International Trade and Universal Access to Treatment in Africa Talking notes prepared by by Thomas DEVE For the “Working for Health: Innovative Models in HIV and AIDS programming in the World of Work.” Symposium held on 27-29 June 2007 at Intercontinental Hotel, Lusaka, Zambia: International Trade and Universal Access to Treatment in Africa Talking notes prepared by by Thomas DEVE For the “Working for Health: Innovative Models in HIV and AIDS programming in the World of Work.” Symposium held on 27-29 June 2007 at Intercontinental Hotel, Lusaka, Zambia Thomas@mwengo.org.zw
Some key observations: Some key observations A statement issued by people living with HIV/AIDS and their allies at the Third Session of the African Union Conference of Ministers of Health held in Johannesburg, South Africa from 9-13 April, 2007 makes interesting reading for those who follow closely the links between Trade and Health.
It was noted that:
q We will not go back to the days when only the rich in our countries could afford antiretroviral therapy.
q We will not go back to the days when HIV prevention was pitted against treatment instead of both interventions seen as mutually reinforcing and equally important.
q We will not go back to the days when strengthening health systems was seen as a prerequisite for antiretroviral therapy instead of a critical way to galvanize communities to demand their right to health and build momentum for better primary care services.
Some key observations: Some key observations But most importantly, the statement notes that, “Both AIDS treatment and prevention depend on strengthening our health systems, but AIDS is an emergency that needs an extraordinary response. We believe that rapid scale-up of AIDS services need not compromise health systems and AIDS can be the engine of strengthening primary medical care in Africa”
The group makes very pertinent remarks on Free Trade Agreements. It is stated that “No country in Africa should sign free trade agreements or other treaties that restrict their ability to ensure access to a sustainable supply of affordable medicines by producing or importing medicines or their active pharmaceutical ingredients as allowed under the TRIPS agreement and TRIPS flexibilities need to be incorporated into national laws and regulations without delay”.
What some governments have said.: What some governments have said. In other continents, senior government officials are making such calls.
Ministers of Health of ten South American countries Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Uruguay and Venezuela issued a joint declaration on Access to Medicines and Public Health in Geneva on 23 May 2007 committing themselves to avoid “TRIPS plus” provisions in bilateral and regional trade agreements, to facilitate the use of compulsory licensing and parallel importing and to avoid broadening the scope of patentability and the extension of patentable areas.[i]
The South American Ministers' Declaration said that access to medicines and critical raw materials is an integral part of the right to health, which is a basic human right of every individual and a fundamental prerequisite that governments have a duty to ensure.
[i] TWN Info Service on WTO and Trade Issues, 1 June 2006, Third World Network
An alternative trade policy: An alternative trade policy WTO activists for an alternative trade policy have always argued that in international trade diplomacy, some governments push forward the notorious WTO corporate trade agenda that undermines the world campaign for a fair international trade policy that puts people over profit. What is needed is democratically controlled trade policy that does not bend to global corporate interests but that promotes the rights of the people for an environmentally sustainable and socially just development.
WTO negotiations that started in 2001 have been in crises for several years now. In contrast to their public rhetoric proclamations of a development round, Industrialized countries are aiming at far-reaching liberalization and privatization policies in their corporate interests. Both developing countries and an international protest movement have opposed these plans.
An Alternative trade policy: An Alternative trade policy As a leader of La Vía Campesina, Basque farmer, Paul Nicholson one stated: “WTO is an octopus that is why we have been attacking its head, now we need to start cutting the tentacles. Now is time to develop our global, regional, national and local strategies to bury the WTO and more importantly, to bring food sovereignty, our alternative, as the alternative of the citizens of the world and into the agenda of the social movements...”
It is in this context that we should take heed of the call in the statement highlighting tat:
q We will not go back.
q We will not be silent.
q We will hold you to your promises.
q We will hold you accountable.
q We will be watching you.[i]
Similar views have been expressed elsewhere but have placed more emphasis on the agriculture-related aspects of trade [i] Statement issued by people living with HIV/AIDS and their allies at the Third Session of the African Union Conference of Ministers of Health held in Johannesburg, South Africa from 9-13 April, 2007
In the WTO: In the WTO Since the WTO summit in Cancun in September 2003, the Doha Round has been blocked by worldwide growing protest against trade liberalization and because many developing countries have opposed an aggressive agreement pushed by the EU and the US. Few powerful countries try to impose to the rest of the world an agreement in order to go further into trade liberalization and market opening. Such an agreement would have catastrophic impacts on rural development.
Free-trade and privatization are not in the interest of the poor. Increasing competition in agricultural markets marginalizes the great majority of small scale producers. Transforming agrarian resources into commodities allows corporations to take over the land, the water, the seeds and the knowledges at the expenses of rural communities.
The same has happened in the health sector with respect to corporate control of production, licencing and acess to essential, affordable and life-saving medicines.
Impact of Trade on health: Impact of Trade on health The Regional Network for Equity in Health in east and southern Africa (EQUINET) has examined trade agreements at World Trade Organisation (WTO), regional and national levels for their impact on health, and argues that all trade agreements must be subject to an assessment of health impacts and publicly debated, before governments conclude or sign them.[i]
In the same publication, it is also argued that to improve health, countries in east and southern Africa need to develop economic and trade systems that promote health and which help to organise and sustain equitable health systems. In other words at minimum, trade and economic policies should do no harm to health.
