UN Political Declaration on TB Likely to Be Re-Opened, With Pushback Against the US

South Africa has “broken silence” on the UN’s declaration on TB, and the draft will be re-opened for talks.

New Delhi: The UN has released the final draft of the political declaration on the ‘Fight against Tuberculosis,’ dated July 20.

The Wire had secured one of the last iterations of this declaration and broke the story last week: After two months of negotiations and pressure from the US on developing countries, the final versions did not have references to TRIPS (Trade-Related Aspects of Intellectual Property Rights) flexibilities, even while several earlier iterations did.

The UN’s public release of this draft – versions of it were so far only being leaked to the public – triggered what is known as a period of “silence.” The draft was “under silent procedure” until late evening on Tuesday. This period is for delegations to obtain final approval from their governments.

But soon after this period ran out, South Africa has now reportedly broken the silence, by expressing objection to the text of the final published draft. Breaking the silence is considered a rare action at these discussions.

South Africa’s bold stand will re-open the text for negotiations. The text has already been negotiated in New York for the last two months with officials from around the world, including India.

What has India been saying in New York?

While there has been speculation that India also took a bold stand along with South Africa, Indian officials at India’s Permanent Mission to the UN have declined to confirm this.

However, two senior officials posted to India’s Permanent Mission to the UN in New York, have said differing things about the status of the negotiation.

One said, “Negotiations are not on for now as differences remain” and “Negotiations are not moving anywhere.” Another official involved in the process said, “The negotiations on the issue are underway.”

Sources told The Wire that while developing countries like India, Brazil and South Africa had been resisting the removal of references to TRIPS flexibilities until the end, India then capitulated – India agreed to drop the references to this from the operative section of the text and contend with just one passing reference to this, in the perambulatory section.

Significantly, one of the senior Indian officials also said that the G77 countries are looking at a harmonisation across two political declarations which are currently being hashed out at the United Nations – one on non-communicable diseases (NCDs) and this one on TB: “It is a complex process with two negotiations going on simultaneously – TB and NCDs. The G77 had already asked for extension of silence on TB so as to work on a common strategy on both TB and NCD.”

Civil society watchers have raised issue with drafts of the NCD declaration as well, saying that it doesn’t have enough of a focus on affordability of medicines, with patents being an obstacle to that. The Indian bureaucrat’s comments are significant because while TB is seen as the developing world’s burden, NCDs affect developed countries and developing countries both. And a “common strategy” in these two agreements would need to see harmony on issues of affordability of medicines, for both NCDs and TB, which will impact both developed and developing countries.

South Africa, on the other hand, has been pushing ahead at a fast pace, in tackling its tuberculosis burden. Last month the South African government released data and a statement on the results of the introduction of new TB drug bedaquiline, into the treatment regimens of South African TB patients. Of 200 patients put on the drug, three-quarters of them had a “favorable outcome” including “cure and treatment completion.”

With its TB burden being the highest in the world, India has committed to eliminate tuberculosis by 2025, even though the global commitment on this has been set to 2030.

Global activists have already begun to put pressure on governments as well as Janssen, the pharmaceutical company which manufactures bedaquiline, to drop prices on the drug.

TRIPS is a multilateral agreement with members of the World Trade Organisation. It deals with intellectual property and among other things, it extends rights and benefits to developing countries to control the prices of medicines and keep them affordable.

Having language that reaffirms commitments to TRIPS flexibilities, matters to developing countries, who not only struggled to get these provisions introduced into the TRIPS but now struggle to keep that in the memory of big countries like the US.

“Constantly removing this language, over time, dilutes the global belief and commitment to TRIPS,” said a researcher on trade and patent issues, speaking on the phone from Geneva.

One of the last mentions of TRIPS flexibilities in the operative portion of the global declaration, was in the draft of July 10, which The Wire reported on Saturday. It had said:

“The use to the full, of existing flexibilities under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) specifically geared to promoting access to and trade in medicines; and ensure that intellectual property rights provision in trade agreements do not undermine existing flexibilities, as confirmed in the Doha Declaration on the TRIPS Agreement and Public Health…”