The document discusses how international organizations like the WTO and treaties it has established like TRIPS and GATS impact healthcare. The WTO aims to liberalize trade and its dispute process enforces agreements. TRIPS established intellectual property standards that require drug patenting, raising prices. Some countries like Brazil and South Africa have issued compulsory licenses to produce cheaper generics, facing opposition from pharmaceutical companies but helping improve access to treatment.

1. WTO and Health

2. Introductions

3. Summary of the session
 International Organisations
 WTO
 GATS
 TRIPS
 Brazil
 South Africa
 Video!!!

4. International Organisations
What are they?
– UN
– WHO
– WTO

5. WTO
 World trade organisation
 Founded in 1995 from GATTs
 the only international organization dealing
with the global rules of trade between
nations. Its main function is to ensure that
trade flows as smoothly, predictably and
freely as possible.
 Trade liberalization

6. How the WTO works
 Rounds of negotiations
 One member one vote
 Creates treaties
 Binding rules

7. Why it has such and impact
 It has Bite
 Trade courts punishes infringements
 Treaties prevent evasion of free trade
promises
 Countries monitored in periodic reviews

8. Infringements
 Countries can say that another country has
broken the agreements
 A review
 A panel decides
 decision

9. SO … how does all this impact on
health?
BRAINSTORM

10. Two explicit ways!
 General Agreement on Trade in services
(GATS)
 Trade related intellectual property rights
(TRIPS)

11. GATS
 General agreement on trade of services
 What is a service?
– Anything that you can’t drop on you foot (160
categories)
 Health as a service

12. GATS…
 Doesn’t force health services into agreement
 If put health in the agreement – can’t take it
out

13. TRIPS
 Trade related intellectual property rights.
 Treaty signed in 1994 as a result of the Uruguay
round.
 Sets standards for patenting
 Based on industrial country standards
 Developing countries were given a grace period to
bring their practices in line
 Dictates the minimum protection required by each
member on intellectual property

14. To make you think
‘Our combined strength enabled us to
establish a global private sector-government
network which laid the groundwork for what
became TRIPS’
– Edmund Pratt, CEO, Pfizer

15. Patents
 Grants monopolies
 Patent on process and product (article 28)
 The patents last for 20 years (article 33)

16. So what does this mean?
 Drug prices are high – set by pharmaceutical
companies
 People and governments can’t afford them

17. Alarm bells!!
 Only started ringing after the ‘ink was dry’ on
the agreement
– consumer groups
– developing country generics industry
– groups campaigning on ‘patenting of life’
– HIV crisis
 Agreement followed by renewed pressure for
TRIPS compliance from US

18. Doha Round
 Reinforced flexibility within TRIPS
 Recognised need to protect public health
 Encourage research and development

19. Compulsory licenses
 Countries can issue them
 Have to have legislation
 6 month rule
 How to produce them?
 Canada and India

20. So why aren’t there lots of generics?
 Difficult to produce
 Complicated process
 Uphill struggle

21. Who has taken advantage?
 Malaysia issued a compulsory license in
2004
 Cost of ARV’s is 17.4% of the cost in 2001
 Six times the people are treated for the same
money
 Patent holders also dropped their prices

22. Brazil
 Health minister announced a compulsory license
 Drug companies reacted
 Drug prices cut by pharmaceutical companies – 40%
in some cases
 Providing free ARV treatment
 Can legally make or import generic drugs if the
patent holder doesn’t manufacture it locally within 3
years

23. South Africa
 Pharmaceutical companies brought a court case
(Pharmaceutical Manufacturers Association)
 Part of the legislation in SA does not fit in with TRIPS
– giving health minister the right to import generic
drugs
 Supported by WHO
 Lots of international pressure
 Dropped the case and paid the costs

24. New treaties
Regional free-trade agreements - IP included
under the agreement
– US proposals would
restrict grounds for compulsory
licensing
extend patent holders monopoly
beyond 20 years