ARVs still scarce years after WTO declaration

Most HIV-positive people in Africa still lack access to antiretroviral (ARV) medication half a decade after a historic declaration that allowed poor nations to copy expensive branded drugs.

Five years ago, the World Trade Organisation (WTO) met in Doha, capital of Qatar, and unanimously agreed to ensure that Intellectual Property Rights (IPRs), or copyright, would no longer prevent developing countries from providing anti-AIDS medication in their health systems.

Although the decision allowed poorer countries greater flexibility in being able to tackle pandemics such as HIV/AIDS with first-line drug regimens, according to international medical relief group Médecins Sans Frontières (MSF), second-line medications were still patented and much too costly.

"Many countries are making use of the Doha Declaration to import cheaper generic versions of patented first-line drugs from countries such as India.

But we might end up back where we started, as people develop resistance to their initial therapies and need more expensive patented second-line regimens," Ellen 't Hoen, director of policy advocacy for MSF's medicines campaign, told IRIN/PlusNews.

Essential second-line ARVs, such as Kaletra, were usually 50 times more expensive than first-line drugs, and middle-income countries were paying around US$5,000 per patient per year for it.

'T Hoen charged that a monopoly still reigned over as much as 74 percent of second-line anti-AIDS medicines, and stressed that there was an urgent need to "reinvigorate the spirit that produced the Doha Declaration".

During the late 1990s, developing countries and civil-society organisations (CSOs) expressed concern over the impact of IPRs, which were introduced in the Trade-Related Aspects of Intellectual Property Rights Agreement (TRIPS), on access to medicines.

The CSOs claimed that copyright created monopolies on patented medicines, and public outrage led to the eventual enactment of the 'Doha Declaration on the TRIPS Agreement and Public Health' in November 2001.

International humanitarian agency Oxfam is convinced that little has changed since then, with many developed countries and pharmaceutical companies not honouring the Doha Declaration's intent.

A senior Oxfam official said patented medicines continued to be priced out of reach for the world's poor, and trade rules were still a major barrier to affordable generic versions of patented drugs.

"Rich countries have broken the spirit of the Doha Declaration ... global health statistics are grim but the US continues to negotiate trade deals, with even stricter rules that limit how a country can use public health safeguards," said Oxfam's 'Make Trade Fair' campaign chief, Celine Charveriat, in a statement.

Of particular concern to Charveriat were the far-reaching consequences of side-stepping trade rules for countries struggling to maintain good public health.

Warning against the dangers of "coming full circle" in the struggle to make essential medicines more affordable to poorer nations, Oxfam and MSF urged wealthy countries to keep their promises and stop undermining the Doha Declaration.

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