1. Human Rights and Access to Medicines Sean Flynn AU, Washington College of Law Abuja, Nigeria, November 2008

2. State of Affairs 2 billion lack access to essential medicines Improving access to existing medicines would save 4 million in Africa and South- East Asia 15% consume 90 % of medicines 90% of R&D targeted at 10% of population

3. UP-AU Project Access to Medicines and Human Rights Course in May 2008, 2009 Survey research Joint clinical project 1. Resolution establishing framework (2008) 2. Country specific submissions (2009)

4. Problems from surveys National supply systems to not reach all Stock outs People have to travel long distances Prices are high and inequitable New medicines are not available or priced very high Lack of meds for neglected diseases

5. Globalization of IP WTO TRIPS Agreement 1994 Monopolies on newest medicines Drives R&D to richest target populations Inequality drives prices up in poor countries

6. Norway ARV Demand

7. Profit Maximizing Norway

8. South Africa

9. Profit Maximizing SA

10. Market v. Human Rights Logic Market logic leads to market segmentation and inequity India is a market of “40 million” Human Rights logic shifts equity to the core Demands government action to redress market failure

11. UN CESCR “Medical care in the event of sickness, as well as the prevention, treatment and control of diseases, are central features of the right to the highest attainable standard of health. These features depend upon access to medicines. Thus, access to medicines forms an indispensable part of the right to the highest attainable standard of health.”

12. The Right to Access Needed Medicines Availability Existing and new Accessibility Physical Economic Information Acceptability Ethics and culture Quality

13. Duties: Respect Not denying or limiting equal access implementing all flexibilities in TRIPS Not enter “TRIPS Plus” agreements

14. Monopoly vs. Competition: AIDS drugs

15. Protect evidence-based and scientifically appropriate standards prevent unreasonably high prices truthful and complete information; regulate conflicts of interest Pro-health interpretations of competition, IP, consumer protection

16. Fulfill Minimum core - essential medicines list for ALL National medicine strategy Participation Patent and registration status readily available Expediting regulatory review Need-based R&D incentives

17. Jurisprudence Africa – University of Pretoria Regional systems – American University