Investors’ IP Rights Unbound: The Danger of Investment Clauses to Access to Medicines

Although access to medicines activists have been wise to focus our attention intently on convincing low- and middle-income countries to adopt and use all possible TRIPS-compliant flexibilities and to oppose the TRIPS-plus IP chapters in free trade agreements, we have neglected to interrogate another chapter in free trade agreements and bilateral investment treaties that perhaps pose an even greater threat to our collective access to medicines’€“ investment chapters

 

Investors’€™ IP Rights Unbound:  The Danger of Investment Clauses to Access to Medicines

by Prof. Brook K. Baker*, Policy Analyst Health GAP, Northeastern U. School of Law, Program on Human Rights and the Global Economy, Honorary Research Fellow, University of KwaZulu Natal

April 20, 2013

 

Access-to-medicines activists have recently had much to celebrate.  In India, the Supreme Court upheld India’€™s strict standards of patentability and rejected an “€œevergreening”€ patent on Glivec, an important cancer medicines that Novartis sells for $70,000 per year [i]. Earlier last year, the Indian Comptroller of Patents issued India’€™s first compulsory license on a Bayer cancer medicine, Nexavar, to Natco, thereby shaving the price by 97%.  The Intellectual Property Appellate Board of India affirmed that decision which is now on appeal to the High Court [ii].  On the trade front, India health activists succeeded in convincing the Indian government to reject European demands in EU-India trade negotiations that would have imposed data monopolies and extended the length of patent monopolies [iii].  Fortunately, India is not acting alone; Indonesia also quietly issued compulsory licenses on seven hepatitis and HIV antiretroviral medicines last year [iv], and Argentina recently adopted proactive guidelines to restrain secondary patents on minor modifications to existing medicines[v].   Last summer, the over-reaching Anti-Counterfeiting Trade Agreement was rejected by the generally pro-IP European Parliament [vi] and Europe was forced to reconsider its draconian border measures that had resulted in the seizure of lawful in-transit medicines in the Netherlands and elsewhere [vii].Even the U.S. is reconsidering its willingness to patent isolated genes[viii] while Canada is accelerating its rejection of patents on medicines that fail to make required disclosures, e.g., Pfizer’€™s Viagra [ix].

We could wish that the tide was irreversibly turning against the excesses of patent and data monopolies on medicine that erect ever-higher and stronger exclusivity barriers that price poor people and poor countries from accessing life-saving public goods.  But anyone who thinks that Big Pharma is sitting still and that their allies in European and US trade offices have found a new religion is dangerously wrong.  We’€™ve know for a decade and a half that Big Pharma and its rich-country trade rep allies have been seeking to ratchet-up longer, stronger, and broader patent and data monopolies in a string of bilateral and plurilateral free trade agreements such as US-CAFTA and EU-Caricom [x].  Those efforts are intensifying in the TRIPS-plus demands that the US and EU are putting forth in current negotiations, e.g., the Trans-Pacific Partnership Agreement [xi] and the EU-India FTA.  In these trade negotiations, the US and EU typically seek patent term extensions, eased standards of patentability, restrictions on patent opposition procedures and patent revocations, data exclusivity [xii], and greatly enhanced enforcement powers in terms of “€œdeterrent”€ damages, mandatory injunctions, enhanced border enforcement, and expanded criminal enforcement [xiii].  This IP-maximalist agenda is pursued not only in secret free trade agreement negotiations, but through diplomatic pressure, threats of sanctions found in IP/trade assessments (like the U.S. Special 301 Watch List), biased technical assistance and training to IP examiners and judges, and a thorough-going disinformation campaign that casts intellectual property rights as irreducible and irreplaceable, as the only engine for innovation and creativity, and as the prime fount of foreign direct investment, technological advancement, and development more broadly [xiv].

Although access to medicines activists have been wise to focus our attention intently on convincing low- and middle-income countries to adopt and use all possible TRIPS-compliant flexibilities and to oppose the TRIPS-plus IP chapters in free trade agreements, we have neglected to interrogate another chapter in free trade agreements and bilateral investment treaties that perhaps pose an even greater threat to our collective access to medicines – investment chapters.

