[Ip-health] fixing Canada's Access to Medicines Regime: items in Globe & Mail and The Mark

Richard Elliott relliott at aidslaw.ca
Fri May 14 09:57:25 PDT 2010

The campaign to reform Canada's law on compulsory licensing of pharmaceuticals for export continues, in the lead-up to the G8 Summit next month - at which maternal and child health are expected to be a priority item on the agenda.  The relevance to maternal and child health of a workable scheme of compulsory licensing to supply affordable medicines for HIV and other needs is obvious, particularly given the public commitment by the largest generic manufacturer that, if the proposed reforms are enacted, its first step will be to seek to export a paediatric formulation of the existing product already exported once to Rwanda.

Proposed amendments before a Parliamentary committee but facing stiff opposition from the patented pharmaceutical industry.  Below are two items that recently appeared in national media.


The Globe and Mail
Thursday, May 13, 2010


Saving the many, not the few 

Six years ago this week, royal assent was given to legislation passed unanimously by Parliament to create Canada's Access to Medicines Regime (CAMR). CAMR is supposed to help get lower-cost, life-saving generic medicines to people in developing countries who are dying because they cannot afford brand-name drugs protected by patent monopolies. 

Sadly, unnecessary red tape has meant that, over the past six years, only a single AIDS drug has been supplied to a single country, Rwanda (The African Century - May 12). Parliament could fix this by passing private member's Bill C-393, which passed second reading in December, despite a campaign by the brand-name pharmaceutical industry. 

Proposals to fix CAMR are endorsed by dozens of prominent Canadians, including former prime minister Paul Martin.  A Pollara poll found that 80 per cent of Canadians also support key changes proposed by Bill C-393.

Prime Minister Stephen Harper announced Canada will champion the health of women and children in the developing world. Ensuring CAMR works is one way to do that. 

Richard Elliott, executive director, Canadian HIV/AIDS Legal Network 


Fix the Access to Medicines Regime

Canada has the opportunity to save the lives of thousands of people with HIV/AIDS in developing countries at no extra cost to taxpayers.

Richard Elliott
Executive Director, Canadian HIV/AIDS Legal Network.

Fix the Access to Medicines Regime

Canada has the opportunity to save the lives of thousands of people with HIV/AIDS in developing countries at no extra cost to taxpayers....

First published May 13, 2010

This Friday, May 14, should be a happy anniversary in the effort to tackle the global AIDS crisis. Instead, it underlines Canada's failure to fully maximize an opportunity to save thousands of lives in developing countries.

Six years ago, on May 14, 2004, royal assent was given to legislation that created Canada's Access to Medicines Regime (CAMR). It was passed unanimously by the House of Commons and the Senate with support from all parties - a rare occurrence.
This initiative was supposed to help send lower-cost, life-saving generic medicines to people in developing countries who were - and still are - dying because they cannot afford the high-priced, brand-name versions protected by patents.

Unfortunately, the system has proven flawed and largely unworkable. Instead of ensuring a steady supply of medicine, the past six years have seen only a single order of drugs shipped to a single country, Rwanda.

Why is it not working?

The primary problem is the cumbersome bureaucracy which weighs down the system - likely the intention of opponents who wish to be seen doing something but have little interest in creating a system that actually works. An in-depth explanation is available at www.aidslaw.ca/camr.

It is particularly embarrassing that CAMR's six-year anniversary highlights its dismal results mere weeks after Prime Minister Harper announced that Canada will use its presidency of the G8 to champion the health of women and children in the developing world, and make it a priority of the upcoming G8 summit. It should be obvious that preventing and treating HIV is critical to maternal and child health, particularly in settings where HIV is a major cause of mortality. Access to affordable antiretroviral drugs that can prevent the transmission of HIV from mother to child in the first place, and keep both mothers and children with HIV healthy and alive, must be part of the package. Making CAMR work would be one easy way to boost a broader maternal and child health initiative at no additional cost.

The government's position is that "insufficient time has passed" for us to evaluate CAMR's effectiveness. Nobody buys this: a single order of drugs in six years is what is insufficient.

Fortunately, a slim majority of MPs seem to agree that Parliament should try to fix CAMR. Last December, the House of Commons passed Bill C-393, a private members' bill that would greatly fix the system, by a vote of 143-127 - again with supporters from all parties, including a dozen courageous Conservatives. The bill is now before the Standing Committee on Industry, Science, and Technology. The Committee must ensure that it gives a careful consideration to the proposed reforms, including hearing directly from people and organizations living and working on the ground in the countries that are the intended beneficiaries of more affordable, generic medicines.

The main reform proposed in Bill C-393 is a "one-licence solution" that would cut through the current system's red tape. As it stands now, CAMR requires a country-by-country, order-by-order process of compulsory licensing. Bill C-393 would change this so that the licence would only need to be obtained once without the current, arbitrary two-year time limit or the cap on the maximum quantity of the medicine that can be supplied. This would allow a generic manufacturer to respond quickly and flexibly as countries identify the need for additional quantities. Furthermore, the licence wouldn't be limited to supplying just one country at a time, but would allow exports to any of the eligible developing countries already covered by the current law (which parliamentarians unanimously approved).

Such reforms make good business sense. Making it easier to supply multiple countries simultaneously on an ongoing and flexible basis would generate economies of scale, further lowering the final price of the medicines. Developing countries could stretch limited health care dollars - including foreign aid money from Canada - to treat more people. Plus, it creates opportunities for Canadian companies while addressing pressing public health needs.

A full 80 per cent of Canadians support the key changes proposed by Bill C-393, according to a poll done by the opinion research firm Pollara for the Canadian HIV/AIDS Legal Network, Canadian Crossroads International, and UNICEF Canada.
In the time it took to read the above, dozens of children died because they lacked affordable, life-saving medicines. In sub-Saharan Africa, where efforts to prevent the transmission of HIV from mothers to their babies still lag behind, half of all children born with HIV won't live past their second birthday. The majority of adults with HIV in the developing world lack access to treatment; less than 15 per cent of the children who need antiretroviral treatment get it.

Adopting Bill C-393 is a tangible measure Canada could take - at no extra cost to taxpayers - to help save thousands of lives, especially of mothers and children. It would be particularly appropriate for Parliament to move on this before Canada hosts the world next month, especially since maternal and child health will be at the forefront of discussions. 

Canada's reputation is at stake, but more importantly, lives are being needlessly lost.


Richard Elliott
Executive Director | Directeur général
Canadian HIV/AIDS Legal Network | Réseau juridique canadien VIH/sida 
+1 416 595-1666 ext. 229
relliott at aidslaw.ca | www.aidslaw.ca 

Children Can't Wait! Dying for Drugs in Developing Countries - see www.aidslaw.ca/camr 
Les enfants ne peuvent attendre! Le manque de médicaments tue, dans les pays en développement - voir www.aidslaw.ca/rcam 

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