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Address of the Permanent Observer of the Holy See to the United Nations in Geneva - One-third of the population without medicine
Mr. President,
I join previous speakers to congratulate you on your
election. The World Health Organization (WHO) estimates that about one-third of
the population lacks regular access to essential medicines and vaccines. It
believes that 10 million lives could be saved annually if such resources were
more readily available.
The Least Developed Countries (LDCs),
as the poorest and weakest segment of the international community, are most
vulnerable. The
classification of LDCs is contingent on a number of key human development
indicators, including levels of poverty, literacy and infant mortality. At the
beginning of the Millennium, the Least Developed Countries enjoyed the
strongest and longest growth rates since the 1970s, benefiting from sustained
global growth, surging commodity prices and buoyant capital flows. Between 2000
and 2008, the average annual growth of this Group’s real gross domestic product
(GDP) exceeded 7 per cent, raising hopes that some LDCs may be able to graduate
from this category within the present decade. However, with the global
financial crisis in 2008 and the drastic change in external conditions, LDCs
have experienced a slowdown of economic activity. As a result, their economic
growth has been much weaker during the past five years. It has been well below the target rate of 7
per cent annual growth established in the Istanbul Programme of Action (IPoA)
which is considered necessary for attaining the Millennium Development Goals
(MDGs).
With the recovery of the global economy remaining slow
and uneven, the LDCs faced a challenging international environment in
2013. This sluggish global economic
growth, which translated into weaker international demand for commodities and a
consequent decline in their prices, adversely affected the economic growth and
export performance of several LDCs. The outlook for the LDCs in the short and
medium term remains uncertain. While global output is expected to strengthen
moderately in the medium term, uncertainty about the pace and the strength of
the recovery persists. A fragile and uncertain global recovery could hinder
LDCs’ economic performance due to weak international demand and lower commodity
prices. Adjusting to a changing external environment has always been a key
challenge for these economies, but this is now exacerbated by a weak world
economy and prevailing uncertainties. The less favourable external environment,
coupled with LDCs’ weaker growth performance, suggests that achieving the MDGs,
or the SDGs that are planned to succeed them, will be difficult.
As underlined in the Istanbul Program of Action, LDCs
are the most “off-track” in the achievement of the internationally agreed
development goals. Their productive capacity is limited, and they have severe
infrastructure deficits[1].
In 2011, of the 34
million people living with HIV worldwide, some 9.7 million lived in LDCs. Of
these, 4.6 million were in need of antiretroviral treatment (ART); however only
2.5 million had received it[2].
Up to one-half of those deprived of treatment were expected to die within 24
months[3]. In the
49 countries designated as LDCs by the United Nations, non-communicable
diseases as well are rising much faster than in higher income countries.
Mr. President,
Some LDCs have used the transition period as a major
selling point for attracting investment in their local pharmaceutical industry[4].
However, some LDCs have provided patent protection for medicines despite the
availability of the transition period or have signed free trade and investment
agreements that may contain IP provisions curtailing any benefits arising from
the transition period. In this context, the report observed that the transition
period in itself, though important, will not be sufficient to attract generic
companies to invest in local pharmaceutical production[5].
However, the transition period is intended to provide LDCs with the necessary
policy space to take measures that would facilitate the growth of industrial
capacity in desired sectors without being impeded by the existence of patents,
which could hinder the development of the local industry.
Since 2000, there has been a noticeable decline in the
number of new HIV infections in LDCs since 2000, as in the developing world as
a whole, reflecting improvements in early diagnosis, access to treatment,
nutrition, and responsible behaviour change. However, despite such
improvements, the goal of universal access to anti-retroviral treatment is far
from achieved and requires continuing investment and both health and community
system strengthening. Moreover, the
deficiencies of health systems in LDCs
have been sharply highlighted during 2014 and 2015, in conjunction with the
significant outbreak of the Ebola Virus Disease in Coastal West Africa. Such
health emergencies could jeopardize, or
even reverse, the achievements of several LDCs in terms of human and economic
development.
We have before us a critical opportunity to help LDCs
to reach health and sustainable development goals and the failure to do so
could put millions of lives at risk. Access to adequate healthcare, including
affordable medicines, remains a key challenge in most LDCs. The current
flexible intellectual property arrangements for LDCs are a crucial tool for
improving health. In fact, the
flexibility agreed in TRIPS Article 66.1 has been accepted in recognition of
the economic, financial, and administrative constraints preventing LDCs from
immediate observance of all the obligations set out in the TRIPS Agreement. The
general transition period may be useful in supporting the development of a
strong chemical industry that could gradually move toward to production of API
(Active Pharmaceutical Ingredient). Long-term sustainability of the local
pharmaceutical industry would require the development of the internal capacity
to manufacture generic formulations thus reducing dependency and the high
import costs for obtaining APIs. In particular, there is a need to develop a
second line HIV treatment which, a present, is more than double the price of
the first line regime. Moreover, the
costs for a third line HIV treatment could be as much as 15 times the price of
first line treatment. Clearly, in this context, the establishment of a
pharmaceutical industry is particularly important.
Mr. President,
As clearly stated by the TRIPs Agreement, a
well-designed intellectual property system “should contribute to the promotion
of technological innovation and to the transfer and dissemination of
technology, to the mutual advantage of producers and users of technological
knowledge, in a manner conducive to social and economic welfare, and to a
balance of rights and obligations”[6].
In conclusion, Mr. President, the Holy See Delegation
hopes that a sense of common responsibility, as shown in the decision adopted,
will bring us all to recommend to the General Council a waiver for LDCs from
obligations under Articles 70.8 and 70.9 of TRIPS for as long as they remain
LDCs.
Thank you, Mr. President.
[1] Istanbul Plan of Action (par.4)
doc. A/CONF.219/3. http://ldc4istanbul.org/uploads/IPoA.pdf
[2]TRIPS transition period extensions for
least-developed countries, UNDP and UNAIDS Issues Brief,/13,
February 2013.
[3] Mr. Michel Sidibé, UNAIDS
Executive Director, Report to 31st UNAIDS Programme Coordinating Board,
December 2012, http://www.unaids.org/en/media/unaids/contentassets/documents/speech/2012/12/20121211_SP_EXD_31st_PCB.pdf
[4] UNCTAD (2011), Investment in
Pharmaceutical Production in the Least Developed Countries: A Guide for
Policymakers and Investment Promotion Agencies (UNCTAD Secretariat, Geneva, New
York), pp. 40-42, available at http://unctad.org/en/Docs/diaepcb2011d5_en.pdf
(last visited 3 June 2015)
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