Under investment chapters, foreign IP investors, like Novartis and Bayer, are recognized as “€œinvestors”€ who have made “€œinvestments”€ involving expenditures and expectations of profit [xv].  Suddenly intellectual property rights, already hugely protected, are given another mantle of protection, namely protections as investments.  In addition, investors are given rights to bring claims for private arbitration directly against governments whenever their expectations of IP-based profits are frustrated by government decisions and policies.   Decisions of these private arbitral tribunals consisting of three international trade lawyers are not subject to judicial review, but are reducible into court judgments that can be levied against government property.

Using loose and imprecise standards addressing “€œminimum standards of treatment,”€ “€œindirect expropriation,”€ and “€œnational treatment,”€ multinational pharmaceuticals might claim that denying patents, granting oppositions, revoking patents, issuing compulsory licenses, and registering generics while referencing clinical data or doing so before patent expiration all violate their legitimate expectations for profit.  Although the “€œminimum standards of treatment”€ clause was originally designed to prevent grossly abusive and discriminatory courtroom adjudications totally outside the bounds of normative due process, it has morphed to decisions with a much more lenient standard that rewards investors even when they have been given a full panoply of due process safeguards.  The expropriation standard, originally adopted to deter nationalization of businesses and seizures of real property has similarly morphed to prevent indirect expropriations, what we call regulatory takings in the U.S., where changes in government regulations -€“ many designed to protect public health, environment, and other legitimate public interests -€“ are challenged as having diluted the investor’€™s expectations of profit.  Finally, the national treatment standard, though originally adopted to ensure that foreign investors are treated equivalently to domestic investors, is also morphing in new directions.

Threats like these with respect to pharmaceutical IPRs used to be theoretical, but the theoretical has now become real.  In November of 2012, Eli Lilly sued the government of Canada for $100 million under NAFTA’s investment chapter because Canada invalidated a Bayer patent on a medicine used to treatment attention deficit disorders [xvi].  Courts in Canada, including its Court of Appeals, reviewed the patent in depth as part of an invalidation case initiated by Teva.  The patent was declared invalid pursuant to requirements in Canadian patent law that an applicant must satisfy its “€œpromise of utility”€ (more commonly called industrial applicability) by disclosing evidence pointing to a claimed benefit as an inventive medicine.  Eli Lilly objected because the promise doctrine had been developed judicially and that it had been clarified only after Bayer had filed its common patent application in the format authorized by the Patent Cooperation Treaty, of which Canada was a member.

Eli Lilly didn’t like this ruling, so it is seeking to greatly expand the accepted meanings of minimum standards of treatment, indirect expropriation, and national treatment to argue that Canada should not be able to modify any of its patent standards or even to have a patent standard on utility and disclosure of utility that is any higher than that currently practiced in the US and EU.  It argues further that it should not have to disclose information needed to satisfy patent requirements in Canada that is above and beyond what is required in patent applications filed pursuant to the Patent Cooperation Treaty, even thought the PCT clearly covers procedures for filing patent applications, not substantive requirements of patentability enforced as a sovereign rights by each country.  It is important to note that Eli Lilly is pursuing a patent invalidation claim despite an express provision in the NAFTA investment chapter that purports to exclude NAFTA-compliant patent granting, revocation, and compulsory license decisions from investor dispute resolution [xvii].

If Eli Lilly can file this kind of expansive, topsy-turvy claim in Canada with respect to its decision to revoke a patent, what would prevent Novartis and Bayer from filing comparable claims against India because it too has adopted strong protections against evergreening in section 3(d) of its Patents Act and has allowed compulsory licensing in section 84?  India has international investment agreements with 82 countries and has been subjected to 17 known investor-state claims [xviii].  Although no claims to date have been brought based on pharmaceutical IPRs, these are exactly the kinds of claims that a major international corporate law firm, Jones Day, is urging companies to file under existing investment clauses that India has ill-advisedly entered into [xix].

