The author argues for a new financial system that is transparent and accountable to all. The G20's task is to expose all that has gone wrong, including the role the African leaders have played in the crisis, through the externalisation of billions of pounds intended for the development of their countries. These activities, Nabudere notes, have helped position Africa as a net creditor to the world, with the external assets of 40 African countries outstripping their external liabilities over the period from 1970–2004. In other words, he says, despite the widely held view that Africa was 'decoupled' from the global economy, African leaders have contributed to the activities of ‘shadow banks’ being used to create ‘toxic debt’, their wealth contributing to the global economic turmoil.
Health equity in economic and trade policies
In this policy brief, the author argues that the world Intellectual Property Organisation (WIPO) development agenda is a valuable opportunity to place the notion of the 'public domain' at the centre of the intellectual property debate. In this regard, she proposes the creation of an international register for public domain matters that countries, particularly developing countries and least developed countries (LDCs), should be able to rely on in order to boost their local innovation and creativity. The author recommends that governments and other stakeholders preserve the public domain and support norm-setting processes that promote a robust public domain, initiate discussions on how to further facilitate access to knowledge for developing countries and LDCs in order to foster creativity and innovation, and establish a forum for exchange of experiences on open collaborative projects such as the Human Genome Project.
Oxfam International, Health Action International (HAI) and Knowledge Ecology International (KEI) have voiced their alarm over recent seizures by the Dutch government of shipments of legitimate generic pharmaceuticals passing through Europe on their way to developing countries. The recent seizure of legitimate generic antiretroviral medicines in transit from India to Nigeria by Dutch customs authorities could lead to HIV-positive Nigerian patients missing critical treatment. They have called on the European Union to review and modify its regulations on counterfeiting that are prompting the seizures. They also urged the EU to reconsider inclusion of its regulation in regional free trade agreement negotiations. If it does not, ‘this could prove disastrous for access to medicines in some regions,’ they said.
Developing nations, led by Brazil and India, continue to press strong concern over seizures of legitimate shipments of generic pharmaceuticals destined for poor patients in the developing world. Brazilian Ambassador to the WTO, Roberto Azevêdo, told reporters that flexibilities developing countries have under WTO rules on intellectual property rights may be ‘jeopardised’ and that the possibility of a dispute settlement case was not ruled out. He said that as many as a dozen developing countries made statements in support of the concerns, and two of those countries spoke on behalf of the African Group and the Least Developed Countries group, each of which have dozens of members. However, the European Union denies any conflict with WTO rules in its efforts to catch shipments of counterfeits.
We are falling behind in meeting the Millennium Development Goals. Answering this challenge, a new initiative, Economic Governance for Health (EG4Health), aims to harness the voice and public health mandate of the global health community. In partnership with other civil society groups, the initiative seeks fundamental reforms of the global economic system in favour of just, climate-friendly and pro-health development. At the root of EG4Health are three simple points: the global economy is critically important to health, especially in developing countries; if we hope to achieve global health equity, we must first restore democracy and fair play to global economic governance, free from the undue influence of wealth and power; and the voice of the global health community can and should help to inform, stimulate, and shape the required reforms to the governance of the global economy.
The ambassadors to the World Trade Organization (WTO) from Brazil and India charged that other WTO members had no grounds to block legitimate shipping of generic medicines on the basis of potential intellectual property (IP) rights conflicts in the transit country and said recent cases of doing so in the Netherlands call into question WTO rules. The complaint was supported by seventeen other developing country governments at the recent WTO General Council meeting. The Brazilian ambassador was gravely concerned with the setting of a precedent for extraterritorial enforcement of IP rights. Attempts to extend the rights granted by patents beyond national borders have critical systemic implications, he said. Furthermore, extraterritorial enforcement of patent rights violates a nation’s sovereign right to take measures to protect its public health, including access to medicines.
The generic industry is in trouble again, and the issue is now becoming a major non-tariff barrier against developing countries like India. Two large drug consignments of generic medicines were seized in Netherlands by its customs authorities recently. The drugs, while in transit to Peru, were held at Rotterdam port because they infringed patents in EU. Sources said that recently many essential drugs have been held at European ports on way to Africa or Latin America from India by EU customs for intellectual property infringement or by labelling them 'counterfeits'. India is a source of affordable life saving medicines for many African and developing countries, and companies use the established trading route passing through EU ports for supplying essential medicines to millions across the world, potentially jeopardising the lives of those needing drugs in those countries.
With regard to The Lancet’s series of articles on the inter-relations between the two policy spheres of trade and health, the author of this paper expresses his disappointment with the hazy direction and lack of leadership of the global governance in addressing inadequate access to essential medicines for the poorest population as a result of market exclusivity and patent protection, rendering statements and declarations made by heads of states and leaders of international organisations as rhetoric. The paper draws this conclusion from lessons learned from the experience of compulsory licensing in Thailand and the management of disptutes between Thailand and patent-holding companies and their parent-country governments.
The World Trade Organization's Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) set global minimum standards for the protection of intellectual property, substantially increasing and expanding intellectual-property rights, and generated clear gains for the pharmaceutical industry and the developed world. The question of whether TRIPS generated gains for developing countries, in the form of increased exports, is addressed in this paper. The authors consider the importance of pharmaceuticals in health-care trade, outlining the essential requirements, implications, and issues related to TRIPS, and TRIPS-plus, in which increased restrictions are imposed as part of bilateral free-trade agreements. TRIPS has not generated substantial gains for developing countries, but has further increased pharmaceutical trade in developed countries. The unequal trade between developed and developing countries (ie, exporting and importing high-value patented drugs, respectively) raises the issue of access to medicines, which is exacerbated by TRIPS-plus provisions, although many countries have not even enacted provision for TRIPS flexibilities. The paper focuses on options that are available to the health community to advance negotiations to their advantage under TRIPS, and within the presence of TRIPS-plus.
Developing countries have voiced concerns at a meeting of the Executive Board of the World Health Organization (WHO) over the Secretariat using the term ‘counterfeit’ to describe problems relating to the quality, safety and efficacy of medical products, and addressing such problems through the International Medical Products Anti-Counterfeit Taskforce (IMPACT). Some countries felt the WHO's anti-counterfeit taskforce, IMPACT, was unsuited to address the issue of quality, safety and efficacy (QSE) of medical products because it lacked a mandate from the WHO's governing bodies; and because of its emphasis on counterfeits; the involvement of the private sector in its activities raising issues of conflict of interest; and its lack of transparency.’