Professor Brook K. Baker, Northeastern U. School of Law
Policy Analyst Health GAP
Full Paper – PDF
On or about March 18, 2014, a third draft of the renamed “equitable access” proposal was released by Mark Dybul, Executive Director of the Global Fund, to partners for further input. If anything, this third draft, the text of which is attached , is worse than the previous two drafts:
- The equitable access objectives of the Task Force are less tiered-pricing centric, but tiered pricing is still hard-wired in as the single solution that the proponents continue to champion.
- A key intervention mentioned in the second draft has been deleted, namely IP reform and increased and coordinated use of TRIPS public health flexibilities. This is an intentional exclusion and cannot be justified – overcoming IP barriers is in many circumstances to only way to increase affordability.
- Most of the proposal addresses the needs of poor people in MICs as if the problem of access to needed health products has been met in LICs, which is clearly untrue.
- The focus on “basic” medicines only is highly undesirable. The focus should be on all needed medicines, including medicines for infectious diseases, childhood diseases, neglected diseases, chronic and non-communicable diseases, etc.
- Low- and middle-income governments should be in the driver’s seat in articulating needs, solutions, and flexibilities; they are inappropriately excluded from input in the concept paper that will guide the Task Force.
- Private industry’s interests are unduly reflected in this draft and industry inappropriately has a key place on the Task Force; instead, originators and generics should be excluded except with respect to consultations.
- Other listed partners have been given an illusory and bizarre option of presenting one issue that needs to be addressed as a means of ensuring their buy-in to the Task Force proposal; this is not an evidence-based way to develop a well-considered list of equitable access options.
- The idea of a WTO enforcement mechanism has been dropped but the WTO is still inappropriately listed as an interested institution.
Listed partners and countries should rebel against this ill-conceived top-down proposal and insist on a country-led process that considers the broad range of options available to countries to ensure equitable access to affordable medicines needed for all health conditions.