Novartis and Bayer, and the rest of Big Pharma, are relentless in their search for monopoly rights and monopoly profits.  The right to sue governments directly when their unquenchable thirst for profits is thwarted is a dangerous escalation of corporate power.   These kinds of investor cases are expensive to defend (average cost to governments over $8 million/case) and have cost taxpayers globally nearly $3 billion and counting.  Five hundred and eighteen known investor-state cases have been filed, of which only 244 have been concluded [xx].  The pace of new cases is escalating (62 new cases filed in 2012 alone), as is the rate of investor wins (70% of investors claims decided on the merits in 2012 were favorable to claimants).  When investors win, they can win a lot, like the $1.77 billion, plus compounded interest, costs, and attorney’s fees, awarded to Occidental in its claim against Ecuador.  But even when they don’€™t win, investors can coerce settlements on favorable terms (approximately 27% of case are settled).  Once the pharmaceutical floodgate is unlocked, the number of claims and taxpayer exposure will expand as well.

India and other trade negotiators should heed the entreaties of trade, IP, and health activists who are warning against the inclusion of an Investment Clause in the EU-India FTA [xxi], the Trans-Pacific Partnership Agreement, and in the many other trade agreements that are underway or soon-to-be initiated.  Preferably, investment chapters will be rejected in their entirety, as they are becoming a corporate sword of Damocles that hangs over the head of rich and poor governments alike.  At the very least, IP should be totally defined out of “€œinvestments”€ and no investor claims whatsoever should be available for alleged frustration of IP-based expectations.  IP right holders already have multiple forms of enforcement including private lawsuits, border seizures, criminal prosecution, and state-state dispute resolution.  Enough is enough.  Expanded and unbound investment rights for Big Pharma under the cover of underscrutinized investment chapters is a grave threat -€“ a threat with deadly consequences to millions of patients who rely on governments’€™ rights to regulate IPRs and to use any and all TRIPS-compliant flexibilities to ensure affordable access to medicines for all.

—————————————————————————————-

[i] Novartis cancer drug patent bid rejected by Indian court in landmark ruling, The Guardian (April 1, 2013). 

[ii] Patent board rules in favour of Natco in cancer drug case; Bayer to challenge decision, CNN-IBN Live (March 5, 2013).  

[iii] India-EU FTA won’t hit generic drugs industry: EU envoy, Business Standard (April 13, 2013). 

[iv] Indonesia to override patents for life-saving medicines, IRIN News (March 25, 2013).

[v] Argentina adopts new guidelines to examine patent applications for pharmaceuticals, Don’€™t trade our lives away (May 31, 2012). 

[vi] European Parliament rejects ACTA piracy treaty, The Telegram (July 4, 2012).

[vii] India Ministry of Commerce and Industry, India EU Reach an Understanding on the Issue of Seizure of Indian Generic Medicines in Transit (July 28, 2011); see Brook K. Baker, Settlement of India/EU WTO Dispute re Seizures of In-Transit Medicines: Why the Proposed EU Border Regulation Isn’t Good Enough, PIPIF Research Paper Series (2012). 

[viii] Justices Consider Whether Patents on Genes are Valid, New York Times (April 14, 2013).

[ix] Canada’s Supreme Court strips Viagra Patent from Pfizer, Reuters (Nov. 8, 2012).

[x] Baker, B. and Avafia, T., (2011), The Evolution of IPRs from Humble Beginnings to the Modern Day TRIPS-plus Era: Implications for Treatment Access.  Working Paper prepared for the Third Meeting of the Technical Advisory Group of the Global Commission on HIV and the Law, 7-9 July 2011. 

[xi] Sean M. Flynn, Brook Baker, Margot Kaminski & Jimmy Koo, The U.S. Proposal for an Intellectual Property Chapter in the Trans-Pacific Partnership Agreement, 28 Am. U. Int’l L. Rev. 105, 149-184 (2012).

[xii] Id.

[xiii] Id. at 183-200.

[xiv] Brook K. Baker, Debunking IP for Development:  Africa Needs IP Space, Not IP Shackles (draft 2013).

[xv] Trans-Pacific Partnership, Intellectual Property Rights Chapter September 2011 Draft (Selected Provisions), available at http://www.citizenstrade.org/ctc/wp-content/uploads/2011/10/TransPacificIP1.pdfSee Brook K. Baker, Corporate Power Unbound:  Investor-State Arbitration of IP Monopolies – Eli Lilly and the TPP (draft 2013).

