DEVELOPING COUNTRIES AND IP: ACCESS TO HEALTH CARE EDUCATION MATERIALS Karen A. LeCuyer, Ph.D. University of Connecticut School of Law 30 May 2007

Outline TRIPS, IP, and the WTO Doha Declaration: IP and Public Health Access to Health Care Information: HIV/AIDS Health care worker education Public education Strategies for Improving Access to Health Care Information in the Developing World

TRIPS Agreement: 1994 Sets out minimum standards for IP Patents, copyright, trademark, geographical indications, industrial designs, etc. Enforcement framework within international trade, enforced by the WTO Linkage between IP and international trade all nations participating in the WTO are required to adhere to IP standards in order to participate in non- IP trade issues

WTO and IP WTOs mission is to lower trade barriers and provide a platform for trade negotiations between its member countries Developed and developing nations benefit from WTO membership Administration of trade agreements Forum for negotiations and settling disputes

TRIPS and Developing Countries TRIPS has been criticized for not considering the needs of developing countries and forcing them to adhere to global IP standards Increased IP standards can negatively impact access to essential medicines in developing countries

TRIPS, Fair Use and Public Access Protectionist IP policies are a problem for developing nations as net importers of IP Doha Declaration of 2001 addresses circumvention of patent rights for access to essential medicines However, health care education and technology transfer are also critical for developing countries Copyright issues have not been explicitly addressed

Doha Declaration: IP and Public Health

The Doha Declaration Developing and less developed countries given additional time to comply with TRIPS Doha Declaration on the TRIPS Agreement and Public Health affirmed the rights of TRIPS members to protect public health and especially to promote access to medicines

Doha Declaration and TRIPS TRIPS Agreement does not and should not prevent members from taking measures to protect public health, Paragraph 5 Use, to the full, the provisions in the TRIPS Agreement, which provide flexibility for this purpose, Id. Member nations determine what is a national emergency- AIDS/HIV

Doha Declaration and AIDS Improved availability of HIV/AIDS medicines, particularly in Africa Circumvent patents with a compulsory license Problems Less developed countries lack ability/infrastructure to produce drugs Pharmaceutical companies have opposed licenses Access to drugs is not the only problem

Extension of Doha Principles Beyond Patents Language of the Doha Declaration suggests that the principles apply to IP, not patents Heath care as essential for sustained development Both health care provider and patient education are critical areas for extension of the Doha principles

WHO, IP and Public Health WHA Resolution on Intellectual Property and Public Health (2003) reaffirm the importance of public health Commission on Intellectual Property, Innovation, and Public Health (CIPIH), 2004 investment in the human resources and the knowledge base, especially the development of tertiary education

Access to Health Care Information Educational materials are a critical means for the international flow of ideas, information and knowledge Extension of Doha Principles to fair use in copyright for materials related to health care and technology transfer Strong IP protection in the developed world while assisting the developing world

Access to Health Care Information: HIV/AIDS Health care worker education Public education

Developing Countries and HIV/AIDS 38.6 million people with HIV in million lost their lives to AIDS in 2005 Sub-Saharan African countries such as Botswana and Lesotho have HIV infection rates approaching 25% of the population At least in Sub-Saharan African, many drug companies have reduced prices

Education of Health Care Workers Training in antiretroviral therapy and clinical strategies for patient management Need for continuing education, particularly in remote areas Digital media and Internet-based tools and information Providing materials in a culturally sensitive way

Public Health Care Education Lack of education is a risk factor for HIV infection Education programs developed in the United States have been shown to be effective in developing countries Use of simpler text and pictograms Digital media and Internet-based tools and information

Strategies for Improving Access Initiatives for improving access to educational materials and technology Creative Commons Open source A2K Support of nongovernmental agencies Foundations formed by pharmaceutical companies Bill & Melinda Gates Foundation Clinton Foundation

Creative Commons Authors retain some rights and dedicate others to the public License menu: Attribution License, Noncommercial License, Developing Nations License Science Commons Free access to scientific journals over the Internet

Open Source Movement Open source software: open source code Reverse engineer and develop Moving from open source to open access Positive: eliminate costs, creation of additive works Negative: removes economic incentives, open source materials subject to vandalism and/or misinformation

A2K Objective: protect and enhance [expand] access to knowledge, and to facilitate the transfer of technology to developing countries Unlike the Creative Commons, A2K IP standards are mandatory and not defined by the author

A2K and Copyright Make original works more affordably available, particularly for educational purposes Limit copyright protections to works that meet a creativity threshold

A2K and TRIPS TRIPS establishes minimum IP protections A2K establishes maximum IP protections A2K may foster the ability of developing nations to produce knowledge by making information more accessible

Nongovernmental Organizations Provide medicines as well as health care worker and public education NGOs are essential to identifying and reproducing best practices to work with HIV/AIDS

Pharmaceutical Companies SECURE THE FUTURE, Bristol-Myers Squibb Funds training for health care professionals as well as public health care education in Sub-Saharan Africa Botswana/Gates/Merck partnership Health care worker training, prevention initiative Positive Action Program, GlaxoSmithKline Education program for men in Kenya Corporate HIV/AIDS site- information for health care professionals

Bill & Melinda Gates Foundation Global Development and Global Health Provides no-cost access to computers, the Internet, and technology training in public libraries and reading rooms in Chile, Mexico, Botswana, Latvia, and Lithuania Fund public health and education strategies aimed at reducing the transmission of HIV, and the stigma associated with HIV/AIDS

The Clinton Foundation Clinton Foundation HIV/AIDS Initiative (CHAI) affordable treatment combined with care and prevention programs Use business-based procedures to integrate care, treatment and prevention Care Consortium of research and treatment institutions to allow real-time sharing of data and information

Summary Doha principles can be expanded beyond patents IP protection in the developed world need not be sacrificed to aid developing countries HIV/AIDS is a global health crisis that is at the forefront of efforts to increase access to knowledge worldwide Businesses can help by improving access to information and support of NGOs