1. WTO and medicines: from Doha to Cancún
Germán Velásquez
Essential Drugs and Medicines Policy
World Health Organization
Geneva, March 2004

2. Failure of the WTO Ministerial Conference, Cancún, Sept. 2003…
“(…) instead of global rules negotiated by all, in the interest of all, and adhered to by all, there is too much closed-door decision-making, too much protection of special interests (…) and the victims can be counted in the billions.” (1)
(1) Message of the UN Secretary-General, Kofi Annan to WTO Ministerial Conference in Cancún, 10 September 2003

3. TRIPS/Public Health tensions
HIV epidemic – pricing of ARVs
Challege to South Africa Law (compulsory licences and parallel imports)
USA/Brazil on compulsory licences
Bilateral trade/IPR agreements

4. The TRIPS Agreement and medicines
Patent protection for pharmaceutical products
Reinforcement of patent process
20 year minimum duration
Transitional periods with exclusive marketing rights
Enforcement

5. Safeguards in TRIPS for public health
Parallel imports
Exceptions to exclusive rights ("Bolar")
Compulsory lincenses
Government non-commercial use
Extension of the transitional periods

6. WTO Doha/Health Negotiations
On 14 November 2001, WTO Members isued the historic Doha Declaration on the TRIPS Agreement and Public Health

7. The Doha Declaration Calls for:
Interpretation and implementation of the TRIPS Agreement to support WTO Members' rights to protect public health, particularly access to medicines.

8. Paragraph 6 of the Doha Declaration
The Council for TRIPS should have:
Found a solution to the problem of WTO Members with insufficient or no pharmaceutical manufacturing capacity;
Reported to the General Council before the end of 2002.

9. Pending Problem of Paragraph 6
Permission for third parties to make, sell and export patented medicines and othe health technologies to address public health needs

10. The Council for TRIPS:
Held five formal meetings and several informal discussions (post-Doha to end 2002);
Failed to reach a consensus.

11. The Paragraph 6 Decision
WHO is content with the consensus reached
Is the Decision a solution?
Its implementation will tell us …
WHO will follow and support countries during its implementation.

12. 30 August 2003 Decision on Paragraph 6
A good decision?
A solution?

13. 30 August 2003 Decision on Paragraph 6
In good faith to protect public health and … not for industrial or commerical objectives
Need to establish the lack of manufacturing capacity
Notification to Council for TRIPS (name, quantity, period) and website
2 CL (importing and exporting country)
Compulsory lincense only to export specified amount
Specific labelling or marking measures to prevent re-export
Compensation

14. Next steps...
We must monitor the implementation of the decision to ensure:
stability to guarantee its longevity;
Transparency
Simple and speedy legal procedures;
Equal opportunities for countries needing medicines;
Facilitation of multiplicity of potential suppliers;
Broad coverage in terms of health problems and range of medicines

15. 2 years of negotiations...
Many new actors: NGOs, media and communications, other agencies and UN agencies;
The legal trade debate has become an ethical and human rights issue;
The response is still insufficient and extremely slow ...

16. The future of the debate must pass through ...
The ethical aspects of the problem
The ED as a public good
Access to ED as a human right
Alternatives to R & D based on the real health problems...