[xvi] The investor-state claim is Eli Lilly and Company v. The Government of Canada, Notice of Intent to Submit a Claim to Arbitration under NAFTA (Nov. 7, 2012), available at http://italaw.com/sites/default/files/case-documents/italaw1172.pdfSee Public Citizen, U.S. Pharmaceutical Corporation Uses NAFTA Foreign Investor Privileges Regime to Attack Canada’s Patent Policy, Demand $100 Million for Invalidation of a Patent (2013). 

[xvii] NAFTA, Article 1110(7).

[xviii] Biswajit Dhar, Reji Joseph & T.C. James, India’€™s Bilateral Investment Agreements:  Time to Review, 52 Economic & Political Weekly 113-122 (2012).

[xix] Jones Day Commentary, “€œTreaty Protection for Global Patents:  A Response to a Growing Problem for Multinational Pharmaceutical Companies,”€ 3 (October 2012).

[xx] UNCTAD, Recent Developments in Investor-State Dispute Resolution (2013).

[xxi] Does the EU/India free trade agreement spell the end of cheap drugs for poor countries?, The Guardian (February 10, 2013).

 

*Brook K. Baker is a law professor at Northeastern University School of Law (US) and an affiliate of its Program on Human Rights and the Global Economy. He is also an honorary research fellow at the University of KwaZulu Natal, Faculty of Law, South Africa. He is a policy analyst for Health GAP (Global Access Project) and writes frequently on IP, trade, and access to medicines issues.

 

News Link n. 45

 

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries.

 

News Link 45

Editorials Address China’s Response To Emergence Of H7N9 Bird Flu Strain 

L’eredità della SARS: sorveglianza e controllo delle epidemie all’età della globalizzazione 

After the vote: Future of Italian aid still uncertain

UN experts urge World Bank to adopt human rights standards in its policies 

In My Place: Oxfam, Coldplay and you fight land grabs

Climate change: how a warming world is a threat to our food supplies

Health and Foreign Policy Bulletin: March 2013 issue 

Chagas: A silent killer

Mind the GAPPD: A Pivotal New Resource Offers Global and Local Strategies to Overcome Leading Child Killers

Change@WHO – April 2013 newsletter on WHO reform

La Tobin Tax è il primo passo per curare la finanza malata 

The Novartis Decision: A Tale Of Developing Countries, IP, And The Role Of The Judiciary 

Companies  work  t o  employ  India’s  poor:  Business  Call  to  Action  announces  new  initiatives during  G20  Inclusive  Business  Workshop  in  Mumbai

6 reasons companies fail to reach the bottom of the pyramid

President Obama’s Budget Request Signals Confidence In Global Fund

It’s Half-time at the Global Fund 

Greek Gene Bank’s Struggle Indicative Of Changing Times 

Measuring universities’ commitments to global health

Viral transmission linked to injecting illicit drugs: finding the best medicine 

Access to HIV meds secured for Pacific

Unwelcome side effects of mining in Mozambique 

Riflessioni intorno all’Emergenza Nord Africa

 

 

 

 

 

 

 

 

News Link n. 44

 

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries.

 

News Link 44

Race For WTO Director General Down To Five Candidates 

Reports: Obama’s Proposed 2014 Budget Favours Patent Office, Generic Drugs 

The Good, The Bad And The Budget: What Obama’s Plan Means For Foreign Aid 

Questions Follow Sharp Rise In Investor-State Disputes, Far-Reaching Cases 

Global Fund: A $15 Billion Target for a Transformative Effect

New Draft Traditional Knowledge Bill Published In South Africa

South Africa Announces Rollout Of New Single-Dose ARV Therapy

The BRICS Summit in Durban: too soon to write it off

BRICS agree development bank and science forum

Australia and China: New partners in aid

How Turkey is emerging as a development partner in Africa

‘Beyond MDGs and beyond aid’ 

Implementing the European Union  gender action plan 2010-2015: challenges and opportunities 

World Bank and IMF Spring Meetings – Nancy Birdsall and Todd Moss

Africa: Is the Bank’s Attitude Towards Participatory Development Changing? 

