indonesia, Thailand, Cambodia, Turkey, and Singapore. According to the author, developing countries “collect and share influenza viruses with WHO’s Global Influenza Surveillance Network with the understanding that those viruses are to be used for public health.” However, proprietary claims can prevent access to technology and products produced with a given technology, he said.
The report notes that poor-quality, or "substandard", medicines threaten patients and public health in developing countries. Prioritisation of medicines regulation by developing-country governments, with the technical and financial support of rich countries, is badly needed. Yet under the guise of helping to address dangerous and ineffective medicines, rich countries are pushing for new intellectual-property rules and reliance on police - rather than health regulatory - action. This approach will not ensure that medicines consistently meet quality standards. Worse, new intellectual property rules can undermine access to affordable generic medicines and damage public health. Developing countries must improve medicines regulation - not expand intellectual-property enforcement - in order to ensure medicine quality.
The United Nations has been enjoined in a court case in Kenya case challenging a potential threat to supply of generic drugs for HIV and AIDS. It claimed enforcement of the Anti-Counterfeit Act 2008 would endanger the lives of people infected. The High Court in Nairobi heard those affected would not access affordable and essential drugs. The UN Special Rapporteur indicated his wish to intervene as an interested party to support the constitutional principles of access to essential medicines, according to advocate Ombati Omwanza. Justice Daniel Musinga allowed Anand Grover to represent the UN in the suit. The court allowed importation of generic anti-retrovirals, pending the hearing and determination of this case. The interim order issued in April 2010 was aimed at saving the lives of those living with the virus. The judge’s interim order stopped the implementation of three sections of the new Anti-Counterfeit Act.
This review by the Chinese ambassador to Botswana marks the 35th anniversary of the establishment of diplomatic relations between the China and Botswana. According to the ambassador, trade and technical co-operation serve as the driving force behind bilateral relations between the two countries, as China considers mutually beneficial co-operation as more important and useful than unilateral assistance. The Chinese government has also undertaken technical exchanges and transfers with Botswana, notably in agriculture and health. From the 1970s to 1980s, China helped train a group of agriculture technical personnel from Botswana and sent experts to conduct local land survey and planning projects. Three Chinese senior agricultural experts are now helping Botswana in agricultural policy making and improving farming technology. In health and medicine, China has sent medical teams to Botswana since 1980, like the Twelfth Team, comprising 40 medical staff and six support staff, who provide medical services in public hospitals in Gaborone and Francistown. In the review, the ambassador acknowledges that his country aims to further scale up human resources development as an important component of bilateral relations. Since 1999 almost 300 Botswana officials and technicians have attended seminars, workshops and short-term training programmes in China – covering areas of administrative management, commerce, information etc – and the number is set to increase.
The Graduate Institute’s Global Health Programme, in cooperation with the University of Ottawa, held a public seminar at the Institute in April 2011 to discuss the threat that fake and substandard medicines pose to public health and the potential role of the World Health Organisation (WHO) in resolving this daunting health challenge. A major theme running throughout the seminar was the need to redress the critical imbalance in the provision of international legal tools to tackle the illicit trade and criminal production of fake medicines. A complete legal system would address both the positive challenge, to promote greater access to safe, WHO-qualified treatments, as well as the negative challenge, to stop criminal activity and bogus treatments that are intentionally fraudulent, illicitly traded and sold. Currently, the global system lacks balance, with most legal tools addressing the issue of counterfeit medicines. In other words, the international system is currently more prepared to tackle this issue as a violation of intellectual property rights rather than as a significant danger to public health.
One of the action plans emerging from the Forum on China-Africa Co-operation – the main platform for Chinese-African relations – is the Sharm El Sheikh Action Plan, in which the Chinese government committed itself over the period 2010-2012 to, among other things, send 50 agricultural technology teams to Africa and help train 2,000 African agricultural technicians, build and implement 20 agricultural technology demonstration centres in Africa, and implement 100 joint research and demonstration projects to aid science and technology transfer. The government has also committed to contribute medical equipment and malaria-fighting materials worth 500 million yuan (US$76.35 million) to 30 hospitals and 30 malaria prevention and treatment centres built by China for Africa in the three-year period. China will invite African professionals working in the field of malaria to attend training programmes in China in an effort to ensure sustainable development of the project. The country will also help relevant African countries train a total of 3,000 doctors, nurses and administrative personnel. Africa and China pledged to scale up joint efforts to prevent and treat major communicable diseases like HIV, malaria, tuberculosis, avian influenza and influenza A (H1N1). The two sides will continue to enhance co-operation in setting up mechanisms to handle public health emergencies.