With PEPFAR, the US shouldn't be the hurdle for manufacture of cheap drugs

In 2006 the World Trade Organisation (WTO) granted Least Developed Countries (LDCs) a 10-year window to continue manufacturing generic drugs using the intellectual property rights of established companies from the West. The window is set to close in this December and negotiations for a permanent extension have already started. Uganda is one of the LDCs manufacturing the drugs under the WTO waiver, and has been leading in negotiations – along with Nepal and Bangladesh on behalf of LDCs – to remain protected from the enforcement of patents and other intellectual property rights on the manufacture of pharmaceuticals. The talks have been going on in Geneva, Switzerland. However, between the LDCs and the grant for a permanent waiver on patents on medicines is the United States. And, no doubt at the behest of powerful lobbies representing big pharmaceutical companies (big pharma), America is adamant that the LDCs should not be granted their wish for a permanent waiver. The big pharma would rather be left to control the global pharmaceutical industry by enforcing patents, thereby taking away the LDCs ability to manufacture the much cheaper generic drugs that are a lifeline for most people in the Third World. It is no coincidence Uganda is spearheading the push. In collaboration the Indian generic drug maker Cipla, Uganda’s Quality Chemicals Limited (QCIL) Limited has been manufacturing ARVs and artemesinin-based combination therapies (ACTs) for malaria since 2009. Permanent extension of the patents will enable Uganda and other LDCs develop capacity and engage in local manufacturing of essential drugs without fear of future hindrance, and ensure continued access of cheap medicines for their most vulnerable (also see, “WTO: Don’t compromise on access to essential medicines”, The New Times, October 10, 2015). The management of HIV offers a good example, of which it is unseemly that the America should be the hurdle with all the goodwill it has earned globally with US President’s Emergency Plan for AIDS Relief (PEPFAR). Launched in 2003, PEPFAR is in “Phase III” focusing on Sustainable Control of the Epidemic. Aptly dubbed PEPFAR 3.0, the aim is to reach the Joint United Nations Programme on HIV/AIDS’ (UNAIDS) ambitious 90-90-90 global goals: 90 percent of people with HIV diagnosed, 90 percent of them on ART and 90 percent of them virally suppressed by 2020. But this is what US Secretary of State John Kerry told UN General Assembly in September, 2014: “In a tight budget environment – and everybody faces that – every dollar, yen, and euro counts. And that’s why we need to focus on data, on mutual accountability, transparency for impact, and put our weight behind HIV prevention, treatment, and care interventions that work.” The key words here are “tight budget environment” and “interventions that work”. The hand that gives cannot continue giving forever. And perhaps the better it would be to ensure capacity is developed to entrench interventions that work. In other words, by conceding the LDCs be granted a permanent waiver, it will be empowering and akin to “teach a man to fish, and you’ve fed him for a lifetime.” There is talk that the US is only willing to concede and extension period of 17 years after the current waiver elapses. But, as some experts assert, it makes sense that poor countries get a permanent waiver because the transition the US is offering is too short a period for LDCs to develop the capacity required. The European Commission, among other global actors, including UN agencies World Health Organisation, United Nations Development Programme and UNAids, as well as the humanitarian organisation Medecins Sans Frontieres, have come out in support of the LDCs’ push for a permanent waiver in a bid to improve global health indicators. As this column observed sometime last month (see “WTO: Don’t compromise on access to essential medicines”), the tenth WTO Ministerial Conference (MC10) set for Nairobi in December will be one of those major international events in the region to watch out for. Should the US continue to hold out, the opportunity should not missed to bring international pressure to bear at the MC10 for America to allow the permanent waiver.

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With PEPFAR, the US shouldn't be the hurdle for manufacture of cheap drugs