Health Research Colloquium Calls On Countries To Invest More In R&D

Movies, fashion and food: Halle Berry joins Michael Kors to fight hunger 

Why Chemotherapy That Costs $70,000 in the U.S. Costs $2,500 in India 

Cipla, The Human Care Company  

Climate Conversations – World Health Day 2013: Combating malnutrition and infection with forests

Healthcare cuts may have lasting effect on obesity: Think tank

Let’s end the two biggest child killer diseases

New SMS Tool To Report Non-Tariff Trade Barriers At African Borders

 

 

 

 

 

 

 

 

Publications: Archives

 

ARCHIVES 

 

PUBLICATIONS  

I. TPP Deal and access to medicines: prospects from Asia-Pacific Geopolitics 

II. Humanitarian Aid, Health: International Financing needs to reinvent itself 

III. Il gap Nord-Sud nell’accesso a farmaci di qualità: un problema di salute pubblica globale 

IV. Farmaci substandard e contraffatti: il mercato nei Paesi in Via di Sviluppo 

V. L’industria internazionale della contraffazione. Altolà alle “cattive medicine”: ma il generico è un altra cosa 

VI: Cina, contro l’AIDS occorrono più farmaci indiani 

VII. Irrevocable Johnson&Johnson’s “No” to the Medicines Patent Pool? 

VIII. MNC behaviour in the pharmaceutical industry in India after TRIPS 

IX. WHO / EU “Bad Medicine” Plans: Flaws, Coordination Gaps 

X. BRICS e salute globale: contributo montante 

XI. La farmacia India contro le multinazionali 

XII. HIV Medicine Alliance: Lip Service Move to Get Rid of the Medicines Patent Pool? 

XIII: Filling the gap: China’s fight agains HIV/AIDS 

XIV: Nigeria’s Public Health: Gains and Challenges 

XV: Fondo Globale: Più Performance dalla Ristrutturazione

XVI: The AIDS Story You May Not Have Heard

XVII: EU Health Cooperation: Room for Improvement

XVIII: Transnational Health Care and Medical Tourism

XIX: Fondi in Calo per le Malattie Neglette

XX: Access to Medicines and Quality of Medicines: always together!

XXI: Pending Cutback in EU Spending for Development Cooperation

XXII: 26 Years On: A Need for a Moral Revolution in Maternal Health Care

XXIII: Farmaci Essenziali e Malattie Trascurate

 

News Link n. 43

 

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries.

 

NEWS LINK 43

From March Madness to April Anxiety: The WTO Leadership Contest Heats Up 

Who picks up the tab for development?

Global financial flows, aid and development 

Invest in health systems for a balanced approach

DNDi R&D Projects – 2013 Outlook 

What will the new pope mean for the development sector?

Balancing conservation and people’s access to land

The poorest countries are under renewed threat from WTO rules on access to medicines (and yes, this is 2013) 

Novartis Loses Patent Bid: Lessons From India’s 3(d) Experience

The Judgment In Novartis v. India: What The Supreme Court Of India Said 

India Dismisses Antitrust Complaint Against Gilead Sciences

Australian Pharmaceutical Patents Review’s New Report Critical Of Patent Extensions, R&D Funding 

The European Commission calls on EU Member States to fulfil their commitments towards the world’s poorest

Some OECD Nations’ Development Aid Spending Down 4% In 2012, Report Says 

Donors likely to cut down on HIV and Aids funds  

End of polio by 2018 a global win — WHO

US Trade Office Calls For Comments On Transatlantic Trade Deal

Banking on the BRICS for health?

Enter   the  Dragon  and  the  Elephant:  China’s  and  India’s  Participation  in  Global  Health  Governance   

Sizing Up China’s Role in Global Health Aid to Africa

Alcohol and alcohol-related harm in China: policy changes needed 

New apps transforming remote parts of Africa

Gene Patenting: Consequences for Global Health

Crisi finanziaria, austerità e salute in Europa

 

 

 

 

 

 

News Link n. 42

 

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries.

