[afro-nets] WHO Board adopts decision on trade and health

[Claudio Schuftan <claudio@hcmc.netnam.vn>]

WHO Board adopts decision on trade and health
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TWN Info Service on Health Issues (Feb 06/1)
From: Third World Network
http://www.twnside.org.sg

As countries rush to conclude bilateral and regional free trade
agreements, there are growing concerns that these trade agree-
ments could adversely affect the health policies of the develop-
ing countries.

Against this backdrop, the WHO Executive Board has recommended
that the next World Health assembly in May adopt a resolution on
trade and health. Member States are asked to include health min-
istries in negotiations on trade agreements and the WHO Secre-
tariat has been tasked to assist in this process.

In another development, Brazil reported that the WHO-UNAIDS "3X5
initiative" to make antiretroviral treatment to 3 million AIDS
patients in the low and middle income countries by the end of
2005 had failed to achieve its target.

The article below highlights the main points of the resolution.
It is reproduced with permission from the South-North Develop-
ment Monitor (SUNS) # 5953, 27 January 2006.

--
WHO Board adopts decision on trade and health

By Martin Khor and Sangeeta Shashikant

The WHO Executive Board has adopted a decision to recommend that
the next World Health Assembly adopt a resolution on interna-
tional trade and health which urges member states and the WHO
secretariat to take action to make national trade and health
policies more coherent, especially in light of the health impli-
cations of international trade agreements.

The resolution gives a broad mandate to the WHO secretariat to
assist countries to frame coherent trade and health policies and
to understand the implications and challenges that trade agree-
ments may have for health. The WHO is also asked to support pol-
icy coherence between trade and health at regional and global
levels.

The decision was taken on the evening of Wednesday (25 January),
without discussion. It is understood that the final document
(EB117.R5) had already been negotiated by some member states
prior to its being introduced and adopted on Wednesday.

A draft of the resolution had been first proposed by a group of
14 countries, coordinated by Thailand, at the last Executive
Board meeting on 26-27 May last year. The other countries were
Benin, Bhutan, Bolivia, Brazil, Canada, China, Iraq, Jamaica,
Kenya, Nepal, Sudan, Tonga and Vietnam.

The move reflected growing concerns of the developing countries
over the adverse effects of bilateral and regional free trade
agreements on health policies.

In particular, many national health authorities are increasingly
worried that intellectual property provisions in FTAs that have
been concluded or that are being negotiated would affect access
to medicines, as they extend patent protection for medicines,
restrict the grounds for compulsory licenses and establish "data
exclusivity" (protection of clinical trial data), all of which
make it difficult for generic medicines to be supplied.

Some countries have also been concerned about the implications
of the opening up of health services under the WTO services
agreement as well as bilateral FTAs.

A lengthy and sometimes heated debate had taken place at last
May's Board meeting, with proposals made by some developed coun-
tries to water down the original proposal of the developing
countries. The Board decided on 27 May to defer the decision to
its next meeting.

The WHO Secretariat prepared a report (EB117/10 dated 1 December
2005) containing the original resolution, together with alterna-
tive language in some parts reflecting some of the amendments
proposed at the May 2005 meeting.

At Wednesday's meeting, a new draft dated 25 January was
adopted. It contains basically the same resolution as the origi-
nal draft submitted by Thailand.

In the adopted decision, the Executive Board recommended to the
59th World Health Assembly to adopt the resolution. In the reso-
lution, the WHA recognizes the demand for information about the
possible implications of international trade and trade agree-
ments for health and health policy at national, regional and
global levels.

It is also "mindful of the need for all relevant ministries, in-
cluding those of health, trade, commerce, finance and foreign
affairs, to work together constructively in order to ensure that
the interests of trade and health are appropriately balanced and
coordinated."

Member States are urged:

(1) to promote dialogue at national level to consider the inter-
play between international trade and health;

(2) to adopt, where necessary, policies, laws and regulations
that address issues identified in that dialogue and take advan-
tage of the potential opportunities, and address the potential
challenges, that trade and trade agreements may have for health;

(3) to apply, or establish, where necessary, coordination mecha-
nisms involving ministries of finance, health, and trade, and
other relevant institutions, to address public health related
aspects of international trade;

(4) to create constructive and interactive relationships across
the public and private sectors for the purpose of generating co-
herence in their trade and health policies;

(5) to continue to develop capacity at national level to track
and analyse the potential opportunities and challenges of trade
and trade agreements for health-sector performance and health
outcomes.

