Press release |

Statement by Médecins Sans Frontières (MSF) on TRIPS and affordable medicines

Geneva, 19 June 2001 — MSF is an independent humanitarian medical relief organisation founded in 1971. MSF works in 400 projects in more than 80 countries.

In 1999 MSF started the Campaign for access to essential medicines in response to the ever growing access to medicines gap between the developing and developed world.

To enjoy the benefits of scientific progress is a human right. Yet in the field of public health and particularly with regard to pharmaceuticals access to innovations is unequally distributed in the world. One– third of the world population lacks access to the most basic essential drugs and, in the poorest parts of Africa and Asia this figure rises to one-half. Developing countries where three-quarters of the world population lives account for less than 10% of the global pharmaceutical market. A number of new medicines that are vital for the survival of millions are already too costly for the vast majority of people in poor countries.  

The implementation of the WTO Agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS), scheduled to be completed by 2006 by all member states may be expected to have further serious consequences for the availability at affordable prices of new essential medicines.

Essential medicines are not like any other commodities, yet under the present WTO rules for intellectual property they are regulated very much like any other product. But medicines are not CD-Roms, they are not Barbie dolls, they are not computer games. They are for millions of people around the world a matter of life and death.

Today, there is a dire imbalance between the sanctity of patents and the health of people. Access to essential medicines  should not be a luxury reserved for the wealthy, but should be reinforced as a critical component of the human right to health.

We therefore welcome the TRIPS Council session on affordable medicines that will give the WTO member-states a forum to discuss ways to ensure that intellectual property rights do not form barriers to access to medicines.

Though there is a growing awareness among politicians of the faults of the current patent system, pharmaceutical companies have declared at numerous occasions that patents are not the problem and that strong IP protection is needed to ensure new drugs for the future.

The experience of our doctors in the field shows differently:

  • In South Africa we run an AIDS project in Khayelitsha, a township with a population of 400.000 people. Around 25% of the population is HIV positive and at this moment an estimated 5000 people need treatment with antiretroviral drugs. These drugs are priced at more than 2300 $ for one year adult treatment. People in Khayelitsha cannot afford this. We have started treatment with antiretroviral therapy in the township, but we cannot make use of the offer of Indian generic manufacturers of triple therapy for 300$ or less because of patents held my multinationals.
  • In Kenya people pay 6$ per unit of fluconazole an essential drug to treat cryptococcal meningitis. This disorder affects around one in ten people who have AIDS. In some countries, the prevalence is up to 25%. Without treatment, life expectancy is less than 1 month. Generic versions of fluconazole are available for prices as low as 0.10 $ per unit. Pfizer has just announced a donation but only least developed countries – which excludes Kenya - are eligible.
  • 8 million people get active tuberculosis (TB) each year. 2 million people die of TB each year. Yet it has been over 30 years since the last major new TB drug was developed. While pharmaceutical companies argue that their patents must be sacrosanct for the sake of R&D, private sector R&D neglects the need of the poor. Of the 1393 new chemical entities developed between 1975-1999, only 13 were for the treatment of tropical diseases. The present patent system simply does not provide incentives for R&D into diseases of the poor.

The medicines are in the North and the need in the South. The challenge for those meeting tomorrow is how to bridge this gap. Brazil has made important steps to ensure that its HIV/AIDS population can benefit from pharmaceutical advances. By offering universal access Brazil has cut the death rate from AIDS with 50%, and saved 472 million $ in hospital expenditure. At the core of the successful Brazilian programme is the ability to produce the medicines generically and locally. Since Brazil began producing some AIDS drugs generically, the prices of equivalent products fell by 79%.  

As from 2006 all WTO member states should have changed their national IPR laws to be compliant with the TRIPS Agreement. Policies such as those of Brazil, or prices for antiretroviral drugs as offered by Indian manufacturers will no longer be possible because the new drugs will fall under a more stringent patent system required by the WTO TRIPS.

This leaves us with the question what will happen when sources of affordable new medicine in the developing world have dried up and developing countries may be left at the mercy of Big Pharma.

MSF therefore strongly supports a pro- public health interpretation of the TRIPS Agreement. Our demands to Member-States include:

  • To let developing and least developing countries benefit from a wide scope of interpretation of TRIPS Article 31, and in particular to support  fast track administrative compulsory licensing procedures, especially when they relate to public health.
  • To further support compulsory licensing for export to address public health needs.
  • To consider humanitarian and health exceptions to patent rights under article 30.
  • Ongoing assessment of the effects of the TRIPS Agreement on access to medicines.

MSF is not against patents and not against patent legislation. True innovation deserves to be protected and to be awarded. We advocate a balanced IP regulation that takes into account the specific needs and priorities of developing countries and that follows the principles that are outlined in the TRIPS: patents should benefit the innovator and those who need access to the innovation. Should it not be possible to achieve this balance under the present international agreements it will be necessary in the TRIPS review process to strengthen the public interest further by providing explicit exceptions for key health care technologies. Innovation and technological development is not a goal in itself but should be a means to a better life and a more just and humane society. Human life and dignity should count for more than the interest of the commercial sector.