Director-General of the World Health Organization, DrMargaret Chan, has urged countries to find news ways to make medicine forHIV/AIDS and other chronic diseases more affordable to the world’s poorestcountries, without stifling pharmaceutical innovation.

Speaking at the agency’s second session of the Intergovernmental Working Group onPublic Health, Innovation and Intellectual Property, she said the challenge wasto work on multiple fronts: to meet the immediate need for equitable access toquality, affordable medicines, while at the same time working to stimulateinnovation.

Chan said that while she was aware the “price of medicines and other products can beprohibitive, effectively blocking access to care… the need for innovation isconstant”. “Resistance develops and drugs fail, creating an urgent need forsecond- and third-line medicines,” said Chan. “We have seen this problem mostacutely with HIV/AIDS. We are seeing it again with the spread of extensivelydrug-resistant tuberculosis, which is far more costly and difficult to treat.For some diseases, we know our greatest hope rests with the development ofvaccines.”

The WHO’s193 member states are expected to forge a global strategy on the issues of drugdevelopment, patenting and pricing by the end of the week.

Compulsory licenses

Under rules agreed by the World Trade Organization, countries can issue compulsorylicenses to over-ride patent rights, but only after negotiating adequatecompensation with the patent owners. However, if governments declare a publichealth emergency they do not need to negotiate with the drug companies. Braziland Thailand have already invoked the procedure to import cheap genericversions of US drugs for several disease areas, including second-line HIV/AIDSto treat patients who have developed resistance to older anti-retrovirals.

While these moves have been praised by health campaigners they have angered industrygroups. As a result, the US has put Thailand on its copyright watch list ofnations and could invoke trade sanctions if alleged violations worsen.

International aid group Oxfam insists there have been few incidents of compulsory licensingbecause developing countries face pressure from Western governments acting onbehalf of drug companies. At the same time, WHO statistics reveal that 74% ofHIV/AIDS medicines are under monopoly, and that 77% of Africans still lackaccess to treatment.