Health equity in economic and trade policies

In the United States, the complex process of getting health care technologies into practice takes place in a competitive health system that is driven by technological innovation. Federal, state and local governments’ roles in the diffusion process are limited. In low-income countries, where competitive markets are not as prominent, diffusing medical innovations requires an alternative understanding of how new technologies are adopted. This paper describes how, in low-income countries, the lack of functioning markets serves as a barrier to the transfer of necessary health technologies and why governments must act as stewards in promoting technologies there.

The Senate Foreign Relations Committee voted to reauthorize the President’s Emergency Plan for AIDS Relief at a cost of $50 billion over the next five years. No amendments were considered presently for the senate bill introduced by Sen. Biden of Delaware. Of the $50 billion, $4 billion would be allocated to tuberculosis programs and another $5 billion for malaria programs.

In response to the Medicine Patent Pool Foundation’s (MPPF) first voluntary license agreement with pharmaceutical giant, Gilead, the International Treatment Preparedness Coalition (ITPC) and the Initiative for Medicines, Access and Knowledge – both aiming to secure universal access to medicines – called for a meeting with the MPPF, arguing that the agreement represented a setback for universal access. On 2 October 2011, both organisations and members from civil society from the global south met with MPPF and UNITAID in Geneva, and made three demands. First, the agreement with Gilead should be substantially revised or terminated, given Gilead’s bad faith and the controversial terms of the agreement. Second, MPPF should institute an immediate moratorium on negotiations of any new licence agreements with multinational drug companies until such time as standard terms and conditions or a model agreement is agreed to. Third, the current structure of the MPPF needs to be revised, including its governance and administration, goals and mission, and comprehensive reforms must be implemented that are designed to enhance its transparency, accountability and adherence to core principles of health equity.

From the seven cases discussed in this paper, the authors observe that the patent systems in Europe and the United States are being used to promote the misappropriation of traditional knowledge and biological resources from the South. For example, the authors report that a German-based agriculture and healthcare giant corporate has staked a claim to the use of any extract from plants of the Vernonia genus in Madagascar for ‘improving the skin status’. The patent application appears to violate international law, as it duplicates traditional knowledge held by indigenous communities in Madagascar. Another firm is reported to have obtained a patent from the United States Patent Office that allows it to lay claim to extracts from the seeds of the Aframomum angustifolium, a native African plant, which it claims prevents ageing skin, and is the active ingredient in its highly profitable and costly beauty products. Some of the patent claimants say they intend to seek patents in South Africa and other African countries. The authors report that the study found little and, in some cases, no evidence of the existence of prior informed consent agreements for using the resources that form the subject matter of the patents, nor mutually agreed benefit sharing arrangements, as required by the United Nations Convention on Biological Diversity.