KEY POINTS:
Is five years long enough for rich countries and the pharmaceutical industry to put the health of poor patients before profits? The short answer appears to be no. The more worrying answer is there are signs this will happen in the foreseeable future.
Global health remains a scandal.
More than 4 million people were newly infected by HIV in 2005. Cancer rates will probably double by 2020, with 60 per cent of new cases occurring in the developing world.
Meanwhile, the World Health Organisation says 30 per cent of the world's population - the vast majority, of course, from developing countries - still do not have regular access to essential medicines.
There are many reasons why medicines remain out of their reach - too little aid and investment in public health systems, not enough doctors and nurses, poor delivery and poor health infrastructure. But an important reason is the pharmaceutical industry's unjustified patent monopolies in developing countries. All of these barriers can be fixed.
Strict patent monopolies mean that medicine prices can be prohibitive. It has been proven that generic competition can reduce the price of medicines in a sustainable way.
Five years ago world leaders asserted the right of developing countries to use safeguards incorporated in the WTO Trade-Related Intellectual Property agreement (Trips) to protect public health. The Doha Declaration was a key reason why countries agreed to a new round of trade negotiations.
Their idea was that developing countries would have a guaranteed right to use existing safeguards to reduce the price of patented medicines. For instance, governments could authorise the production of generic equivalents.
For the United States and the pharmaceutical industry, however, this was merely a signal to change tactics rather than stop pursuing stronger intellectual property laws.
Far from honouring the spirit of the declaration, the US has been negotiating trade deals with developing countries that impose even stricter intellectual property rules to preserve and prolong patent monopolies, keep prices high and limit how they can use public health safeguards.
The US - at the behest of the industry - has also continued to threaten unilateral trade sanctions against countries that do not comply with its intellectual property standards. These standards exceed WTO obligations and severely threaten access to affordable medicines in poor countries. This year the US has cited India and Brazil, among others, for failing to comply with their demands.
Other rich countries, particularly in the European Union, have done little but passively observe US actions. The industry itself has gone even further by suing countries - as Novartis is now doing in India and Pfizer in the Philippines - that have tried to use Trips safeguards to protect public health. Each country's crime has been attempting to provide cheaper medicines used to treat cancer and hypertension for those who are too poor to pay higher prices.
Novartis is challenging the Indian Government's right to interpret the Trips agreement to produce generic medicines. If they are successful it could have profound implications for the global generic export industry. India is the world's leading exporter of generic medicines, with 67 per cent of its exports going to developing countries.
The industry says it needs strong global patent laws in order to remain profitable, to innovate, and recoup its research costs. This does not stand much scrutiny. The pharmaceutical sector is one of the most profitable industries, returning an average annual profit of 19 per cent compared to a 5 per cent average for the world's Fortune 500. It spends about 32 per cent of its revenues on marketing and administration compared to between 14 per cent to 20 per cent on research and development. Also, the industry doesn't innovate for diseases prevalent in poor countries. Between 1975 and 2004, only 21 out of 1556 new chemical entities were targeted at diseases like malaria.
Oxfam and others are demanding the US, the pharmaceutical industry and other rich countries stop the pressure and instead help developing countries assert their rights.
* Barry Coates is the executive director of Oxfam New Zealand
