Exclusive: Draft UN Text on TB No Longer Carries Provisions on Affordable Medicines

India and other developing countries had been resisting US pressure to dilute the global declaration but it seems like the text is being diluted.

New Delhi: Officials from around the world have been debating for two months now, the text of the final declaration which will be released at the first-ever UN General Assembly High Level Meeting on Ending Tuberculosis, in September this year.

The Wire has reviewed the current draft of the declaration – one of the last iterations of it – which was prepared on Friday, July 20. This draft will probably be discussed in what may be the last round of talks on Monday.

The draft has completely dropped critical language which developing countries were fighting for – language that would affirm the rights of these developing countries to access affordable medicines via TRIPS (Trade-Related Aspects of Intellectual Property Rights) flexibilities.

Developing countries like India, Brazil, South Africa and Egypt had been pushing back against the US, over the last two months of talks so far.

While the US did not want the declaration to mention TRIPS flexibilities, these countries along with others in the G-77 and the EU had so far been resisting the pressure. Previous drafts of this text had included mentions of TRIPS flexibilities.

The lack of mention of TRIPS flexibilities in this draft, at this final stage, has caused alarm in the global public health community, which has been watching the negotiations closely. The fear is that the US has managed to strong-arm developing countries, against their best interests, to give up affirmations to affordable access to medicines for TB.

The matter should be of urgent concern to India as the government has committed to eliminating TB by 2025, even though the global goal for this has been set as 2030.

A press release from Medecins Sans Frontières said,

“The U.S. is exerting extreme pressure on other negotiators by refusing to sign the declaration at the U.N. General Assembly in September if language such as paragraph (PP19) that “recognizes the importance of affordable medicines” and “urges countries to enforce intellectual property rules in ways that promote access” is included.”

“We’re appealing to all countries, including those in the Group of 77, and Brazil, Russia, India, China and South Africa, that have a high burden of TB, to urgently stand up right now against bullying that aims to keep medicines out of the hands of your people who need treatment,” said Leena Menghaney, South Asia head of MSF’s access campaign.

Thiru Balasubramaniam at Knowledge Ecology International said, “The [Donald] Trump administration has engaged in a full court press to purge the political declaration of the UN High Level Meeting on Tuberculosis from references to the WTO Doha Declaration on the TRIPS Agreement and Public Health and the use of TRIPS flexibilities.”

In the area of public health, TRIPS allows countries certain flexibilities in order to protect their citizens from medicines being unaffordable due to patent monopolies. For example, it legally allows countries the ability to issue ‘compulsory licenses’ which can override patents, allow generic drugs and drop prices.

The UN High Level meet will release this ‘Political Declaration on Fight Against Tuberculosis’ in September. The text is vital because it will indicate the direction of the global community in acting against TB. It will cover areas such as research funding as well as development of new drugs and treatments.

What earlier drafts said

The Wire has reviewed versions of this “draft elements paper” from May 30, June 8June 25, July 10 and the current draft, from July 20.

As of the version on July 10, the provisions on TRIPS flexibilities were still maintained in the text, in the preambular as well as operative portions.

For example, the operative portion in this draft had a substantial section on TRIPS, with the EU and G-77 countries in support of keeping that language in, and the US stand on it being “delete para”.

“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…”

However, the July 20 draft does not have this section at all. It only mentions TRIPS flexibilities once, in the preambular section, and there is no mention in the important operative section:

“further recalling the 2001 WTO Doha Declaration on the TRIPS Agreement and Public Health which recognizes that intellectual property rights should be interpreted and implemented in a manner supportive of the right of Member States to protect public health and, in particular, to promote access to medicines for all, and that intellectual property rights are an important incentive in the development of new health products”

While the draft of July 10 had 31 operative provisions, the one on July 20 had 30, with the portion on TRIPS conspicuously missing.

The US media has been reporting on this matter. Earlier this month, STAT reported on US pressure on this declaration: “Amid growing frustration over the cost and development of tuberculosis medicines, the US government is pushing changes in global policy at a United Nations meeting.”

In June, Politico Europe reported that the US and EU were both trying to strike off language on “delinking” in this TB declaration. Delinking is the idea that research and development costs should not be linked to the price and volume of sales of a medicine, as this will keep the prices of medicines low.