Common health policy interests and the shaping of global pharmaceutical policies

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Author: Meri Koivusalo
Date: Winter 2010
From: Ethics & International Affairs(Vol. 24, Issue 4)
Publisher: Carnegie Council on Ethics and International Affairs
Document Type: Article
Length: 8,884 words
Lexile Measure: 1880L

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The global focus on pharmaceutical policies and, in particular, on intellectual property rights (IPR) and medicines has been dominated by debates over access to medicines in developing countries and the lack of resources for research and development (R&D) to address tropical and neglected diseases. These concerns were reflected in the negotiations before the World Trade Organization's (WTO) Doha Declaration on public health; (1) the establishment of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and other global initiatives addressing access to medicines for these three diseases; the work of the World Health Organization's (WHO) Commission on Intellectual Property Rights, Innovation, and Public Health; and, most recently, during negotiations for the World Health Assembly's Global Strategy and Plan of Action on Public Health, Innovation, and Intellectual Property. (2) However, while the provision of additional resources for tackling HIV/AIDS, tuberculosis, and malaria and the investment in research and development in neglected diseases are certainly important, such resources alone are not sufficient to tackle global health challenges. Access to medicines and inadequate research and development are usually framed as problems that prevail only with regard to specific diseases and only in the poorest developing countries, and which can be remedied through an increased allocation of aid without further changes to innovation, trade, or industrial policies globally. But this approach is becoming untenable. For example, middle-income countries, such as Brazil and Thailand, have been embroiled in legal disputes for their efforts to ensure access to affordable drugs to their populations, while the link between intellectual property rights and the pricing of medicines is a concern for an increasing number of countries. (3)

In order to achieve more ethical global health outcomes, health policies must be driven by health priorities and should take into account broader health policy requirements, including the needs of specific national health systems. It is thus important to recognize that the division of interests in key policy areas are not necessarily between the priorities of rich and poor countries, but between (1) pharmaceutical industry interests and health policy interests, and (2) national industrial and trade policy interests and public health policies. If common interests in health policies across countries remain unrecognized, they are more easily undermined by the lobbying efforts of the pharmaceutical industry. (4) Furthermore, governments that effectively defend the interests of the global pharmaceutical industry at the international level may in effect undermine the priorities of their own health systems and citizens, who could benefit from stronger government intervention in pharmaceutical policies and pricing. The issue is thus not only about the ethics of forcing developing countries to follow equal or more demanding requirements for intellectual property protection than what is required in rich countries but also the extent to which the lack of recognition of common policy concerns limits and delays actions that could benefit all countries. (5)

Health has remained to a large extent outside <'high" politics and is rarely the focus of international or external policies. The prominence of trade over health considerations in international...

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