TCS Daily

World Health Disorganisation

By Roger Bate - June 9, 2004 12:00 AM

What is the new head of the World Health Organisation is up to?

Dr. JW Lee, Director General of the WHO, has apparently lost his ability to check basic facts in an effort to placate his left-wing health activist allies and further a pointless agenda against western drug companies and their patents. It makes him look foolish, undermines the credibility of the WHO, damages drug company morale and goodwill, which is essential for further research into diseases that affect the poorest countries, and promotes the interests of groups that have been largely unhelpful in increasing access of the poor to drugs, but have been effective at sidetracking the world's media into concentrating on irrelevant issues. And with his colleague's latest announcement (and unfortunately by me drawing attention to it) WHO keeps patents central to a media debate about drug access when they should have long been discarded to old copy.

At issue is whether patented drugs lower access for the poor. Some drug patents are in effect for some drugs in some key countries, such as South Africa where most antiretroviral drugs (ARVs) are patented. It is possible, and occasionally demonstrable, that because of patents, drugs may be more expensive and hinder treatment. But on the whole they rarely exist in most poor countries and cannot account for lack of access to good treatment there.

In a recent study in the Health Affairs Journal it was demonstrated that, in the poorest 65 countries in the world, drugs on the WHO essential drug list were patented only 1.4% of the time. For ARVs the percentage is higher -- about 20%. But even where patenting is more widespread, as it is in South Africa (about 85% for ARVs), lack of access to drugs has little to do with patents. It has more to do with lack of political will, poor medical infrastructure and lack of trained staff.

Unfortunately the mistaken belief that ARV drug patents are the chief obstacle to effective treatment is not just confined to activist circles and left-wing media but even public announcements from the head of the World Health Organisation. At the World Health Assembly last month, Dr. Lee announced: "In March, the Government of Mozambique issued a compulsory license for manufacturing a triple combination of antiretroviral drugs to meet national needs. In doing so they became the first African country to take this important step in implementing the Doha Declaration.[1]"

What Dr. Lee and, amazingly, the Mozambican Government failed to realise was that the three HIV/AIDS drugs to be compulsorily licensed (lamivudine, stavudine and nevirapine) had never been patented in Mozambique - in other words, this 'important step' was pointless. Most ironically, the Mozambican Government promised to pay up to 2% royalties to the original patent holders - payments to which they are not entitled[2]. Given this folly from the Mozambican Government, repeated by the DG of WHO, it is not surprising that the world's media consider patents to be THE issue.

But Dr. Lee's colleagues are compounding his folly. On Tuesday in a World Health Organisation bulletin[3] Dr Kim (head of the HIV/AIDS program for WHO) stated that "Recent developments at the World Trade Organization have allowed poor countries -- in the event of a pandemic like HIV/AIDS -- to import generic drugs made under compulsory licensing, if they are unable to manufacture the medicines themselves. Several countries are doing this now."

Not only has Mozambique not compulsory licensed a patented medicine, as alleged by Dr. Lee, but no other country has enacted compulsory licensing, either. Dr. Kim is talking rubbish, too.

It is a real mess when the WHO's top men in the field cannot even have their staff check the veracity of their statements. Its time the WHO lost all its AIDS funding until it demonstrates an ability to deal with the disease and not just play to the activist crowd.

Roger Bate is a visiting fellow of the American Enterprise Institute and a director of health advocacy group Africa Fighting Malaria.


[1] 18th May 2004 speech to 57th WHA.

2 Compulsory Licence no 01/MIC/04



TCS Daily Archives