 

News Link 42

Obama After Meeting with African Leaders

Novartis Loses Patent Bid: Lessons From India’s 3(d) Experience

India Dismisses Antitrust Complaint Against Gilead Sciences

India pressured by U.S. Congressional committee, Pfizer, over drug patents  

Indonesia to override patents for live-saving medicines

East African Community Doubles Efforts To Boost Local Drug Production 

Shasun Signs Licence With MPP to Produce Low-Cost HIV Medicines 

 –Far diventare i farmaci evergreen, come alcune canzoni

The Lancet series: Health in Europe 

UN high-level panel highlights 5 areas of reform post-2015

UPOV 1991 Will Adversely Impact Farmers In Tanzania, Civil Society And Farmers Say 

Sahel crisis not over yet, WFP chief warns

Donate ฿99 To Provide School Meals For Girls In Asia For 2 Weeks (Thailand)

US food aid revolution: rumour or reality?  

A Growing Opportunity: Measuring Investments in African Agriculture

Inequality out of World Bank’s 2030 strategy?

World Bank live chat: Have your say on managing risk and opportunities  

Canada’s International Development Agency Is No Longer; Maybe That’s Not Such A Bad Thing 

‘Grand Challenges In Global Health’ Initiative Calls For Applications For The ‘Next Generation Of Condom’  

Innovation, IPR Cooperation Among Top Priorities For BRICS

BRICS development bank: ‘The devil is in the detail’ 

Callan, Blak and Thomas on China’s foreign aid and investment 

New VSO paper sets out how post-2015 process could put women’s empowerment at the heart of fighting poverty 

Biovision: Personalised Medicine, Climate Change, Sustainability Need Innovation 

Former US Congressman Howard Berman Joins Lobbying Firm

The USA and global health diplomacy: goals and challenges 

 

 

 

 

News Link Archives

 

 

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Interview: Jorgen Stassijns, malaria advisor at the Belgian branch of Médecins Sans Frontières

 

GESPAM had the pleasure to interview Mr. Jorgen Stassijns as malaria advisor and specialist in tropical disease at the Belgian branch of Médecins SansFrontières (MSF). Mr. Stassijns is a medical doctor, working for MSF since 1998. He did missions in different countries, covering different medical fields: refugee projects in South Sudan and Guinea, TB project in Russia, access to health care project in Sierra Leone and migrant project in Belgium. Since 2007, Mr. Stassijns is working in the headquarters, first as medical-operational coordinator for projects in Eastern Africa, then as malaria expert

 

Interview

 Jorgen Stassijns

Malaria Advisor and Specialist in Tropical Disease at the Belgian branch of Médecins Sans Frontières

Background information from WHO 2012 Malaria Report:

..... International disbursements for malaria control rose steeply from less than US$ 100 million in 2000 to US$ 1.71 billion in 2010 and were estimated to be US$ 1.66 billion in 2011 and US$ 1.84 billion in 2012.....
.....The enormous progress achieved appears to have slowed recently. International funding for malaria control has levelled off, and is projected to remain substantially below the US$ 5.1 billion required to achieve universal coverage of malaria interventions......
....There were an estimated 219 million cases of malaria (range 154-€“289 million) and 660 000 deaths (range 610 000-€“971 000) in 2010......Country level malaria estimates available for 2010 show that 80% of estimated malaria deaths occur in just 14 countries and approximately 80% of estimated cases occur in 17 countries. Together, the Democratic Republic of the Congo and Nigeria account for over 40% of the estimated total of malaria deaths globally. The Democratic Republic of the Congo, India and Nigeria account for 40% of estimated malaria cases.
.....millions of people continue to lack access to preventive therapies, diagnostic testing and quality-assured treatment.....
......resistance to artemisinins -€“ the key compounds in artemisinin-based combination therapies -€“ has been detected in 4 countries of the South-East Asia Region, while mosquito resistance to insecticides has been found in 64 countries around the world......
.....There is a critical need to strengthen malaria surveillance......
.....There is an urgent need to identify new funding sources to maintain and expand coverage levels of interventions so that outbreaks of disease can be avoided and international targets for reducing malaria cases and deaths can be attained.....

