Comment on the draft text of the agreement on the Free Trade Area of the Americas

Human Rights Watch -- HIV/AIDS Program
February 27, 2003

Principal concerns over the provisions of the draft FTAA agreement

The FTAA's "TRIPS-plus" provisions pose a significant danger to developing countries facing public health emergencies such as HIV/AIDS. Millions of people are infected or affected by HIV/AIDS in Latin America and the Caribbean, many of them subjected to violence, abuse, discrimination, and other human rights abuses. The Doha Declaration recognizes that an effective response to the AIDS epidemic requires flexibility in reconciling public health objectives with private intellectual property rights. A TRIPS-plus patent regime would undermine the Doha Declaration and constrain countries' efforts to promote the health and human rights of their citizens.

Latin America and the Caribbean still have an opportunity to avert an AIDS epidemic of the nature and scale witnessed in sub-Saharan Africa. In Brazil, extensive prevention efforts combined with state-funded antiretroviral treatment have, in the face of widespread poverty, reduced AIDS-related mortality by more than 50 percent since 1996. The cornerstone of Brazil's treatment program has been the local production of generic equivalents of brand name HIV/AIDS drugs, which has driven down the cost of antiretroviral treatment. Brazil's national AIDS strategy is within the reach of many Latin American and Caribbean countries. The public sectors in Argentina, Costa Rica, and Uruguay, all parties to the FTAA agreement, have already begun to provide free and universal antiretroviral treatment to their HIV/AIDS populations. Barbados, also a party to the FTAA and estimated to have a 1.2 percent HIV prevalence rate, is preparing to implement a national HIV/AIDS care and treatment program.

The Declaration on the TRIPS Agreement and Public Health (the Doha Declaration) clarified that TRIPS "does not and should not prevent Members from taking measures to protect public health." Instead, TRIPS "can and should be interpreted and implemented in a manner supportive of WTO members' right to protect public health and, in particular, to promote access to medicines for all." The Doha Declaration was agreed to by 142 WTO member states including the United States. It encourages states to make full use of the TRIPS provisions allowing for protection of public health interests, such as the following:

The principal thrust of the Doha Declaration is that any expansion of intellectual property rights must be balanced by the right of access to health care. Specifically, the Declaration reinforces the right of member states to use generic drugs and market competition to make the provision of medicines possible in situations of public health crisis. The Doha Declaration has been applauded and affirmed by a broad global consensus. In April 2002, the United Nations Commission on Human Rights passed by consensus a resolution welcoming the Doha Declaration and agreeing that "the TRIPS Agreement does not and should not prevent World Trade Organization members from taking measures to protect public health." The World Health Organization similarly lauded the Doha Declaration in a statement to the TRIPS Council in March of this year: "The Declaration enshrines the principle WHO has publicly advocated and advanced over the last four years, namely, the re-affirmation of the right of WTO Members to make full use of the safeguard provisions of the TRIPS Agreement in order to protect public health and promote access to medicines."

In addition to signing the Declaration, the United States further codified its commitment to Doha in its 2002 Trade Promotion Authority (TPA) Act, which specifies "respect for the [Doha] Declaration" as one of the objectives of the TPA. Meanwhile, the United States and other developed countries have continued to make use of the framework affirmed by the Doha Declaration for their own domestic purposes. When faced with an anthrax scare, both Canada and the United States used the threat of compulsory licensing to negotiate heavily discounted rates on Ciprofloxacin, an antibiotic that treats anthrax. President Bush recently introduced rules to quicken the approval of generic drugs in the U.S. market.

Despite the global consensus reached in TRIPS and Doha, the USTR continues to negotiate bilateral and multilateral agreements that go beyond TRIPS in their protection of pharmaceutical patents, including the FTAA. The USTR's negotiating objectives and the draft text of the FTAA disclose several ways in which the current FTAA draft would undermine the right of member states to protect public health:

Certain FTAA proposals would also expand investor protections against "expropriation." At their most extreme, such proposals could increase the compensation due to a patent-holder in the event of compulsory licensing from reasonable royalties, which are granted under TRIPS, to the full market value of a patent. Finally, some FTAA proposals would grant companies standing to sue governments in FTAA-specific tribunals for alleged violations of the investment chapter of the agreement. This new legal remedy would be over and above TRIPS' existing requirement that states provide domestic adjudicative relief for intellectual property infringements. As in other areas of the FTAA, these dramatic expansions of protections for patent-holders are likely to deter member states from successfully exercising their right to protect public health under Doha.

