Letter from American AIDS Doctors to Robert Zoellick on WTO Negotiations on TRIPS and Healthcare

The Honorable Robert B. Zoellick
600 17th St., N.W.
Washington D.C., 20508

December 19, 2002

Re: WTO negotiations on public health and access to medicines

Dear Ambassador Zoellick,

As medical doctors specializing in AIDS care and research, we are writing to share our views with you on the status of negotiations at the World Trade Organization (WTO) on public health, access to medicines and intellectual property rights.
The WTO was charged with producing a solution to the problem expressed in paragraph 6 of the WTO Doha Declaration on the TRIPS Agreement and Public Health:

³6. We recognize that WTO Members with insufficient or no manufacturing capacities in the pharmaceutical sector could face difficulties in making effective use of compulsory licensing under the TRIPS Agreement. We instruct the Council for TRIPS to find an expeditious solution to this problem and to report to the General Council before the end of 2002.²
These negotiations should be guided by the needs and interests of poor people who are suffering without access to medicines. As the Doha Declaration states, a workable solution is one that supports countries¹ right to ³protect public health and, in particular, to promote access to medicines for all.²

There are aspects of draft solutions currently being negotiated that would undermine this right.

They include:

  1. Disease restrictions

    A workable solution must not be restricted to medicines used in treatment of AIDS, tuberculosis and malaria. While there is no doubt that these epidemics are ravaging developing countries, they cannot be considered the sole public health threats in sub Saharan Africa or other poor regions‹either now or in the future. Furthermore, the WTO is not the relevant forum for determining sovereign countries¹ national public health needs.

  2. Limitation to medicines only

    Vaccines, diagnostic, and monitoring tests are important medical technologies for developing countries. They should not be excluded from any solution.

  3. Geographic limitations

    While sub-Saharan Africa is in particularly acute need of increased access to medicines, it should not be the only region to benefit from a solution. The establishment of a protectionist system that excludes countries with more moderate levels of development will only compromise efforts to increase medicines access.

  4. Burdensome ³safeguards²

    Low-cost generic medicines intended for consumption in poor countries should not be diverted to rich country markets. But any new burden of monitoring borders and guarding against flow of medicines from poor to rich country markets should be borne by the rights holder and by rich countries‹not by countries where the product was intended to be consumed.

Increasing the pace of innovation in pharmaceuticals is necessary if the medical community is to have any hope of success in battling major public health problems. But rewarding innovation must not come at the expense of broad, sustainable access to these essential inventions.

We urge you to reject any solution that includes any of these restrictions.


Scott M. Hammer, MD
Harold C. Neu Professor of Medicine, Professor of Public Health
College of Physicians and Surgeons
Columbia University
Division Chief, Infectious Diseases
Columbia Presbyterian Medical Center

Marla J. Gold, MD
Dean, School of Public Health
Drexel University
Philadelphia, Pennsylvania

Paul Farmer, MD, PhD
The Maud and Lillian Presley Professor of Medical Anthropology
Harvard Medical School
Vice-Chair, Division of Social Medicine and Health Inequalities
Brigham and Women's Hospital
Medical Director, Zanmi Lasante, Cange, Haiti
Founding Director, Partners In Health
Boston, Massachusetts

Stephen Gloyd, MD, MPH
Director, International Health Program
Professor, Department of Health Services,
School of Public Health and Community Medicine
University of Washington
Seattle, Washington

Jim Yong Kim, MD, PhD
Chief, Division of Social Medicine and Health Inequalities
Brigham and Women's Hospital
Executive Vice-President, Partners In Health
Assistant Professor of Medicine and Medical Anthropology
Director, Program in Infectious Disease and Social Change
Harvard Medical School
Boston, Massachusetts

Alan Berkman, MD
Coordinator, Global AIDS Projects of Special Significance
Department of Epidemiology
Mailman School of Public Health
Columbia University
New York, New York

James A. Hoxie, MD
Professor of Medicine
University of Pennsylvania
Director, University of Pennsylvania Center for AIDS Research
Philadelphia, Pennsylvania

Karam Mounzer, MD
Medical Director
Philadelphia FIGHT
Philadelphia, Pennsylvania

Michael Chung, MD, MPH
Senior Fellow, Department of Allergy and Infectious Diseases
University of Washington
Seattle, Washington

David Hoos, MD
Assistant Professor, Clinical Epidemiology,
Mailman School of Public Health
Columbia University
Procurement Specialist, MTCT Plus Program
New York, New York

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