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.
Health equity in economic and trade policies
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.
In this essay, the author considers the impact of the India-Brazil-SouthAfrica (IBSA) and the Brazil-Russia-India-China (BRIC) summits on South-South co-operation and development. In terms of the health sector, the author argues that IBSA and BRIC offer synergies among the countries in the alliances. As regards HIV/AIDS, for instance, the interests of the three countries are quite convergent. India has the second largest number of HIV-positive people (2.4 million) and also the largest generic drugs industry. Brazil has developed role-model public policies in fighting AIDS and exports its know-how to several African, Asian and Latin American countries. South Africa has a high demand in this regard, since it has the largest number of HIV-positive people (5.7 million) and faces severe constraints in democratising public health services regarding the epidemic. In recent years the IBSA countries have been prominent in the G-21 lobby that succeeded in lessening the negative effects of the Trade-Related Aspects Of Intellectual Property Rights agreement (TRIPS). Flexibilities in TRIPS permit governments to issue licenses for generic drug production for the domestic market in the interests of public health, without the consent of the patent owner, to help bring down the high costs for patented drugs in developing countries. India is one of the world’s leading producers of generic medicines. While a trilateral trade agreement has been alluded to on numerous occasions, the author alleges it is unlikely to materialise between India, Brazil and South Africa, which are technically bound to regional trade blocs.
According to this article, China has become one of Africa's leading trading partners, with trade totaling US$106.8 billion in 2008, up 45 per cent from the previous year. China's increasing demand for raw materials to fuel its domestic growth has resulted in agreements on access to and extraction of minerals and oil from resource-rich African countries. China has also become an emerging player in providing financial assistance for infrastructure development in Africa, helping African countries address their infrastructure needs such as railways, hydropower and roads. China has sought to provide concessional financing for infrastructure and construction projects through its Export-Import Bank, often using Chinese companies to carry out the projects. Since 200, China's foreign policy in the region has been directed through the Forum on China-Africa Co-operation (FOCAC), which is the main vehicle for China's activities in Africa, providing a multilateral platform for dialogue with a view to reaching mutually agreeable goals. A number of action plans have emerged from FOCAC, which outline commitments to Africa by the Chinese government, such as the 2009 Sharm El Sheikh Action Plan, in which the Chinese government commits itself to finance the training of African nurses, as well as contribute to malaria health services by supplying equipment and anti-malaria drugs.
A decade ago, the anti-malaria drug artemisin – available only from the sweet wormwood plant, Artemisia annua – was scarce and expensive. But by 2007, the market was wallowing in a surfeit of the drug as farmers flocked to grow the crop. Now, as a US$343-million initiative starts to battle malaria through hugely subsidised medicines, suppliers are again worried that there will not be enough artemisinin to go around, while farmers, plant breeders and synthetic biologists are hoping that they can snap the drug out of its roller-coaster supply cycle. Farmers and scientists are struggling to keep up with needs of ambitious medicine-subsidy programme, the article notes. The authors observe that artemisin yields could be improved by planting new Artemisia strains. On average, one kilogram of its dried leaves yields some 8 grams of artemisinin. Researchers have used selective breeding to create hybrid plants that produce up to 24 grams, according to a British Artemisia breeding consortium. These plants are now being grown and harvested commercially in Madagascar, and trialled in South Africa, Uganda, Zimbabwe and the United States, as well as in Britain.
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.
In February 2011, experts gathered at the World Intellectual Property Organisation (WIPO) to rewrite the negotiating document on intellectual property rights and traditional knowledge. The new document caused disagreements over common language in most articles, in particular, Article 1 on the subject matter of protection of traditional knowledge, which includes the definition of traditional knowledge (TK), the criteria for eligibility and on secret TK. To accommodate different opinions, several options were listed in the draft document. In Article 1, one of the options mentions the fact that, among eligibility criteria, protection should extend to TK not widely known outside that community, which could imply that some TK already in the public domain would not be considered as eligible. A representative of the Indigenous Peoples Council on Biocolonialism argued that the language in Article 1 might be misconstrued as intellectual property language and it was important that Article 1 really reflect the integrity of TK in its cultural context as a dynamic form of knowledge transmitted from generation to generation to serve the interest of the community. Article 2 only contains two brackets signifying lack of agreement, one of which is around the word ‘nations’ as beneficiaries of protection. Some countries would like the protection to include indigenous peoples, local communities and nations. The representative of the Indigenous Peoples Council on Biocolonialism said beneficiaries should be TK holders themselves, and not nations. A developed country source agreed, noting that indigenous peoples and local communities are holders of TK and should be beneficiaries and managers of their rights, but that nations could not be beneficiaries of the instrument being elaborated as this would confuse intellectual property rights with public heritage protection.
The proposed intervention by The Global Fund to drastically reduce prices of Artemisinin Combined Therapies (ACTs) through its Affordable Medicines for Malaria programme (AMFm) will see ACTs from six foreign companies sell ACTs at a reduced, monitored price regime of between US$0.40 and 0.47. However, controversy has arisen over two competing development goals - making high quality medicines available to those in need at affordable prices vs strengthening local industrial capacity. The paper argues from the Nigeria situation, that manufacturers in Nigeria have practically no access to bank credit and provide their own infrastructural requirements, compared to foreign counterparts who may have access to cheap credit, enjoy tax reliefs and export incentives. This makes it difficult for Nigerian manufacturers to compete with their foreign counterparts. It is not clear whether there are actual foreign assistance efforts aimed at building the capacity of malaria endemic countries in Africa to produce their own pharmaceutical products. The author suggests that if such a longer term project were started in parallel with efforts like AMFm, there may be more acceptance for temporary set backs in the local market, given that the international community is trying to strengthen countries’ abilities to fight malaria into the future. The author calls for an aid programme that can address the infrastructural problems facing Nigerian manufacturers and provide a legal framework that protects intellectual property and gives the local companies a fair chance to compete.