 

GESPAM:  Mr.Stassijns, as regards progress so far, how to maintain momentum and do the utmost to hold back malaria resurgence?

Jorgen Stassijns: Over the past years, some successes have been achieved in malaria control, and in some countries, the numbers are going down. However, huge challenges remain in high burden countries such as DRC or Niger, contexts where MSF is active in the fight against malaria. In 2012 for example , the malaria burden in these countries has been higher than previous years. For some other contexts, reliable data are lacking. Clearly, all efforts to control malaria should continue and funding should be increased if we want  to reduce the malaria burden.

GESPAM: Do MSF functions include partnerships and collaboration with counterparts for malaria action?

Jorgen Stassijns: In its projects, MSF always works in close collaboration with or in support to the National Malaria Programs in the countries. We don’t have formal agreements or partnerships with other actors.   

GESPAM: Pending or already made cuts in foreign aid expenditure are threatening the gains achieved in malaria control and prevention. Relevantly, adding to a December 2012 call by the Executive Director of Roll Back Malaria Partnership for “….new financing mechanisms..” including “.. financial transactions taxes..”, ALMA (African Leaders Malaria Alliance) recently asked for “…innovative financing mechanisms, including introducing levies on financial transactions…” to further scale up and sustain malaria control efforts.

Do you share that revenues from a Financial Transaction Tax (FTT) would be a suitable resource for the European Union to partly allocate to  Global Fund needs for malaria fight?  

Jorgen Stassijns: I am a technical expert, not involved as such in financing mechanisms, so I can’t give a relevant opinion on that topic.

 GESPAM: What about MSF position regarding cheap for malaria medicines currently being rolled out by emerging countries’ industries?

Jorgen Stassijns: MSF position has always been clear: patients suffering from malaria should have access to good quality antimalarial medicines. As MSF, we have put in place a system of quality control and work with validated manufacturers, some of them based in emerging countries.

GESPAM: Do MSF functions include partnerships and collaboration with counterparts for malaria action?

Jorgen Stassijns: In its projects, MSF always works in close collaboration with or in support to the National Malaria Programs in the countries. We don’t have formal agreements or partnerships with other actors.   

GESPAM: Parasite resistance to artemisinins (the key compounds in artemisinin-based combination therapies) has now been detected in 4 countries of the Greater Mekong subregion: Cambodia, Myanmar, Thailand and Viet Nam.

What extent are counterfeit and substandard medicines accountable for resistance?

 – Jorgen Stassijns: This is probably one of the causes of the emerging resistance, together with other factors such as the availability of monotherapies. However, considerable efforts are being done to ban monotherapies and substandard drugs. In Cambodia for example, mechanisms have been put in place to provide the private sector – treating the majority of malaria cases – with quality antimalarial drugs. In Africa, resistance to artemisinin has not been documented (yet), but similar risk factors are present and everything should be done to avoid that resistance spreads to Africa.

GESPAM: As per recent WHO release, “…Tracking progress is a major challenge in malaria control. At present, malaria surveillance systems detect only one-tenth of the estimated global number of cases. In as many as 41 countries around the world, it is not possible to make a reliable assessment of malaria trends due to incompleteness or inconsistency of reporting over time…”.

 As such, how to strengthen malaria surveillance and ensure that interventions are delivered to areas where they are most needed?

  Jorgen Stassijns:  Putting in place a performing surveillance is challenging and requires resources,  but is a key intervention that allows to monitor the progress in malaria control.

GESPAM: As recently stressed “…children with no immunity who have been protected over the past three years are beginning to get exposed, and the number of malaria cases among young children is expected to increase significantly this year if replacement nets do not come..”.

What about in your experience?

Jorgen Stassijns: Long Lasting Insecticide Treated Nets (LN) are considered as one of the most effective tools for the prevention of malaria, but their lifetime is about 3 years. Therefore, regular replacement of the LN is needed. In some of the countries we’re working (Niger, DRC), funding for LN is insufficient and this could indeed have a negative impact on the malaria burden, and increase the number of cases.

