Toward a New Foreign Policy.

In May 1999 the World Health Assembly, the policymaking body of the World Health Organization (WHO), passed a resolution that declared public health concerns "paramount" in intellectual property issues related to pharmaceuticals. Although Washington had vociferously opposed earlier efforts to obtain passage of a similar resolution that said public health concerns should take priority over commercial matters, the U.S., after insisting on minor changes, voted in support of the 1999 resolution. It is now time for Washington to bring its foreign policy into full compliance with the accepted notion that public health protection is the most important goal in shaping pharmaceutical patent policy.

First, the U.S. should announce that it will terminate all bilateral pressure on Brazil, Argentina, and other countries related to health-related intellectual property disputes. While it was an advance for the U.S. to agree that countries can adopt TRIPS-legal measures to make medicines more available, it should not seek to press TRIPS monopoly patent protections to their limit.

Second, the executive order about AIDS medicines and policy recognizing that health issues deserve special consideration in intellectual property disputes should be broadened. The U.S. should accept compulsory licensing and parallel importing as integral parts of the intellectual property system and crucial to delivering essential medicines in poor countries. The executive order should be broadened to cover all health-related technologies, not just those related to HIV/AIDS, and all parts of the world, not just Africa.

Third, the U.S. should announce its support for the South African effort to enable compulsory licensing and parallel imports, and urge the pharmaceutical companies that continue to block implementation of the South African Medicines Act through litigation to drop their lawsuit.

Fourth, the U.S. should stop seeking expansion of TRIPS ("TRIPS-plus") in international trade agreements like the FTAA. There should be no provisions to enhance patent protections in new trade agreements.

Fifth, the U.S. Ex-Im Bank should abandon its drug lending program. The U.S. should instead provide massively stepped-up aid for AIDS treatment and prevention, channeled through appropriate UN agencies.

Sixth, the U.S. should immediately license to the WHO all of the HIV/AIDS drugs that have been developed with government funding and for which the U.S. government holds patent or other intellectual property rights. Existing law permits Washington to take such steps. With a license, the WHO could contract with private generic makers to produce the medicines and distribute them widely in the developing world. Since many of the most important HIV/AIDS remedies--such as ddI--were developed with significant U.S. government funding, the U.S. government controls rights to many important HIV/AIDS treatment pharmaceuticals.

Finally, it should be reiterated that although access to essential medicines is of critical importance, much more must also be done to prevent the spread of HIV/AIDS and to improve treatment of those infected. An essential step in combating the transmission of this disease is to cancel the foreign debts of the poorest countries, since debt servicing siphons off funds from investment in public health. World Bank and IMF structural adjustment programs that impose policies--such as requiring copayments from indigent patients--also make it more difficult for those with HIV/AIDS to gain access to medical care. And African governments must do more to support AIDS education and prevention efforts and to destigmatize people with the disease.

Key Recommendations

* The U.S. should terminate all bilateral pressure on countries for pursuing intellectual property policies designed to make essential medicines more available to those in need.

* The U.S. should cease efforts to incorporate intellectual property protections in new trade agreements, especially those that contain provisions that go beyond TRIPS.

* The U.S. government should license to the World Health Organization all HIV/AIDS drugs that the U.S. government has played a substantial role in developing to ensure widespread distribution in the developing world.

Robert Weissman <[e-mail]> is editor of Multinational Monitor magazine and codirector of Essential Action, a corporate accountability group. He is coauthor of Corporate Predators: The Hunt for MegaProfits and the Attack on Democracy (Monroe, ME: Common Courage Press, 1999; see http://www.corporatepredators.org/).