[e-drug] WHA press release and resolutions

["Andy Gray" <andy@healthlink.org.za>]

E-DRUG: WHA press release and resolutions
------------------------------------------
[crossposted from DRUGINFO with thanks to Andy
for being the correspondent in Geneva. 
2 messages in 1. NN]

Hi all

As always, it's worthwhile seeing how WHO's own PR efforts 
portray the outcomes of the Assembly. A press release (available 
at  http://www.who.int/inf-pr-2001/en/pr2001WHA-6.html) starts 
with the statement that: "After eight days of intense deliberations 
the 54th World Health Assembly closed its business in Geneva 
today. The biggest event in the annual calendar for the World 
Health Organization (WHO), the Assembly charts the global 
course for the Organization and its 191 Member States in dealing 
with major public health threats."

Here's how it portrays the Medicines Strategy resolution:

"Another important resolution linked to access to drugs was the 
one on WHO medicines strategy. Highlighting the fact that one-
third of the human population still lacks access to essential drugs, 
the resolution urges Member States to promote equitable access 
to medicines. It requests the WHO Director-General to "stimulate 
the development of drugs for diseases whose burden lies 
predominantly in poor countries" and to "enhance efforts to study 
and report on existing and future health implications of international 
trade agreements". It also speaks of the need for "systems for 
voluntary monitoring drug prices and reporting global drug prices 
with a view to improving equity in access to essential drugs in 
health systems"."

Two other sections have drug policy import. The first deals with 
suggested policy on schistosomes and soil-transmitted helminths:

"One-third of the world?s population is infected by schistosomes 
and soil-transmitted helminths worldwide with 300 million 
experiencing severe morbidity. These infections are invariably more 
prevalent in the poorest sections of the least developed countries. 
Repeated chemotherapy with safe, single-dose affordable drugs at 
regular intervals keeps the infection at bay. The Assembly adopted 
a resolution urging Member States to "ensure access to essential 
drugs against schistosomiasis and soil-transmitted helminth 
infections in all health services in endemic areas for the treatment 
of children, women and other groups at risk of morbidity, with a 
goal of attaining a minimum target of regular administration of 
chemotherapy to at least 75% of all school-age children at risk of 
morbidity by 2010"."

The second, which dominated the Assembly in many ways, related 
to the UN Secretary-General's speech and HIV:

"For the first time in the history of the Organization, the United 
Nations Secretary-General addressed the Assembly. In his AIDS-
focused speech, Mr Kofi Annan outlined the structure of a multi-
billion dollar Global AIDS and Health Fund to fight HIV/AIDS and 
"other infectious diseases that blight the prospects for many 
developing countries ? starting with TB and malaria".

In a resolution on the global response to HIV/AIDS, Member States 
to the Assembly called on WHO Director-General to "take an 
active part, together with other international actors, in the 
development and establishment of a global HIV/AIDS and health 
fund and to maintain close collaboration with the international 
community and the private sector with the aim of providing the 
availability of medicines for HIV/AIDS, including antiretroviral 
therapy"."

regards
Andy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Andy Gray
Discipline Chair: Pharmacy Practice
School of Pharmacy and Pharmacology
University of Durban-Westville
email: andy@healthlink.org.za
Tel: +27 31 2044358 Fax: +27 31 2044792

---

 
Hi all

All the resolutions passed by the 54th World Health Assembly are 
now available from the WHO web site. The specific URLs for those 
of relevance to drug policy are:

WHA54.10: Scaling up the response to HIV/AID
(http://www.who.int/wha-1998/EB_WHA/PDF/WHA54/ea54r10.pdf)

WHA54.11: WHO medicines strategy
(http://www.who.int/wha-1998/EB_WHA/PDF/WHA54/ea54r11.pdf)

The final resolution mentioned was that tabled by South Africa (on 
behalf of the Non-Aligned Movement) on "strengthening health 
systems in developing countries". The version adopted also shows 
the dead hand of compromise (WHA54.13: Strengthening health 
systems in developing countries; available at 
http://www.who.int/wha-1998/EB_WHA/PDF/WHA54/ea54r13.pdf).

In the first place, the preambulatory clause on globalization had a 
section added which noted that "globalization presents 
opportunities and challenges for all countries", before the 
statement that "developing countries, especially the poorest, are 
vulnerable to those effects of globalization that lead to greater 
inequities in health and health care". 

However, it does retain the direct statement that "lack of access to 
safe and affordable essential medicines and other health 
technologies is a significant factor in perpetuating and extending 
such inequities". 

Throughout the document, references to HIV/AIDS are extended to 
include "tuberculosis and other [priority/related] diseases". 

In another clause of the preamble, the resolution noted the 
resolution (2001/33) of the 57th session of the Commission on 
Human Rights on "access to medication". This now reads "access 
to care", a subtle but significant difference.

The most extensive change is in operative clause 3(3), which 
initially urged Member States to "ensure that ministers of trade 
adopt a decision on public health and the Agreement on Trade-
Related Aspects of Intellectual Property Rights at their forthcoming 
meeting, so as to address the issues of concern to developing 
countries in the area of access to essential medicines". This 
original wording appeared to acknowledge that the TRIPS 
negotiations in Doha (Qatar) in June will be led by Trade and 
Industry experts/ministers, rather than by Ministers of Health or 
their advisers. The clause finally adopted urges Member States "to 
participate in the special discussion of the WTO TRIPS Council on 
intellectual property issues relevant to the access to essential 
medicines, with a view to addressing the concerns expressed by 
developing countries". The primacy of health over economic 
concerns is somewhat lost.

Operative clause 3(5) initially urged Member States to "ensure that 
countries are not hindered in their efforts to use the options 
available to them under international agreements, including parallel 
importation and compulsory licensing, in order to protect and 
advance the access to life-saving and essential medicines". This 
has been weakened in that it now calls on them "to make every 
effort to ensure ...", but even more importantly, removes specific 
reference to PI and CL. 

The move to free member states from coercion was reinforced in 
operative clause 3(7), which initially urged Member States "to 
refrain from all measures, including unilateral coercive measures, 
that are contrary to international law, including international 
conventions, and which hinder health service delivery and deny 
care to those in greatest need". The final version has removed 
mention of unilateral coercive measures. That such measures have 
been resorted to cannot be denied, but whether they were ever 
contrary to international law is another question. The impression of 
a "sanitised" version of the resolution is nonetheless created.

The balance of the resolution remains largely intact, if innocuous. 

Finally, for those engaged with conflict of interest issues, the 
resolution on "Transparency in tobacco control process" 
(WHA54.18) can be read at http://www.who.int/wha-
1998/EB_WHA/PDF/WHA54/ea54r18.pdf - it calls for monitoring of 
linkages with the tobacco industry by all country delegations. The 
sense at the Assembly amongst public health NGO groupings was 
this vigour was not even-handedly being applied to other 
commercial interests, even where potential conflicts of interest 
were identified. 

regards
Andy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Andy Gray
Discipline Chair: Pharmacy Practice
School of Pharmacy and Pharmacology
University of Durban-Westville
email: andy@healthlink.org.za
Tel: +27 31 2044358 Fax: +27 31 2044792
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