Several civil society organizations working in Uganda’s health sector have petitioned the US government through its Kampala mission to review its current position in the ongoing negotiations with the so-called least developed countries in Geneva, Switzerland, over access to affordable medicines.
Locked in negotiations with the US are Uganda, Nepal and Bangladesh which are the lead negotiators on behalf of the world’s 34 Least Developed Countries (LDCs).
The LDCs insist an exemption from protection and enforcement of patents and other forms of intellectual property rights on pharmaceutical products should stay for as long as they remain categorized as so.
Despite total support from the European Union and UN agencies [WHO, UNAIDS and UNDP], the US is opposed to the idea and its negotiators have told the TRIPS Council—the World Trade Organization body responsible for protection and enforcement of intellectual property rights—that the LDCs should instead get an extension of only ten years.
Addressing journalists in Kampala on Oct. 27 ahead of the resumption of talks on Oct. 28, representatives of key civil society organisations in Uganda said the US government approach to essential medicines sharply contradicts what it preaches under its PEPFAR programme.
According to the health rights activists, there is a serious risk LDCs will be forced to accept the demands of the US, despite the negative impact this will have on access to essential medicines in the poorest countries in the world and despite the fact that the US is completely alone in its opposition to the LDCs’ position.
The activists say robust generic drug production is the reason today 15 million people in the developing countries are alive, thanks to access to ARV treatment, when just 12 years ago, fewer than 300,000 people had access.
The activists called the US’ position ironic considering that the US government preaches sustainability and lowest price through its PEPFAR bilateral AIDS programme.
“President Obama’s government is on the wrong side of this battle –from a human rights perspective, from a public health perspective, and from the perspective of economic development in poor countries,” said Kenneth Mwehonge of HEPS Uganda—a Kampala-based non-profit.
“While PEPFAR is searching for ways to reduce the cost of life saving treatment for HIV, US trade negotiators are trying to block nations from defending and promoting the human rights of people suffering without access to medicines. This contradiction is deeply troubling.”
Moses Mulumba, the executive director of the Centre for Health, Human Rights and Development (CEHURD) said the US government negotiators’ demand for a time-limited; ten-year extension from LDCs is “nothing.”
“A permanent waiver is the only approach that provides the legal certainty needed by generic suppliers so that LDCs remain a viable market for newer medicines. LDCs need much longer time periods in order to secure investments in long term generic supply and to promote strong local production of life saving medicines,” he said.
Mulumba said the rules of the WTO are clear—as long as a request is ‘duly motivated’ by another member of the WTO, the request shall be granted. The US is simply not playing fair with LDCs, and lives are at stake, he said.
On Sept. 10, the head of trade for the European Commission released a statement on behalf of the EU affirming its unconditional support for the LDC request, calling intellectual property rights protection a ‘non-issue’ whenever access to medicine is at stake.
Although Kenya is no longer an LDC, its president, Uhuru Kenyatta, said on Sept.30 he is also in support of the request for generic manufacturing capacity in the region, in particular from Uganda.
Mulumba noted that although Uganda recognises the fact that some individuals and companies do invest in research and development and eventually the medicines that come out of their efforts, there are clear obligations to these companies [in relation to] intellectual property protection.
Some of these obligations include the fact that critical sectors of the economy are not affected.
“In Uganda, health is such a critical sector and you cannot improve without medicines and in the era of HIV-AIDS, tuberculosis and malaria, we really need to access these medicines.”
“The current discussions seem to focus more on rewarding the inventors and for partners like the US it becomes more sickening if they speak on one hand to provide help and on the other hand, to adopt policies and laws that will be taking away the medicines.”
Mulumba said there is still need for flexibility and options in the legal regime such that big companies come into countries like Uganda to produce these life-saving drugs.
“When you adopt a stance that forbids some companies like Quality Chemicals [Uganda’s only manufacturer of generic ARVs] to stop enjoying copying this intellectual property on medicines, it means that companies in LDCs can only keep producing those drugs that are no longer patented.”
The activists are fearful of a situation where new versions of life-saving drugs that will eventually come will not be produced because a company like Quality Chemicals will not be able to utilize the patents that would have already been issued on the new drugs.
“Our call today is that LDCs should enjoy the policy space indefinitely not time-limited because since the TRIPs agreement was passed in 1994, some progress has been made but it is not sufficient for the LDCs to provide our people with the medicines they need.”