Kanaga Raja
The UN noted with concern that, for millions of people throughout the world, the full and equal enjoyment of the right to health remains a distant goal.

The United Nations Human Rights Council, in a resolution adopted on 1 July, has recognised that access to medicines is “one of the fundamental elements in achieving progressively the full realization of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.”

In a resolution, orally revised and adopted without a vote, the Council decided to convene a panel discussion at its thirty-fourth session in March next year “to exchange views on good practices and key challenges relevant to access to medicines as one of the fundamental elements of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, taking into account all relevant reports, and that the discussion shall be fully accessible to persons with disabilities.”

Brazil, introducing the draft resolution, said that for millions of people throughout the world, the full enjoyment of the human right to health still remains an elusive goal.

According to the World Health Organisation (WHO), at least one-third of the world’s population has no regular access to medicines.

Health is a fundamental human right, indispensable to the enjoyment of many other human rights and necessary for living a life in dignity, it said.

Brazil requests a panel discussion to exchange views on good practice and key challenges relevant to access to medicines to take place during the next March session (of the Human Rights Council).

The challenges are no longer limited to developing countries or to the so-called neglected diseases, which is affecting people in the Global North as well, stretching the health budgets of all governments and impacting frequent to common diseases like hepatitis and cancer.

It said that the existing global framework does not allow the fruits of medical innovation to be equitably shared in particular to those who are most in need of them.

“It has only resulted in skyrocketing prices for life-saving medicines and vaccines, promoted discriminatory access to medicines based on geographic location or economic status and has further widened the health inequities.”

The increasing healthcare costs have become the leading cause of induced poverty pushing nearly 150 million people into impoverishment every year. Moreover, the innovation model that thrives on the current system has failed to address the health R&D needs of the developing countries, said India.

This is evident from the lack of any new medicines and vaccines for long known infectious diseases like TB and malaria, which continue to take a huge public health toll.

In a general comment, the United Kingdom, while joining the consensus on the resolution, said it found that a number of provisions in the text were problematic.

For example, the UK said that while it fully supports the right of everyone’s enjoyment of the highest attainable standards of physical and mental health, it did not recognise its link with access to medicines.

Switzerland said it had some reservations about the resolution. It fully supports its aim, i. e. the full enjoyment of the highest attainable standard of physical and mental health for all.

Though it joined the consensus, Switzerland said that it would have liked to see a more well balanced resolution.

Switzerland maintained that the reference to the price of medicines are an inadequate simplification. Patents and prices are not directly linked, it claimed.

The assumption that the right of inventors are the single, or even the main, impediment to innovation and access to health overlooks a key finding of the 2012 joint WHO/WTO/WIPO study on promoting access to medical technologies and innovation, that the lack of access to medical technologies is rarely due entirely to one single determinant, the EU maintained.

The EU also expressed its concerns about the risk of duplication with discussions in other fora. The EU however said that it will join the consensus on the draft resolution as orally amended.

The resolution (A/HRC/32/L. 23/Rev. 1), orally revised and adopted without a vote, noted with appreciation the UN Secretary-General‘s decision to establish a High-level Panel on Access to Medicines, with the mandate to make proposals on how to address policy incoherence in public health, trade, the justifiable rights of inventors, and human rights.

THe UNHCR was concerned about the inter-relatedness between poverty and the realization of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, in particular the fact that ill health can be both a cause and a consequence of poverty.

It recognized that universal health coverage implies  ensuring that the use of health services does not expose users to financial hardship, with a special emphasis on the poor, vulnerable, and marginalised segments of the population.”

The Council recalled that the Doha Ministerial Declaration on the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and Public Health “confirms that the Agreement does not and should not prevent members of the World Trade Organization from taking measures to protect public health and that the Declaration, accordingly, while reiterating the commitment to the Agreement, affirms that it can and should be interpreted and implemented in a manner supportive of the rights of members of the Organization to protect public health and, in particular, to promote access to medicines for all, and further recognizes, in this connection, the right of members of the Organization to use, to the full, the provisions of the above-mentioned Agreement, which provide flexibility for this purpose.”

It noted with deep concern that, according to the World Health Organization in its World Medicines Situations Report of 2011, at least one third of the world population has no regular access to medicines, while recognizing that the lack of access to medicines is a global challenge that affects people not only in developing countries but also in developed countries, even though the disease burden is disproportionately high in developing countries.

It was concerned “at the lack of access to quality, safe, efficacious and affordable medicines for children in appropriate dosage forms, and problems in the rational use of children’s medicines in many countries, and that, globally, children aged under five years still do not have secure access to medicines for the treatment of pneumonia, tuberculosis, diarrheal diseases, HIV infection, and malaria, as well as medicines for many other infectious diseases, non-communicable diseases and rare diseases.”

The Council was also concerned that the increasing incidence of non-communicable diseases constitutes a heavy burden on society, with serious social and economic consequences, which represent a leading threat to human health and development.

It recognized the urgent need to improve accessibility to safe, affordable, efficacious and quality medicines and technologies to, diagnose and to treat non-communicable diseases, to strengthen viable financing options, and to promote the use of affordable medicines, including generics, as well as improved access to preventive, curative, palliative and rehabilitative services, particularly at the community level.

The Council expressed deep concern at recent outbreaks of highly infectious pathogens with epidemic potential, which demonstrate the potential vulnerability of populations to them and, in this context, reaffirmed and underscored the importance of the development of new and innovative medicines and vaccines and of ensuring access to safe, affordable, efficacious and quality medicines and vaccines to all, as well as strengthening health system capacities for preventing and responding to outbreaks.

It recalled the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property of the World Health Organization, and commended the efforts of the Organization to fill gaps in health research and development for the relevant needs of developing countries, including neglected diseases and potential areas where market failure exists, through the follow-up to the report of the Consultative Expert Working Group on Research and Development.

It reiterated that “health research and development should be needs-driven, evidence-based, guided by the core principles of affordability, effectiveness, efficiency, and equity, and considered a shared responsibility.”

The Council called upon States “to promote access to medicines for all, including through the use, to the full, of the provisions of the Agreement on Trade-Related Aspects of Intellectual Property Rights which provide flexibility for that purpose, recognizing that the protection of intellectual property is important for the development of new medicines, as well as the concerns about its effects on prices.”

It reiterated the call upon States to continue to collaborate, as appropriate, on models and approaches that support the de-linkage of the cost of new research and development from the prices of medicines, vaccines and diagnostics for diseases that predominantly affect developing countries, including emerging and neglected tropical diseases, so as to ensure their sustained accessibility, affordability and availability and to ensure access to treatment for all those in need.

The Council called upon the international community to continue to assist developing countries in promoting the full realization of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, including through access to medicines that are affordable, safe, efficacious and of quality, and through financial and technical support and training of personnel, while recognizing that the primary responsibility for promoting and protecting all human rights rests with States.

In this context, it called upon all States, United Nations agencies, funds and programmes, in particular the World Health Organization, and relevant intergovernmental organizations, within their respective mandates, and encourages relevant stakeholders, including pharmaceutical companies, while safeguarding public health from undue influence by any form of real, perceived or potential conflict of interest, “to further collaborate to enable equitable access to quality, safe and efficacious medicines that are affordable to all, including those living in poverty, children and other persons in vulnerable situations.”