Beyond Doha

In a recent New York Times article, the former director of Brazil’s HIV/AIDS Program said, “If you prevent countries from using generic drugs, you are creating a concrete obstacle to providing access to drugs. You are promoting genocide, because you’re killing people.”

Prohibiting access to generic drugs equates genocide? While the comparison may seem dramatic, Dr. Pedro Chequer has a point.

While the Doha Declaration on the TRIPS Agreement and Public Health of 2001 made movements to increase access of life-saving pharmaceuticals to the developing world, many gaps remain. And in this case, “gaps” mean millions of lives lost due to the inability of many of the world’s poor to gain access to needed drugs and medicines.

 But beyond Doha, beyond intellectual property rights, beyond the bureaucracy of the World Trade Organization, and beyond the politics and wealth associated with powerful pharmaceutical companies, lies the real deep-rooted problem: crushing, absolute poverty.

Time and time again, the North and the South discover conflicting interests in global health policies. For example, in 2006 the Indonesian government decided to halt the sharing of avian flu samples with the World Health Organization, even though the WHO was using the materials to develop life-saving vaccines. Why did the Indonesian government take such action? Well, precisely because the new vaccine was unaffordable for most Indonesians, as well as other developing nations. Research and development for new vaccines and drugs are integral to solving the world’s pandemics, but why create such innovative solutions and preventions when the populations in dire need of these medicines aren’t able to use them?

Identifying the problem is the easy part: the developing world needs proper treatments to stop the spread of diseases such as HIV/AIDS, tuberculosis, malaria, diarrheal disease, etc. But what is the solution? The North has access to the technology and resources available to manufacture and sell such drugs, but the South remains in desperate need of such treatments and the funding needed to cover such costs. Although the Doha Declaration aimed to ameliorate the regulations behind the patents, costs, and transfer of such drugs, myriad problems persist. 

Although continued discussions and bartering of generic drugs and associated patent rights will continue, charity can close some of the gap.  Just last month, the WHO announced that millions of donated swine flu vaccines would soon reach nearly 100 developing nations. Furthermore, many NGOs and institutions such as the Bill and Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis, and Malaria work to provide the developing world with the medical treatments they so desperately need. Still, charity is not enough.

 Until we can look beyond the politics and legalities (and wealth) associated with pharmaceuticals, the developing world will remain in a state of tenuous health.  While it is idealistic for experts to work to inspire “innovation” in science and medicine in low-income nations, an immediate need remains. If solutions (vaccines, therapies, ARVs, etc.) exist in certain parts of the world, we must connect them to the patients that are in greatest need.   

The cycle of poverty will continue to keep the afflicted in a perilous, often fatal state. While failing to connect the world’s ailing with the proper treatments may not be considered true “genocide,” we cannot simply stand on the sidelines as millions of preventable deaths occur.  We must look beyond the Doha Declaration and explore more pragmatic solutions.

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