Geneva Health Forum Archive

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Health Impacts of Trade Agreements: A Critical Reflection

Author(s): Sisule F. Musungu1
Affiliation(s): 1Acting Coordinator, Innovation, Access to Knowledge and Intellectual Property Programme (IAIPP), South Centre, Geneva, Switzerland
Key issues: Trade agreements in a globalized world have health impacts for three main reasons, namely: trade or trade-related agreements such as the World Trade Organization’s (WTO) Agreement on Trade-Related Aspects of Intellectual Property (TRIPS) and regional and bilateral free trade agreements are currently seen as the main framework for addressing the questions around providing incentives and financing for innovation in the health sector, including equitably sharing the burden within and among countries; trade agreements such as the General Agreement on Trade in Services (GATS) regulate the action of states with respect to the provision of health services; and trade agreements including the General Agreement on Tariffs and Trade (GATT) regulate trade in goods including tariffs, which have implications for trade in pharmaceuticals and other health care products and equipment. The current trade framework has, however, been found wanting because, as confirmed by the World Health Organization’s Commission on Intellectual Property Rights, Innovation and Public Health (CIPIH), it has not delivered. The result is that despite the tremendous advances in health technologies the world now faces a situation where: - There are no appropriate funding and incentive mechanisms for the creation of new medicines and other products for the diseases that disproportionately affect developing countries resulting in the so-called 10/90 gap; and - Even in cases where there are solutions to the healthcare problems of the populations, especially the poor, predominantly in the South but also in the North, there is a tragic lack of access to these solutions because there are no global mechanisms that seek to address the twin issues of innovation funding and access. The key issue is therefore how the trade agreements enable or hinder efforts to address the gaps in funding and incentives for diseases and healthcare problems that disproportionately affect the developing world; and as those gaps are narrowed, how these agreements facilitate availability and affordability of these healthcare solutions across borders to the broadest majority of the human population. PPPs have correctly been identified as one mechanism that is being used to address part of the problem, but clearly PPPs are not a silver bullet. The challenge in thinking about global access to health is to recognize, support and facilitate the contributions of PPPs and other similar mechanisms, while at the same time addressing the broader issues. In a nutshell, the challenge is developing and implementing a trade framework that ensures appropriate funding and incentives for the development of healthcare solutions, especially for the poor and marginalized, and that those healthcare solutions are available and affordable in the short and long term. This presentation will focus on the trade-related issues and challenges that the health community, and the global community more generally, needs to address and confront in order to establish such a framework with the aim of providing recommendations on the way forward, particularly in the follow-up to the World Health Assembly (WHA) Resolution on Public Health, Innovation, Essential Health Research and Intellectual Property: Towards a Global Strategy and Plan of Action (WHA59.24; 27 May 2006).
Summary (max 100 words): Trade agreements in a globalized world have health impacts for three main reasons, namely: trade or trade-related agreements such as the World Trade Organization’s (WTO) Agreement on Trade-Related Aspects of Intellectual Property (TRIPS) and regional and bilateral free trade agreements are currently seen as the main framework for addressing the questions around providing incentives and financing for innovation in the health sector, including equitably sharing theburden within and among countries; trade agreements such as the General Agreement on Trade in Services (GATS) regulate the action of states with respect to the provision of health services; and trade agreements including the General Agreement on Tariffs and Trade (GATT) regulate trade in goods including tariffs, which have implications for trade in pharmaceuticals and other health care products and equipment. The current trade framework has, however, been found wanting because, as confirmed by the World Health Organization’s Commission on Intellectual Property Rights, Innovation and Public Health (CIPIH), it has not delivered. The result is that despite the tremendous advances in health technologies the world now faces a situation where: - There are no appropriate funding and incentive mechanisms for the creation of new medicines and other products for the diseases that disproportionately affect developing countries resulting in the so-called 10/90 gap; and - Even in cases where there are solutions to the healthcare problems of the populations, especially the poor, predominantly in the South but also in the North, there is a tragic lack of access to these solutions because there are no global mechanisms that seek to address the twin issues of innovation funding and access. The key issue is therefore how the trade agreements enable or hinder efforts to address the gaps in funding and incentives for diseases and healthcare problems that disproportionately affect the developing world; and as those gaps are narrowed, how these agreements facilitate availability and affordability of these healthcare solutions across borders to the broadest majority of the human population. PPPs have correctly been identified as one mechanism that is being used to address part of the problem, but clearly PPPs are not a silver bullet. The challenge in thinking about global access to health is to recognize, support and facilitate the contributions of PPPs and other similar mechanisms, while at the same time addressing the broader issues. In a nutshell, the challenge is developing and implementing a trade framework that ensures appropriate funding and incentives for the development of healthcare solutions, especially for the poor and marginalized, and that those healthcare solutions are available and affordable in the short and long term. This presentation will focus on the trade-related issues and challenges that the health community, and the global community more generally, needs to address and confront in order to establish such a framework with the aim of providing recommendations on the way forward, particularly in the follow-up to the World Health Assembly (WHA) Resolution on Public Health, Innovation, Essential Health Research and Intellectual Property: Towards a Global Strategy and Plan of Action (WHA59.24; 27 May 2006).

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