The document discusses how international organizations like the WTO and treaties it has established like TRIPS and GATS impact healthcare. The WTO aims to liberalize trade and its dispute process enforces agreements. TRIPS established intellectual property standards that require drug patenting, raising prices. Some countries like Brazil and South Africa have issued compulsory licenses to produce cheaper generics, facing opposition from pharmaceutical companies but helping improve access to treatment.
5. WTO
World trade organisation
Founded in 1995 from GATTs
the only international organization dealing
with the global rules of trade between
nations. Its main function is to ensure that
trade flows as smoothly, predictably and
freely as possible.
Trade liberalization
6. How the WTO works
Rounds of negotiations
One member one vote
Creates treaties
Binding rules
7. Why it has such and impact
It has Bite
Trade courts punishes infringements
Treaties prevent evasion of free trade
promises
Countries monitored in periodic reviews
8. Infringements
Countries can say that another country has
broken the agreements
A review
A panel decides
decision
9. SO … how does all this impact on
health?
BRAINSTORM
10. Two explicit ways!
General Agreement on Trade in services
(GATS)
Trade related intellectual property rights
(TRIPS)
11. GATS
General agreement on trade of services
What is a service?
– Anything that you can’t drop on you foot (160
categories)
Health as a service
12. GATS…
Doesn’t force health services into agreement
If put health in the agreement – can’t take it
out
13. TRIPS
Trade related intellectual property rights.
Treaty signed in 1994 as a result of the Uruguay
round.
Sets standards for patenting
Based on industrial country standards
Developing countries were given a grace period to
bring their practices in line
Dictates the minimum protection required by each
member on intellectual property
14. To make you think
‘Our combined strength enabled us to
establish a global private sector-government
network which laid the groundwork for what
became TRIPS’
– Edmund Pratt, CEO, Pfizer
15. Patents
Grants monopolies
Patent on process and product (article 28)
The patents last for 20 years (article 33)
16. So what does this mean?
Drug prices are high – set by pharmaceutical
companies
People and governments can’t afford them
17. Alarm bells!!
Only started ringing after the ‘ink was dry’ on
the agreement
– consumer groups
– developing country generics industry
– groups campaigning on ‘patenting of life’
– HIV crisis
Agreement followed by renewed pressure for
TRIPS compliance from US
18. Doha Round
Reinforced flexibility within TRIPS
Recognised need to protect public health
Encourage research and development
19. Compulsory licenses
Countries can issue them
Have to have legislation
6 month rule
How to produce them?
Canada and India
20. So why aren’t there lots of generics?
Difficult to produce
Complicated process
Uphill struggle
21. Who has taken advantage?
Malaysia issued a compulsory license in
2004
Cost of ARV’s is 17.4% of the cost in 2001
Six times the people are treated for the same
money
Patent holders also dropped their prices
22. Brazil
Health minister announced a compulsory license
Drug companies reacted
Drug prices cut by pharmaceutical companies – 40%
in some cases
Providing free ARV treatment
Can legally make or import generic drugs if the
patent holder doesn’t manufacture it locally within 3
years
23. South Africa
Pharmaceutical companies brought a court case
(Pharmaceutical Manufacturers Association)
Part of the legislation in SA does not fit in with TRIPS
– giving health minister the right to import generic
drugs
Supported by WHO
Lots of international pressure
Dropped the case and paid the costs
24. New treaties
Regional free-trade agreements - IP included
under the agreement
– US proposals would
restrict grounds for compulsory
licensing
extend patent holders monopoly
beyond 20 years