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Promoting access to medical technologies and innovation. Intersections between public health, intellectual property and trade.
Geneva, Switzerland, World Health Organization [WHO], 2012.  p.Medical technologies -- medicines, vaccines and medical devices -- are essential for public health. Access to essential medicines and the lack of research to address neglected diseases have been a major concern for many years. More recently, the focus of health policy debate has broadened to consider how to promote innovation and how to ensure equitable access to all vital medical technologies. Today’s health policy-makers need a clear understanding both of the innovation processes that lead to new technologies and of the ways in which these technologies are disseminated in health systems. This study captures a broad range of experience and data in dealing with the interplay between intellectual property, trade rules and the dynamics of access to, and innovation in, medical technologies. The study is intended to inform ongoing technical cooperation activities undertaken by the three organizations (World Trade Organization, World Intellectual Property Organization and World Health Organization) and to support policy discussions. Based on many years of field experience in technical cooperation, the study has been prepared to serve the needs of policymakers who seek a comprehensive presentation of the full range of issues, as well as lawmakers, government officials, delegates to international organizations, non-governmental organizations and researchers.
Journal of Health Care Finance. 2010; 36(4):75-79.When the United Nations declared "health care for all" (at the conferences at Alma-Ata in 1978 and the Ottawa Charter in 1986),(1) the declarations were largely premature to impact the upcoming HIV/AIDS epidemic. These UN declarations still apply today, as multitudes of humanity continue to die from what amounts now to be a treatable chronic disease. Can the wealthier, industrialized countries stand by and watch the decimation of the populations of the developing world by HIV / AIDS? The global "health 9/10 gap," relates that only 10 percent of global heath resources go to developing countries - i.e., those having 90 percent of the poorest world populations. (2) The World Bank/World Health Organization has been at the forefront of providing resources for the global HIV/AIDS epidemic, (3) but for many countries of the developing world (especially Sub-Saharan Africa) it may be too little, too late. This work explores the application of an ecological model to global policy against HIV/AIDS, highlighting access to antiretroviral drugs (ARV). ARV distribution is constrained by patents and laws protecting the intellectual property rights of the international pharmaceutical corporations. In response to this situation, more questions arise. Will governments in the developing world invoke compulsory licensing (patent-breaking) in their negotiations with the international pharmaceutical corporations to provide medications against HIV/AIDS in their countries? Can international political and financial negotiations with these pharmaceutical corporations speed the growing push for a solution to this solvable crisis? The answers may lie in the "Brazilian model," that is a developing world government using all means available to provide ARV drugs for all its citizens with HIV/AIDS. The basis of this model includes negotiating with the pharmaceutical corporations over patent rights and importation of copied drugs from the Far East.
[Wellington, New Zealand], Family Planning International, 2006 Dec. 27 p.This report focuses on the relationship between policies implemented by the World Trade Organisation, World Bank, and the International Monetary Fund, and access to health, particularly sexual and reproductive health. .
Political Declaration on HIV / AIDS. Draft resolution submitted by the President of the General Assembly.
New York, New York, United Nations, General Assembly, 2006 Jun 2. 8 p. (A/60/L.57)We, Heads of State and Government and representatives of States and Governments participating in the comprehensive review of the progress achieved in realizing the targets set out in the Declaration of Commitment on HIV/AIDS, held on 31 May and 1 June 2006, and the High-Level Meeting, held on 2 June 2006. Note with alarm that we are facing an unprecedented human catastrophe; that a quarter of a century into the pandemic, AIDS has inflicted immense suffering on countries and communities throughout the world; and that more than 65 million people have been infected with HIV, more than 25 million people have died of AIDS, 15 million children have been orphaned by AIDS and millions more made vulnerable, and 40 million people are currently living with HIV, more than 95 per cent of whom live in developing countries. Recognize that HIV/AIDS constitutes a global emergency and poses one of the most formidable challenges to the development, progress and stability of our respective societies and the world at large, and requires an exceptional and comprehensive global response. (excerpt)
The role of civil society in protecting public health over commercial interests: lessons from Thailand.
Lancet. 2004 Feb 14; 363(9408):560-563.In October, 2002, two Thai people with HIV-1 won an important legal case to increase access to medicines. In its judgment in the didanosine patent case against Bristol-Myers Squibb, the Thai Central Intellectual Property and International Trade Court ruled that, because pharmaceutical patents can lead to high prices and limit access to medicines, patients are injured by them and can challenge their legality. This ruling had great international implications for health and human rights, confirming that patients—whose health and lives can depend on being able to afford a medicine—can be considered as damaged parties and therefore have legal standing to sue. The complexities of pharmaceutical intellectual property law are most poorly understood by those most affected by their consequences—the patients who need the drugs. The Thai court case was the outcome of a learning process and years of networking between different civil society actors who joined forces to protect and promote the right of access to treatment. Our Viewpoint, based on key interviews and published reviews, summarises the efforts of civil society in Thailand to achieve a fair balance between international trade and public health. These efforts have focused on didanosine, an essential antiretroviral drug that in Thailand has become symbolic of how multinational companies and governments of industrialised countries protect their own interests at the expense of access to essential medicines for the poor. (author's)
AVSC NEWS. 1997 Summer; 35(2):1, 8.Two recent laws adopted by the Colombian Ministry of Health have had a detrimental effect on access to family planning (FP) services and have affected AVSC's work in that country, which is widely regarded as a trendsetter in reproductive health and FP among Latin American nations. One of the laws, which went into effect in 1993, provides universal health care regardless of ability to pay and allows people to choose between public or private health facilities. This law fails to specify, however, which FP services are covered, and the new agencies that act as liaisons between individuals, employers, and hospitals or clinics are unwilling to provide coverage for sterilization or contraception. Individuals who have paid for insurance resist paying an extra amount for contraception. The other law, enacted in 1991, restricts the delivery of anesthesia to anesthesiologists. In hospitals without full-time anesthesiologists, this has impeded delivery of many outpatient surgical procedures or treatment of incomplete abortion. It also prevents performance of female sterilization under local anesthesia. The laws have halted much of AVSC's work in establishing services for female sterilization under local anesthesia in public hospitals. AVSC has responded to the laws by working to help public and private sector providers manage the changes, producing a public information brochure, disseminating the law to service providers, and training anesthesiologists to promote female sterilization. In 1996, the 1993 law was clarified to ensure access to reproductive health and FP services.