While negotiating trade agreements, states must therefore pay attention to their potential impact on health, particularly on population health, on the risks to health, on the resources available for health and on universal access to health services. Where trade agreements and trends have negative impacts on these dimensions of health, they pose increased social and economic burdens for countries and populations, and often for vulnerable groups.
[i] “Health implications of proposed Economic Partnership Agreement (EPA) between
east and southern African countries and the European Union” Equinet Discussion paper 41, February 2007
Intellectual Property Rights (IPR): Intellectual Property Rights (IPR) The above can be easily understood if we examine closely the treatment of Intellectual Property Rights (IPR) in Trade agreements. Broadly, Intellectual Property Rights are rights granted to creators and owners of works that are results of human intellectual creativity. These works can be in the industrial, scientific, literary and artistic domain.
Examples of IPRs are copyrights, trademarks, patents and others. The WTO TRIPS Agreement (1995) for example, requires member countries to provide for patent protection in their national legislation for a minimum of 20 years.
TRIPS sets out the minimum patent protection requirements for WTO members to enforce through their national laws. Developed and developing countries should by now have made their laws TRIPS compliant. The Least Developed Countries (LDCs) have until 2016. Many of countries in east and Southern Africa (ESA) are LDCs.
Interpreting TRIPS: Interpreting TRIPS The Doha declaration allows WTO members to interpret TRIPS in a manner supportive of their efforts to protect public health and promote access to medicines. The Doha declaration gave countries the authority to use the flexibilities provided in the TRIPS Agreement in the interest of public health, including:
q giving transition periods for laws to be TRIPS-compliant;
q providing for compulsory licensing or the right to grant a license, without permission from the license holder, on various grounds including public health;
q providing for parallel importation or the right to import products patented in one country from another country where the price is less;
q exceptions from patentability and limits on data protection;
and
providing for early working (known as the Bolar Provision) allowing generic producers to conduct tests and obtain health authority approvals before a patent expires, making cheaper generic drugs available more quickly at that time.
Slide11: The above is further undermined by the WTO’s preoccupation with service sector privatization and deregulation that we view as anti-development. These negotiations are aimed at requiring countries to transform their public services into new tradable for-profit commodities for foreign companies and to deregulate domestic service sectors to allow foreign corporations to operate without restriction in domestic markets. Yet most experiences of services liberalization in developing countries to date – in water, energy, health, education, the financial sector – have been negative. In particular, public access to privatized services, especially for the poor, is often diminished while the quality of service is compromised and local employment declines.
The Trade Related Intellectual Property Rights (TRIPs) Agreement has functioned to rob our communities of their collective right to resources, seeds, indigenous knowledge and even life itself, and to thwart development by allowing transnational corporations to monopolize technological innovations throughout the whole range of industries.
Impact of TRIPs: Impact of TRIPs It has seriously undermined people’s food sovereignty. By putting corporate profits above public health concerns, TRIPs has facilitated a public health crisis in the form of HIV AIDS that has drastically setback many parts of Africa.
Trade has become the vehicle for the indiscriminate liberalization of developing country economies and the imposition of harmful conditions, instead of supporting sustainable development, poverty eradication and gender equity.
Increasingly, trade rules and many related policies have failed to ensure the right of developing countries to pursue their own development agendas, and putting their people’s interest first.
Apparent failures in the World Trade Organization, international financial institutions and national governments to seriously consider enacting measures to protect public services from enforced liberalization and privatization have negative consequences in developing countries when it comes to securing the right to food and affordable access to essential drugs, and strengthen corporate accountability.
Key Concerns that affect universal access: Key Concerns that affect universal access This has been compounded by the limited accountability and transparency of governments and international organizations to their grassroots constituencies in the formulation of international trade rules and national trade policies.
Privatization of basic services and natural resources, one of the major policies of the neoliberal agenda, is being relentlessly promoted and imposed in many countries through trade agreements. The transfer of control of basic services from national governments to private providers especially big national and international corporations is a deliberate erosion of national sovereignty, human rights, and the quality of people’s lives.
It takes away what little access the poor women, men and children have to basic services and resources. It separates those who can pay for services and those who cannot. It leads to deepening poverty, the increased discrimination and social exclusion of women and marginalized communities, and the destruction of the environment.
Privatization of basic services is an abdication of responsibility by all levels of governments, and surrender to national and international corporations and private providers that do not recognize social responsibility nor accountability to people and communities.
Conclusion: Conclusion There is overwhelming evidence that social progress has slowed down since the adoption of structural adjustment and privatization policies. We urge governments to acknowledge this, and undertake further gender impact assessments.
We must remind governments that the attainment of the Millennium Development Goals and Universal access to treatment requires investment in rights and quality public services and is impossible under the neo-liberal paradigm and policies.
What should be done: What should be done We must relentlessly call on Governments to:
Restore and uphold rights of citizens and communities to control and access natural resources and basic services.
Stop corporatization and privatization of basic services such as health, education, welfare, electricity, housing, water and sanitation, and natural resources such as land, water, forests.
Ensure that multilateral trade agreements are consistent with international human rights commitments and treaty obligations.
Not to enter into bilateral or multilateral trade and investment agreements that grant local and foreign investors rights (including the right to sue the state at international tribunals) without any matching obligations.
Further, African governments must be urged not to close down the critical political space for developing and demonstrating alternatives that restore and uphold rights of citizens and communities, including women, to access to and control of natural resources and basic services
OUR WORLD IS NOT FOR SALE!!!! ANOTHER WORLD IS POSSIBLE!!!