The Honorable Robert B. Zoellick 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.
Vaccines, diagnostic, and monitoring tests are important medical
technologies for developing countries. They should not be excluded from any
solution.
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.
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.
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:
We urge you to reject any solution that includes any of these restrictions.
Sincerely,
Scott M. Hammer, MD
Harold C. Neu Professor of Medicine, Professor of Public Health
(Epidemiology)
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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