IPPF COUNTRY PROFILES. 1992 Aug; SAR 19-24.In 1984 in Pakistan, the government's Council of Islamic Ideology banned contraception unless pregnancy would jeopardize a woman's life. The government soon realized that its 2.9% population growth rate was too high to achieve social and economic development, so it implemented a national population policy, hoping to reduce population growth to 2.5% by 2000. The policy calls for a multisectoral approach, emphasizing mobile services to promote birth spacing and maternal and child health and providing family planning services through the public and private sector and family welfare centers. The policy also aims to increase literacy, reduce unemployment, and improve health care. It targets rural areas where 72% of the population lives. In 1989, only 9.1% of 15-49 year old married women used contraceptives and 58.6% wanted to control their fertility but did not have access to family planning information and services. Pakistan depends greatly on the family planning services of the nongovernmental organization. Family Planning Association of Pakistan (FPAP). FPAP introduced family welfare centers, social marketing, and reproductive health centers to Pakistan. It continues to introduce new contraceptives. FPAP's major projects include educational programs in population, family planning, and nutrition; family planning training; promotion of family planning and maternal and child health; programs emphasizing male involvement in family planning; information, education, and communication; and lobbying Parliament for more funding for family planning and for improvement in women's status.
International Family Planning Perspectives. 1986 Jun; 12(2):49-53.The Convention on the Elimination of All Forms of Discrimination Against Women was adoptedin in 1979 by the UN Gereral Assembly and came into force in 1981. By May 1986, 87 countries had ratified and in so doing become states parties to it. The Forward looking Strategies for implementing the goals of the UN decade for women outline measures that countries must take by the year 2000 to achieve equality between men and women. The Strategies was adopted by over 150 countries in 1985 in Nairobi and endorsed subsequently by UN General. This article discussedes how the Convention and the strategies can be used to promote family planning (FP), reproductive rights, and maternal health. The covention requires states parties to ensure equal access of men and women to health and FP services. The article outlines the many practices and policies that enhigbit equal access to FP services. For example, in some nations, husbands but not wives are allowed to obtain contraceptives without spousal authorization; in others unmarried men but not unmarried women may obtain contraceptives. The strategies recognize that adolescent pregnancy has adverse effects on the morbidity and mortality of mothers and children and requires nations to provide contraceptives on an equal basis to adolescent men and women. The article concludes by explanining that states parties to the convention must report to the committee on the Elimination of Discrimination Against Women, established by the convention, on steps they have taken to eliminate discriminatory practices in health care and FP specifically and other fields generally, and outlines what FP organizations can do to assist in that reporting process. (author's modified)
Journal of Family Law. 1981-1982; 20(2):241-61.Abortion, a topic which challenges the religious and moral values of many individuals, has an impact on population control relied upon by some nation-states in achieving economic and social development. This is seen in India, and previously in the Eastern European states of Czechoslovakia, Bulgaria, East Germany, Hungary, Poland and Romania after WW II. In these states abortion is accepted largely for economic reasons. Abortion has strongly emerged as an issue in the development of international law, particularly in the area of human rights. This article studies that emergence by looking at the right to privacy, its expression in various human rights documents, and both the restrictive and liberal view of its application to woman's right to terminate a pregnancy, without external interference. The fetus' right to life is discussed and finally the interests of women, the fetus, and the public are analyzed to determine the importance of each of these interests to world peace and public order. International human rights agreements, e.g., the Universal Declaration on Human Rights, express the right to privacy in general terms, making it difficult to determine the scope of the right. In a case brought before the European Commission on Human Rights, 2 West German nationals' claimed the scope of the right to privacy includes the right of the woman to decide whether to terminate her pregnancy the commission held that such interference was not a breach of the woman's right to respect for her private life. The primary goal of human rights is to establish maximum respect for the individual and it is in this context that the right of a woman to choose to terminate a pregnancy is analyzed. Autonomy is an element of respect for the individual. Denying women the legal right or information to control fertility limits their ability to control their health, educational, political, social and cultural status. The fact that fertility control substantially affects the status of women is recognized in international human rights agreements. Sex equality is achieved by giving women the right to abortion. Legal proscriptions against abortion are inconsistent with the goals and objectives of human rights, especially the individual woman's right to respect and autonomy.