TRIPS-plus does not correspond with any new consensus about the appropriate balance between private intellectual property rights and public health. On the contrary, experience and research have only reaffirmed the potential dangers to public health of excessive patent protection. The Commission on Intellectual Property Rights, which was convened by the United Kingdom government and included a wide cross-section of experts, found in September 2002 that the international intellectual property system was a constraining factor on access to health care and health care technologies. The Commission stressed that profits from the global intellectual property system do "little to stimulate research on diseases that particularly affect poor people." The Commission explicitly affirmed the Doha Declaration, and encouraged developing-country governments to use compulsory licensing and generic competition to increase access to essential medicines.

The FTAA's TRIPS-plus proposals are particularly troubling given that the USTR itself, in the "negotiating objectives" section of the TPA, purports to be complying with the Doha Declaration. In fact, each of the foregoing TRIPS-plus proposals erodes the Doha Declaration by narrowing and deterring the exceptions whose full use Doha encourages. They do so despite a continued, widespread consensus that TRIPS exceptions provide an essential tool in the provision of affordable HIV/AIDS medicines. By advocating TRIPS-plus provisions in the FTAA, the USTR would betray its public commitment to helping developing countries fulfill their obligation to protect public health.

FTAA and human rights

AIDS is a fatal disease. The cost of impeding access to available and affordable AIDS medication is the sickness and premature death of millions of adults in the prime of their lives, with disastrous consequences for their children and their communities. In some countries, AIDS is threatening to wipe out generations of food producers and contribute to famine and further death. While access to affordable antiretroviral therapy is not a complete solution to these problems, it prolongs the lives of parents and extended families members, strengthens their ability to support their families and communities, and reduces much of the discrimination and stigma associated with the disease. As Brazil's experience has shown, antiretroviral therapy also enhances AIDS prevention efforts by creating an incentive to be tested for HIV and receive lifesaving information about the virus' transmission.

The International Covenant on Economic, Social and Cultural Rights (ICESCR) has been ratified by all thirty-four parties to the FTAA except Barbados and the United States. Article 12 of the ICESCR guarantees the right of everyone to "the highest attainable standard of physical and mental health," which has been interpreted by the United Nations to include "a system of urgent medical care in cases of accidents, epidemics and similar health hazards," as well as "the provision of essential drugs" for prevalent diseases. In its near-unanimous resolution 2001/33 of April 2001, to which the United States abstained, the United Nations Commission on Human Rights (CHR) recognized that "access to medication in the context of HIV/AIDS is one fundamental element for achieving progressively the full realization of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health."

States parties to the ICESCR have both the right and the obligation to ensure that their intellectual property regimes facilitate such access. In a November 2001 Statement on Intellectual Property and Human Rights, the U.N. Committee on Economic, Social and Cultural Rights emphasized that "any intellectual property regime that makes it more difficult [for a state party] to comply with its core obligations in relation to health, food, education, especially, or any other right set out in the Covenant, is inconsistent with the legally binding obligations of the "State party." Similarly, a May 2001 World Health Assembly resolution entitled "Strengthening health systems in developing countries" noted that lack of access to essential medicines was a significant factor perpetuating health care inequality and recognized "the sovereign right of each country to adopt national policies appropriate to the specific needs of its people." States that attempt to introduce generic competition into their markets in order to facilitate access to HIV/AIDS medication are therefore endeavoring to fulfill their obligations under the ICESCR.

As a signatory to the ICESCR, the United States has an obligation not to take actions that defeat that treaty's object and purpose (see Vienna Convention on the Law of Treaties, article 18). The entire international community also has an obligation, according to CHR resolution 2001/33, to "facilitate, wherever possible access in other countries to…pharmaceuticals or medical technologies used to treat pandemics such as HIV/AIDS" and to "ensure…that the application of international agreements is supportive of public health policies which promote broad access to safe, effective and affordable…pharmaceuticals and medical technologies." The efforts of the United States to discourage other nations from guaranteeing access to affordable HIV/AIDS drugs contravene its obligations as an ICESCR signatory.


Though developing countries face inordinate barriers in their struggles against AIDS, one glimmer of hope has been the development of safe, effective anti-retroviral drugs by governments, research institutes, and private pharmaceutical companies. These drugs are a vital part of the limited arsenal countries have in preventing and managing the medical effects of AIDS and thereby securing the human rights of their citizens. By insisting on a particular patent regime at the behest of multinational pharmaceutical companies, one that goes beyond even what is contained in TRIPS, the USTR is betraying an international consensus reached at Doha and arbitrarily interfering with developing countries' good faith efforts to improve and lengthen the lives of their citizens.

We strongly recommend that the United States Trade Representative refrain from using bilateral trade negotiations and WTO dispute resolution mechanisms to discourage countries from fulfilling their public health objectives as contemplated in the Doha Declaration. The USTR should promote flexibility in determining appropriate levels of national patent protection rather than making access to United States markets conditional upon a TRIPS-plus patent regime. The FTAA agreement should be amended in this spirit.

Return to: CPTech Home -> Main IP Page -> CPTech Page on FTAA