In the resolution, the WHA also requests the WHO Director-
General:

(1) to provide support to Member States, at their request and in
collaboration with the competent international organizations, in
their efforts to frame coherent policies to address the rela-
tionship between trade and health;

(2) to respond to Member States' requests for support of their
efforts to build the capacity to understand the implications of
international trade and trade agreements for health and to ad-
dress relevant issues through policies and legislation that take
advantage of the potential opportunities, and address the poten-
tial challenges, that trade and trade agreements may have for
health;

(3) to continue collaborating with the competent international
organizations in order to support policy coherence between trade
and health sectors at regional and global levels, including gen-
erating and sharing evidence on the relationship between trade
and health;

(4) to report through the Executive Board to the Sixty-first
World Health Assembly on progress made in implementing this
resolution.

The resolution will be on the agenda of the World Health Assem-
bly which meets in May. Amendments can still be made to it fol-
lowing discussion of the issue.

A WHO secretariat report on international trade and health, in-
troduced at the May 2005 Board meeting, had discussed the impli-
cations of trade and trade agreements on health. It mentioned
four WTO agreements that may affect public health that are of
particular importance to WHO's work: the General Agreement on
Trade in Services (GATS), and the agreements on Application of
Sanitary and Phytosanitary Measures (SPS), on Technical Barriers
to Trade (TBT), and on


Trade-Related Aspects of Intellectual Property Rights (TRIPS).

Increasing trade in health services challenges the capability of
ministries of health to assess accurately and respond rapidly to
the risks and opportunities for population health, said the re-
port. There may also be the potential of increasing openness in
the health sector under GATS, in its four "modes of supply".

Countries also face challenges in ensuring compliance with the
disciplines of SPS and TBT. This is particularly the case in the
areas of food safety, diagnostic devices and medicines quality,
safety and efficacy, respectively, in which the trade agreement
creates obligations.

The WHO report said that ministries of health "need the capabil-
ity, in terms of expertise and access, to provide their col-
leagues in the trade and finance ministries with the best evi-
dence on the potential impact of trade and trade agreements on
health outcomes, so that ongoing multilateral, regional, or bi-
lateral trade negotiations may be properly informed."



Another highlight of this week's Board meeting was a plea by the
Brazilian delegation for the WHO and the Executive Board to
build solidarity on the need to achieve universal access to
medicines, and to address the problem of intellectual property
in this regard.

Brazil made this call during the discussion on HIV/AIDS on Tues-
day (24 January). It said the "3 by 5 initiative" had failed to
achieve its target, and it was important to analyse why.

Before the Board was the WHO report on "HIV/AIDS Universal ac-
cess to prevention, care and treatment" (EB 1117/6), which
stated that there were almost 5 million new infections and more
than three million deaths from the disease in 2005.

The report recalled the WHO-UNAIDS "3 by 5" initiative aimed at
expanding access to antiretroviral treatment in low and middle
income countries to 3 million AIDS patients by the end of 2005.
Between June 2004 and June 2005 the number of people receiving
treatment rose from 440 000 to about one million, and the report
said the target has been "catalytic at the global level".

However, during the discussion, Brazil said the targets of the
"3 by 5 initiative" had not been achieved. It was important to
recognise this failure instead of painting a rosy picture of the
situation.

It was necessary to have an in-depth analysis of why the "3 by 5
initiative" target was not achieved, said Brazil. Either the
initiative was overly ambitious, or there was a lack of avail-
ability of drugs or finances, or human resource problems.

If the lessons of failure of the "3 by 5 initiative" are not
learned, then there will be failure in providing "universal ac-
cess", said Brazil.

It added that the Brazilian Ministry of Health spent annually
$400 million for ARV drugs, with 67% of the sum spent on only 3
drugs and it is difficult to get major pharmaceutical companies
to reduce prices.

Brazil said the WHO and its Members had a choice of either being
in favour of companies or the people. This is an organization
that has to resolve the problems of people, and thus a strong
position has to be taken on intellectual property rights.

It added that AIDS can be contained, but for that to happen a
firm political decision was needed and there had to be a hard
look at intellectual property and its implication on prices.

Brazil said it could have produced the drugs needed at lower
cost, but there were problems posed by intellectual property. It
also referred to the situation in Africa where the per capita
income is $200-300 per year, but the costs of treatment is very
expensive.

It suggested that the Executive Board has a role to play and
that there needs to be solidarity on this issue. As part of the
solution, the problem of intellectual property had to be ad-
dressed, and a political decision has to be taken to give prior-
ity to research into the health problems of the poor.