GESPAM: Thank you Mr. Stassijns for your insightful answers.

News Link n. 41

 

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries.

 

News Link 41

Water cooperation is an imperative for a better future for all

CIDA no more 

POPE FRANCIS: ‘HOW I WOULD LIKE A CHURCH WHICH IS POOR AND FOR THE POOR!’

Research-based Pharmaceutical Industry and International Federation of Red Cross and Red Crescent Societies Join Forces to Prevent Non-Communicable Diseases  

Global health diplomacy: advancing foreign policy and global health interests  

U.S. CONGRESS PASSES BILL MAINTAINING FULL SUPPORT FOR GLOBAL FUND

US Supreme Court To Hear Arguments On Pay-For-Delay Drug Deals

Tackling poverty and disease with innovative health financing 

Role of Environment in Tackling Poverty in Focus at Discussion on Post-2015 Global Development Priorities

At US-Led Workshop, African Stakeholders Call For “Home Grown IP Agenda” 

How a new trade agreement will hurt the poor’s access to medicines  

KEI notes on the 16th Round of Trans-Pacific Partnership Agreement (TPPA) Negotiations in Singapore  

Japan Announces Goal of Joining Trans-Pacific Trade Talks 

BRICS Bank Provides Opportunities for Africa

Strengthening the Expanded Programme on Immunization in Africa: Looking beyond 2015

 –Accesso alle vaccinazioni nelle popolazioni migranti: convegno Roma 16 – 17 aprile 2013 ISTITUTO SUPERIORE DI SANITA’

Task shifting. L’arte (e la necessità) della delega 

Cure primarie. Confronto shock tra UK e USA 

World Health Organization and Global Fund cite tuberculosis threat

Director-General’s message on World TB Day 

Tuberculosis current concepts    

TB is a leading, but underdiagnosed, cause of child mortality

African Health Ministers Commit to Ramped Up TB/HIV Treatment

Tuberculosis: Europe’s Ticking Timebomb 

EU’s new research mechanism ‘complex and narrow’

‘One step more for realizing the rights and dignity of women and girls’

Analysis: Nepal’s maternal mortality decline paradox 

African Ministers Focus On IP Role In Innovation For Development; Less On Flexibilities  

Richard Smith: Nestlé—a force for good or ill?

 

 

 

 

 

WTBD press briefing at the UN Palais, 18 March 2013

Ladies and gentlemen, let me get into some specifics about the results of the joint work with the Global Fund on estimating the anticipated demand for international funding between 2014 and 2016 in 118 countries eligible to receive financing from the Global Fund. 

 


WTBD press briefing* at the UN Palais, 18 March 2013 

by Mario Raviglione, Director Stop TB Department 

World Health Organization


• Ladies and gentlemen, let me get into some specifics about the results of the joint work with the Global Fund on estimating the anticipated demand for international funding between 2014 and 2016 in 118 countries eligible to receive financing from the Global Fund. 

• Given the upcoming GF pre-replenishment conference in April aiming at raising the necessary resources for the global fight against HIV, TB and Malaria, we estimated the total funding needs, the amount of domestic resources that could be mobilized and the anticipated demand for international funding to close remaining gaps.

• We estimate that about 4.8 Billion US$ is required every year for proper TB care and control efforts. If we assume that countries will continue to increase, to their ability, their domestic investments, we are left with an anticipated demand for international funding of 1.6 Billion US$ per year.

• Of this gap for international funding, 900 Million US$ (almost 60%) is for African countries, that include most of the world’s low-income countries.

• The two areas with the greatest need of increased investment are (1) MDR-TB treatment, with 1.3 Billion US$ needed per year, and (2) the expansion of new rapid diagnostic and associated laboratory strengthening, with 600 Million US$ per year. 

• Of course, the largest investment remains that of the core essential elements of good TB care and control, that also prevent MDR-TB from emerging, that amount to 2.6 Billion US$ per year. 

• If we collectively succeed in mobilizing all the necessary resources, domestically and internationally, and fill all the gaps, then 17 Million people will be treated between 2014 and 2016, thus saving 6 Million lives.  

* published with permission