Brazilian statement to EB 126 (Jan 2010) on public health, innovation and intellectual property

On Monday, 18 January 2010, Brazil delivered the following statement to the 126th session of the Executive Board of the World Health Organization (WHO) under agenda item 4.3 "public health, innovation and intellectual property". In her intervention, the delegate of Brazil stressed,

Access to medication is a critical issue. The Global Strategy refers to the Doha Declaration on TRIPS and Public Health and states the very fact that the price of medicines is one of the factors that hinder access to treatment. Medicines cannot be treated like other products. Strategies to reduce the price of drugs must be pursued, including proposals to de-link the costs of research and development from the price of drugs.


Geneva, 18 January 2010

Mr. Chairman,
Madam Director-General,
Members of the Board,

Allow me to express Brazil's appreciation to the Director-General for preparing a report on public health, innovation and intellectual property, as well as circulating the executive summary of the report of the Expert Working Group on Research and Development Financing.

Few years ago, Brazil and Kenya were the main sponsors of the process that led to the approval of the Global Strategy on Public Health, Innovation and Intellectual Property. We continue to attach utmost importance to the issue. It is our belief that such an intergovernmental agreement was only possible because of our commitment to tackle one of the main root causes of ill-health in the world: inequities within and among countries.

While some have access to the most expensive hospitals, as well as high-tech medical equipment and state of the art treatment for diseases, millions of children, particularly in poor countries, do not have access to clean water, sanitation, food and life-saving vaccines, hindering their chances to grow up healthy. In a nutshell: unbalanced distribution of wealth has a dramatic impact on public health and affects the poor in a disproportionate manner.

Something has to be done to change this picture. It is not only a legal issue, but a moral and ethical matter as well. As States, we are obliged to protect the fundamental rights of our citizens, including "the enjoyment of the highest attainable standard of health". However, this goal seems to be increasingly remote, particularly in the developing world. There is no more time to be wasted. The international community must join efforts now to support the implementation of identified measures and initiatives in the field of public health. All countries and peoples will benefit from results of this global partnership.

After crafting a document to address the interface between public health, innovation and intellectual property, time has come for WHO - Member States and the Secretariat - to turn words into concrete action. Brazil wants to see the Organization, as one of the main stakeholders, fully engaged in implementing the Global Strategy from a purely public health perspective. Brazil is doing its part. We have contributed with financial resources to support the implementation of the Strategy, we are co-founders of UNITAID and have given our support to the creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Mr Chairman,

The Global Strategy provides the tools for channeling resources to the health sector, ensuring access to affordable medicines, vaccines and other medical products, as well as fostering capacity-building, technical cooperation and transfer of technology. It is a crucial framework under which countries with different levels of development can act with more solidarity.

Access to medication is a critical issue. The Global Strategy refers to the Doha Declaration on TRIPS and Public Health and states the very fact that the price of medicines is one of the factors that hinder access to treatment. Medicines cannot be treated like other products. Strategies to reduce the price of drugs must be pursued, including proposals to de-link the costs of research and development from the price of drugs.

Let us be clear: we are not rewriting or renegotiating the TRIPS Agreement. However, TRIPS must be interpreted and implemented in a manner supportive of our obligation, as States, to protect public health. We must ensure that the flexibilities of the Agreement are fully applied. WHO must provide political and technical support to countries which intend to use them. For Brazil, this Board, as one of the governing bodies of WHO, must give guidance to the Secretariat on the issue of ensuring access to affordable medicines, including generic drugs. Furthermore, patients have the right to be clearly informed about all the options they have regarding medicines and treatment .

Brazil is prepared to share its successful experience in providing free and universal treatment to people living with HIV/AIDS. South-South cooperation programs are one of the priorities of Brazil's foreign relations. Our partnerships give special emphasis to capacity-building in developing countries, as well as support for research and innovation in the health sector, and, crucially, the broadening of access to medicines among poor populations.

Madam Director-General,

Allow us to make some specific comments regarding the two documents before us. In our view, the report (EB126/6) should have been more detailed and address aspects that go beyond research and development and innovation. We would have expected a greater focus on intellectual property and access to medicines and health products. The reason that led to the Global Strategy negotiations was mainly the impact of intellectual property rights on access to health products by developing countries.

We missed a better linkage between the indicators of the plan of action and the activities carried on. The document could have been more comprehensive in terms of reporting all the initiatives implemented by regions, such as those carried out in the Americas last year. For example, the Global Forum on Health Research held in Cuba in October; the course on Public Health and Intellectual Property for the Mercosur countries organized by PAHO in collaboration with the Federal University of Buenos Aires (Argentina) in December; and the first Seminar on Economic Regulation of Medicines and Health Products, held in Brazil in April.

With regard to some of the initiatives mentioned on the report, we would appreciate further information on the following: collaboration between WHO, the World Bank, WIPO and UNCTAD mentioned on paragraph 12; the initiative aimed at examining the barriers on the use of innovative technologies in resource-limited settings, mentioned in paragraph 15; on the terms of technology transfer of the cocktail of monoclonal antibodies mentioned in paragraph 16; and, finally, on the independent ethics committee mentioned on paragraph 21.

Mr Chairman,

Paragraph 29 of the report refers to UNITAID and WHO's contribution to activities linked to the establishment of the patent pool. Based on paragraph 4.3.(a) of the Global Strategy, it would be desirable if the EB could consider to present to discussion by WHA the idea of WHO becoming the host and manager of the patent pool to be created by UNITAID.

With reference to the report of the Expert Group on Research and Development Financing (EB126/6 Add.1), we would like to make the following remarks: If you allow me Madam Chair I would like to mention a few points where we see room for improvement:

On paragraph 6, for instance, there seems to be a contradiction between the work done by CIPIH and the IGWG regarding the impact of intellectual property rights on research and development. Notwithstanding, elements that were not agreed upon during the IGWG process, such as tax exemptions, were reintroduced by the EWG. Moreover, the debate should have addressed developing countries as a whole, and not only poor countries, as clearly requested by the Global Strategy. Moreover, the report doesn't contain references on documents it is based on. It is also not clear what were the criteria used to select proposals that met the needs of developing countries.

Finally, in general terms, the report lays responsibility of establishing new mechanisms of financing R&D on Governments and consumers, without any reference to private sector contribution/participation. We would have appreciated the inclusion of the proposal made by the Brazilian Government related to the remittance of profits of the pharmaceutical industry in this regard.

Mr. Chairman,

The implementation of the Global Strategy is an urgent need. Taking into account that the complete report was only made available this weekend on-line, we would like to propose that the DG convenes intergovernmental consultations before the WHA to examine and discuss the document and the recommendations therein. We would also like to support India's proposal regarding the invitation to the UN Special Rapporteur on the Right to Health to address the WHA.

Thank you very much.