Minister of International Development Ms Hilde F. Johnson

Beyond Cancun: Whose access counts?

The International AIDS Conference in Bangkok, 13. July 2004

Check against delivery

MDG Goal 8 - Making the Promise of Trade, TRIPS and Access to ARVs a Reality

MDG 8: “Develop a Global Partnership for Development”

“Develop further an open trading and financial system that is rule-based, predictable and non-discriminating”

Let me start by recalling the statement by Dr Sathirathai, the Foreign Minister of Thailand, on behalf of the Human Security Network last Saturday. The Human Security Network is an interregional network of 12 countries, including Norway and Thailand, and Dr Sathirathai expressed deep concern about the fact that the HIV/AIDS pandemic is posing a devastating threat to human security, undermining the prospects for socio-economic development, and affecting the ability and the right of HIV-affected people to live in security and dignity. He also addressed the factors hampering the availability, accessibility, affordability, provision and distribution of medicines for treating HIV/AIDS. The WTO rules are vital in this respect. I need only cite the WTO’s decision of August 2003 on the implementation of paragraph 6 of the Doha Declaration on the TRIPS Agreement and public health. This important decision must be followed up.

In May this year, Norway amended the Patent Regulations so as to authorise Norwegian companies to produce patented drugs for export to developing countries on the basis of compulsory licences, as from 1 August. I urge other developed countries to do the same. Norway is the only country apart from Canada, which is also a member of the Human Security Network, to have directly followed up the Doha Declaration on this point, according to which WTO member states have the right to implement rules that safeguard public health.

In no other area is this as crucial as when we are addressing HIV and AIDS.

• It is a fact that five to six million people will die within the next two years in low- and middle-income countries unless they receive antiretroviral treatment.

• It is a fact that the world community now has the possibility to save these lives, because treatment is available and the prices are more affordable.

• It is a fact that if we do not save these lives, in addition to the suffering of the victims themselves, millions of children will lose one or both parents, adding to the already unacceptable number of 14 million AIDS orphans world-wide.

• It is a fact that if we provide the drugs, HIV-infected people in their most productive years can continue to care for their children, produce food to feed their families, stay on as teachers or health workers, provide social and public services and thus help to maintain the fabric of their society and the economy of their country.

• It is a fact, as the Chair said, that out of the estimated six million people in poor countries in need of treatment, only 400 000 are receiving it today.

UN Secretary General Kofi Annan has put it this way: “People no longer accept that the sick and dying, simply because they are poor, should be denied drugs which have transformed the lives of others who are better off.”

Millennium Development Goal 8 is about global partnership. It is about the responsibility of rich and poor countries alike. It is about our willingness not only to take on this universal responsibility, but also to be accountable for our actions or our inaction.

In Monterrey we agreed on a global bargain. Poor countries would improve their governance and domestic policies. Rich countries would contribute policy coherence, improve their trade policies and increase their development assistance.

The WTO should therefore not only be a forum for negotiations based on national interests. It should be a forum for the promotion of policy coherence and development.

The HIV/AIDS pandemic is unlike anything we have ever seen. In sub-Saharan Africa it is said that one of the most lucrative businesses nowadays is the manufacture of coffins. Unless something is done by the world community, this business will continue to flourish.

There is only one way to alter the fate of the six million victims: access to life-saving drugs.

Norway has been a key player in the work in the WTO to ensure that the patent system actually is supportive of – rather than an obstacle to – measures to protect public health. The WTO Ministerial Declaration in Doha in 2001 on the TRIPS Agreement and public health, together with the WTO General Council Decision of 30 August 2003 permitting the export of essential drugs on the basis of compulsory licenses, have provided the TRIPS Agreement with the necessary flexibility.

The possibility of using compulsory licenses for the export of essential drugs will facilitate voluntary agreements with pharmaceutical companies on the sale of essential drugs to developing countries at affordable prices.

Norway is also in favour of amending the TRIPS Agreement to include this exception to the WTO rules. This would be the best solution, since we need to be able to make full use of this exception.

To make this work, the developing countries themselves must also play by the rules, by introducing adequate measures to prevent the re-export of such medicines to countries where they can obtain higher prices. There have been several examples of this practice.

However, I am pleased to be able to say that even with the grim facts and figures before us, there are grounds for cautious optimism:

• The adoption of the Doha Declaration indicates that a systematic approach is being followed in the WTO.
  
• The prices of generic drugs have been dramatically reduced, especially through the efforts of producers in Brazil and India and of people like US President Bill Clinton, with whom Norway has been co-operating closely. We will now be working together to provide care and treatment for those infected with HIV in Tanzania, Mozambique and Russia.
  
• Funds have been mobilised on a global scale through the GFATM, the WHO “3 by 5”initiative, President Bush’s PEPFAR Initiative and the Clinton Foundation.
  

These measures will help to provide care and treatment for the poorest victims of the AIDS pandemic.

But we still have a good way to go. I see five main challenges:

1. More must be done by donors: they must provide resources, health care and workers. And they must co-ordinate their efforts to help those in need.
   
2. The WHO’s role as a guarantor of the quality of recommended drugs must be recognised at the global level. This will increase the accessibility of these drugs.
   
3. Poor countries must not be coerced into concluding bilateral free trade agreements that restrict the application of the WTO General Council Decision to implement paragraph 6 of the Doha Declaration on TRIPS and public health. This is critical. The exception must be a reality, not just a symbol.
   
4. The poor countries themselves must demonstrate leadership and resolve, by improving their health services.
   
5. Treatment and care to HIV- and AIDS-afflicted people must be delivered on an equal basis, and must take into account the special needs of women and girls.

Only if rich and poor countries alike hold themselves accountable for achieving MDG 8 – for forming the global partnership – will we all be able to deliver on our promises.