Ambassador Shameem Ahsan (Bangladesh) remarks on UN HLP - Opportunities to Advance Health Technology and Access

On 1 March 2017, Bangladesh, Brazil, India and South Africa, the Secretariat of the United Nations Secretary-General's High-Level Panel on Access to Medicines and the South Centre convened a side event at the World Trade Organization (WTO) on the United Nations Secretary-General's High Level Panel on Access to Medicines: Opportunities to Advance Health Technology and Access. This event took place on the margins of the WTO TRIPS Council.

Shameem Ahsan, Permanent Representative, Permanent Mission of the People's Republic of Bangladesh to the United Nations Office and other international organizations in Geneva, intervened on the subject of the relevance of the UN Secretary-General's High-Level Panel's Report for Least Developed WTO Members. The full text of Ambassador Ahsan's remarks are reproduced below.

Dear Dr. Suerie Moon,
Excellency Madam Ruth Dreifuss,
Excellency Mr. Celso Amorim,
Excellency Mr. Evandro Didonet
and Professor Carlos Correa.

Good afternoon.

This is a great honour to be included in this august panel to discuss such an important topic which concerns well-being of every living human at varying degrees. It is true that we are now witnessing the progress of the fourth industrial revolution. Science and technology had never facilitated our life better than today. However, we think that the humanity today is at a crossroads. On one hand the scientific knowledge, technological developments, infrastructure and productive capabilities are tremendously benefitting few of us while majority are still out of the benefits originating from them and many a times these advancements are creating more divide than gains for everyone due to our own gaps and failures. Against this backdrop, while we consider that right to life is the most fundamental right, then the next most immediate right, i.e., right to health cannot be far behind. With this goal in view, we are fortunate to have this report of the High Level Panel, to ensure and establish our right to health and subsequently, the right to life and achievement of SDG 3.

Though access to health and medicine are equally important for all the countries, either developed, developing or LDC, but when it comes to ensuring physical access, the LDCs are the hardest hit. The report put forward many important general recommendations applicable for all the countries irrespective of level of development. It firstly mentioned the lack of development of medicines for Neglected Tropical Diseases from which an estimated 1.7 billion peoples are suffering. To overcome this, the report observed that coordinated and collaborative efforts of public-private partnerships and product development partnerships (PDPs) had been key to bringing together the resources and strengths of the private, philanthropic and public sectors to innovate and deliver several important health technologies. Here, both private and public sectors in the LDCs are extremely weak to undertake any such collaboration and investment. To implement this recommendation, LDCs will need active support and transfer of technology from the developed countries and their private enterprises.

LDCs will whole-heartedly support the recommendation to make full use of the TRIPS flexibilities. Since LDCs have been granted a generously long transition period under the TRIPS Agreement in terms of pharmaceutical products, I would urge all LDCs to adopt and implement legislation that facilitates the quick, fair and predictable issuance of compulsory licenses as per requirement. We are aware that many countries still don’t have enabling legislation to take advantage of the provisions and LDC government s should enact supporting rules and regulations as early as possible. To complement this, the Paragraph 6 system is now officially a part of TRIPS Agreement. This should enable swift and expedient export of biomedical products from countries with production capacity to LDCs without production capacity. However, this will require genuine goodwill from the producers of medicine and the governments and the administrative authorities to facilitate production and transport unencumbered by any contrary supply-side or administrative action.

Balancing and rationalizing priorities in any free trade agreements is another recommendation that LDCs need to pay particular attention to as we see appearance of more and more FTAs and RTAs every day. In case of an LDC being member of any FTA or RTA, Governments and the private sectors of other members of the same FTA/RTA must refrain from explicit or implicit threats, tactics or strategies that undermine the use of TRIPS flexibilities. In that case, we also agree that such instances of undue political and economic pressure should / could be reported to the WTO Secretariat during the Trade Policy Review of those WTO Members. We also side with the recommendation that the LDC Governments should undertake public health impact assessments before they enter into such agreements.

The Report recommends that public funders of research must require that knowledge generated from such research be made freely and widely available in peer-reviewed literature. Universities and research institutions that receive public funding should adopt policies that promote biomedical research and knowledge that benefits the public health objectives over financial returns in patenting and licensing practices, for example non-exclusive licensing, participation in public sector pools, and donation of intellectual property. However, public funding in LDCs are not very common and I would proposed that any patent originating from any LDC public fund, should not be disclosed to public domain and LDCs or their concerned entities should enjoy natural commercial benefit and data exclusivity which is associated with usual patent rights

As mentioned in the report, LDCs also would like to see a binding R&D convention that delinks the costs of R&D from the end prices and we are happy to participate in any negotiation to establish a Working Group for preparing a Code of Principles for Biomedical R&D. However, as LDCs acutely lack in resources, it may not be possible for them to arrange, incentivize and reward public health R&D. So an alternative source or model of funding is required. In this connection, if the developed countries sincerely carry out their obligations under TRIPS articles 66.2 and 67, this gap of fund and technology would be greatly reduced.

LDCs also want to see implementation of the recommendation of the report that all the Governments, both from the developed, developing and least developed countries, would deal the issue of access to medicine in the light of human rights principles. However, we must remember that for the LDCs, beleaguered by multi-faceted political, economic and environmental problems, ensuring any kind of rights to its people is always an uphill task and we would request everybody to be patient if they appear to be slow to deliver on this particular issue. To avoid gaps and duplication, LDCs also support the Panel for an independent review body tasked with assessing progress on health technology innovation and access and also an inter-agency taskforce to increase coherence between multilateral organizations working on the same issue of health technology innovation and access. We hope that the proposed UN General Assembly Special Session on health technology innovation and access could be convened by 2018.

At this stage, I must say the there are various factors which may impede access to required medicine in the LDCs but the single most important factor is the cost and especially the cost of the patented medicines. LDCs would really like to make all manufacturers and distributors to disclose the cost of R&D, production marketing and distribution of their products, with each category separated, as suggested in the report. Because marketing and distribution in an LDC will be of a fraction of the cost that is incurred in a developed country and this will in turn reduce the price of the medicine substantially in the LDCs. Data for clinical trial should also be made public for the same reason. The WHO should establish and maintain a database of prices of patented, generic and biosimilar medicines in countries where they are registered and similarly, with the help of WIPO, all Governments should establish and maintain publicly accessible databases with patent information status on medicines and vaccines including standard names for biological products, international non-proprietary names, dates of patent grant and expiry.

LDCs now enjoy longer transition period under the TRIPS Agreement for the pharmaceutical products and we now also have the TRIPS Agreement amendment of the Paragraph 6 proposal. However, availability of a legal provision does not necessarily guarantee implementation and assure any benefit if the very capacity to utilize the opportunity is missing. The limits we confront are actually limits to our thought. The report of the High-Level Panel is a very significant and bold step which has been due for quite long time. The report calls for change of not only the current IP-production-marketing regime, it also calls for change of our ideas and approaches. Some more useful observations and recommendations could not be included in the report due to lack of consensus. However, LDCs would expect that we will use occasions at different fora to raise and discuss the report so that we may find out a way to implement the worthwhile recommendations for the benefit of all.