South Africa Comments to WHA Executive Board on Revised Drug Strategy

January 26, 1999

Dr Brundtland, distinguished members of the Executive Board, Colleagues, Ladies and Gentlemen, may I begin by expressing the gratitude of my government at being afforded the opportunity to address the Board on this very important issue.

I am Peter Goosen, Charge d' Affairs at the South African Permanent Mission.

What you may ask, is the reason for South Africa's keen interest in this issue?

The answer is quite simple,

Our constitution commits this government and all future South African governments to providing universal access to quality health care, which by definition includes the access to safe and affordable essential medicines. This goal may be considered by some to be overly ambitious, but we believe that it is achievable and as a government, we remain committed to this ideal.

Secondly, we believe in solidarity in health. It is impossible to conceive of a world that has stability but in which some populations are healthy and others not. South Africa cannot have a healthy population while others suffer ill health. The South African government is committed to working for world-wide equity in health.

We are all familiar with the financial constraints which shape public sector budgets but these difficulties are magnified when considered in the context of developing countries like South Africa.

The cost of medicines constitutes about 20% of South Africa?s total health costs as compared to an EU average of 10.5 %. There is also proof that medicines are more expensive in developing countries in both relative and absolute terms. As a result, many essential medicines are simply unaffordable to the citizens of developing countries.

In an attempt to rationalise the use of our limited resources and to thereby extend the reach of our health services, we embarked upon a review of our drug policy in 1996. This review involved all stakeholders and was executed with technical assistance from the Drug Action Program, resulting in the finalisation of appropriate legislation in October 1997.

This legislation addresses a range of issues to ensure all South Africans have access to safe and affordable medicines. The South African legislation streamlined registration and regulation procedures, ensured transparent acquisition and pricing procedures, secure and efficient methods of distribution, generic substitution, rational prescribing and dispensing. In addition to these accepted international norms, we have passed legislation to enable South Africa to parallel import pharmaceuticals and to allow for the issuing of non-exclusive compulsory licenses.

There have been subtle and not so subtle attempts to bring international pressure to bear on the South African government in regard to this legislation, and while we remain open to persuasion by rational arguments, our commitment to the underlying principles that underpin our legislation is unwavering.

Although this model legislation can not be enacted due to a legal challenge by vested interests - let me be very clear about the South African government?s position.

The clauses in question provide an enabling legal framework for two TRIP?s compliant strategies aimed at making medicines more affordable namely: <>

These strategies to ensure affordable medicines have also been presented as possible policy options in an official WHO publication, Globalisation and the Access to Drugs (WHO/DAP/98.9). These strategies were also validated by the contributions of the experts from WIPO and WTO during at the meeting of the Ad Hoc group. The official WHO publication, Globalisation and the Access to Drugs (WHO/DAP/98.9) is an invaluable resource for persons interested in pharmaceutical policy and indeed international health and trade policy. We understand that the concerns expressed by WTO have been addressed in a revised document and we therefore look forward to receiving the revised publication.

Mr. Chairman, it is our contention that this resolution on the revised drug strategy addresses certain crucial public health concerns in a clear and unambiguous manner. It reaffirms the primacy of the public health principles on which this organisation was founded, thereby offering a small but bright beacon of hope in the uncertain and unpredictable globalized environment of the 21st century. This resolution is in fact a strengthened version of the original as now public health considerations are an issue, not only in international trade agreements, but additionally in international financial agreements. It is WHO?s clear role to protect public health needs at these international forums. As such the revised drug strategy document has the support and endorsement of the South African Government.

This resolution has much in common with our domestic legislation and given South Africa?s international profile, as co-ordinator of the SADC health sector and chair of the Non Aligned Movement, we feel a sense of pride and vindication when goals and ideals, that we hold dear, find resonance, acceptance and consensus at the international level in this manner.

Mr. Chairman, ladies and gentleman, we wish to join others in complimenting Prof Giraud for the way in which he handled a very difficult meeting. His report is an accurate but rather bland record of a very lively meeting and I think that we all understand why this is so. We believe, however, that there are crucial omissions from this report and humbly propose the inclusion of the following elements as a means of enriching the document and correcting any oversights:

  1. The decision by the World Health Assembly to refer this matter for further negotiation needs to be recognised as a rare and extremely important development which raises important questions as to the future role of the Executive Board. This important element appears to have been overlooked in the preparation of the report and of the background documents to agenda item
  2. If the "Ad Hoc Group" mechanism is to be promoted as a consensus building or deadlock breaking mechanism for the future - and we agree that it holds some promise in this regard - sufficient consultation should go into defining a formal mechanism to ensure a democratic and transparent process is followed
  3. We strongly support the view that many issues that surround affordable, equitable and accessible medicines need to be further discussed. In Africa, less than 50% of the people have access to medicines. This is totally unacceptable in a world that should be showing solidarity in healthcare.

    As always, the new democratic government of South Africa will add value to these discussions by its active participation.

    Thank you.

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