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Oxfam International

Five years on, most poor people are yet to benefit from the Doha Declaration

Poor people in developing countries are still being denied cheaper life-saving medicines five years after world leaders signed a formal trade declaration to put health before profits.

In a report published today marking the fifth anniversary of the Doha Declaration, “Patents vs. Patients: Five Years After the Doha Declaration”, international agency Oxfam says that rich countries are taking little or no action towards their obligations and are in some cases actually undermining the declaration.

The declaration says that developing countries must be able to use public health safeguards written into the WTO’s intellectual property rules (called TRIPS) in order to access cheaper generic versions of patented medicines. Generic competition is the most sustainable way to keep the price of medicines down, says Oxfam.

“Rich countries have broken the spirit of the Doha Declaration,” said Oxfam’s Make Trade Fair campaign head Celine Charveriat. “The declaration said the right things but needed political action to work. That hasn’t happened. We’ve gone backwards. People are still suffering or dying needlessly.”

Since 2001 things have become worse for sick people in developing countries:

∙ More than 4 million people were newly infected by HIV in 2005;

∙ Cancer - once considered a “burden of the rich” - is increasingly affecting people in developing countries, wth the rate of disease due to double by 2020 and 60% of new cases occurring in the developing world;

∙ Diabetes has risen from 30 million to 230 million people in the past 20 years with most new cases now reported in poorer countries.

However, the World Health Organization says that 74% of AIDS medicines are still under monopoly, 77% of Africans still have no access to AIDS treatment, and 30% of the world’s population still do not have regular access to essential medicines.

There are many reasons for this but one of the most important is that rich countries, particularly the US, are bullying developing countries to impose stricter intellectual property rules in order to preserve pharmaceutical monopolies. This is restricting generic competition and keeping prices high.

”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 Charveriat.“ If implemented, these deals will result in Colombia having to pay an additional £494 million per year by 2020 to cover the increased cost of medicines, affecting nearly 6 million patients. Similarly in Peru, where the price of medicines could increase by 100% in 10 years and 162% in 18 years.

Other rich countries, particularly those among the European Union, have quietly consented to US actions. Pharmaceutical companies have gone even further by directly challenging countries such as India and in Philippines that have sought to use the safeguards.

In 2005, cancer patient groups in India used Indian intellectual property law to stop a patent application by the Swiss company Novartis for its anti-cancer drug, Glivec. This allowed Indian companies to continue making generic versions at £1,400 per patient per year, as opposed to Novartis having a monopoly priced version for sale at more than £14,000 per patient per year.

However Novartis recently appealed the court’s decision in a direct challenge to India’s right to interpret the TRIPS Agreement to protect public health. If Novartis is successful, it could jeopardize India’s generic export industry. India is the world’s leading supplier of inexpensive generic medicines to developing countries, with approximately 67% of its exports going to developing countries.

“Novartis has told Oxfam that there is no commercial market for Glivec in India and that it is challenging India in order to align Indian intellectual property law with TRIPS,” Charveriat says. “However, India is only trying to use the flexibilities rightfully available to it under TRIPS and Novartis is seeking to block that right.”

Meanwhile in the Philippines, the government has conducted tests and issued a regulatory approval for a cheaper patented version of Norvasc, a heart disease drug now under patent to the US company Pfizer. The government is doing this to ensure that a cheaper patented version of Norvasc that costs almost 90% less will be available immediately from when the patent expires in June 2007.

Oxfam believes that the government’s action is consistent with the TRIPS Agreement and with the Philippines intellectual property law. However, Pfizer is now suing the government. If Pfizer is successful, it will severely limit the government’s ability to access cheaper medicines and assert its right to enforce TRIPS safeguards.

“Developing countries have a responsibility to use the public health safeguards but when they try to do so they are put under huge pressure,” Charveriat said.

In order to make the Doha Declaration work, Oxfam is calling for:

∙ The WTO to review the impact of the TRIPS Agreement to ensure that all members can protect public health.

∙ The US to stop pressuring countries to adopt stricter intellectual property rules, especially through its FTA negotiations;

∙ The EU to clarify that it will not push for TRIPS-plus measures within European Partnership Agreements, and that it gives developing countries the policy space to freely use TRIPS flexibilities;

∙ Rich countries to give political and technical support to developing countries to use the safeguards under TRIPS to ensure access to affordable medicines;

∙ Political will on the part of developing countries to implement the public health safeguards;

∙ An end to lawsuits currently pursued by Novartis and Pfizer against developing countries.

“Rich countries must live up to their commitments and stop undermining the Doha Declaration with their selfish actions,” Charveriat said. “Now more than ever we need a global trading system that puts health before profit and makes medicines affordable for all.”

As part of the report launch, Oxfam is hosting a high-level panel debate at BMA House in Tavistock Square, London, from 11.00a.m. until 1.00p.m. on 14 November, debating the motion “This house believes that the Doha Declaration delivered what is needed from TRIPS in terms of access to affordable medicines”. Speakers include Nobel Prize winner Sir John Sulston and Dr. Harvey Bale, President of the International Federation of Pharmaceutical Manufacturers Associations (IFPMA). Highlights from the debate will be published at, with questions and comments from members of the public welcomed.

Expert opinion

Halter Marek


Halter Marek
Le College de France
Olivier Giscard d’Estaing


Olivier Giscard d’Estaing
COPAM, France
Mika Ohbayashi


Mika Ohbayashi
Institute for Sustainable Energy Poliñy
Bill Pace


Bill Pace
World Federalist Movement - Institute for Global Policy
Peter I. Hajnal


Peter I. Hajnal
Toronto University, G8 Research Group

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