[Ip-health] Foreign Affairs: The UN's battle with NCDs-How Poliitics, Commerce and Science Complicated the Fight Against a "Silent Epidemic"

thiru at keionline.org thiru at keionline.org
Tue Sep 20 02:15:51 PDT 2011

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September 20, 2011
The UN's Battle With NCDs

How Politics, Commerce, and Science Complicated the Fight Against a
'Silent Epidemic'
Sheri Fink and Rebecca Rabinowitz

SHERI FINK is a senior Bernard L. Schwartz fellow at the New America
Foundation. REBECCA RABINOWITZ is a research associate at the New America

The World Health Organization (WHO) calls it an "invisible epidemic." In
the United States and now many parts of the developing world, the biggest
killers are no longer infectious diseases, such as HIV and AIDS or
malaria, but rather chronic conditions, such as heart and lung disease,
cancer, and diabetes. Often the preventable result of unhealthy diets,
tobacco, and alcohol use and a lack of physical activity, these
non-communicable diseases, or NCDs, now account for two out of every three
deaths worldwide [1].


Although the fight against AIDS, tuberculosis, and malaria has attracted
rock-star advocates and billions of dollars in funding in the past decade,
efforts to fight NCDs are much less visible. According to a recent report
[2], less than three percent of the nearly $22 billion spent in 2007 on
global development assistance for health was dedicated to NCDs. If this
week's high-level UN meeting on NCDs is any indication, that is unlikely
to change anytime soon. A hard look at the negotiations that made the
meeting in New York possible is a study in the way politics, commerce, and
science can combine to influence global health policy in a difficult
economic climate. The question is whether an approach that favors
partnership with industry over regulation and that kicks the can forward
on monetary commitments and specific targets to reduce the toll of NCDs
will end up making much of a difference.


During the negotiations leading up to the UN meeting, the toughest
disagreement, according to several people who attended the sessions, was
over whether NCDs should be referred to as an epidemic and a public health
emergency. The decision is about more than rhetoric. Such a designation
would allow countries to invoke flexibilities in World Trade Organization
rules that permit manufacturers to make cheaper generic versions of
patented drugs needed to protect the public's health. Developing countries
with large generic drug industries clearly favored the move. Washington,
of course, opposed the measure, a view clearly in line with the interests
of its large pharmaceutical industry.

"The challenge was whether simply doing away with patent protections on
all drugs that treat non-communicable diseases is the right course," says
Nils Daulaire, the director of the Office of Global Affairs at the U.S.
Department of Health and Human Services. "That, to our minds, was not the
way you get a stream of ongoing research and development and the new and
improved drugs that we continue to need."

Some pharmaceutical and medical device companies have also become deeply
involved in bankrolling the campaign against NCDs, even paying for
messages about the high-level meeting on public radio and underwriting a
Washington Post forum on the subject that was covered by the newspaper
last week. Among the "civil society representatives" the UN invited to
participate in the high level meeting are drug makers with a large U.S.
presence, including GlaxoSmithKline Oncology, Sanofi Aventis, and Varian
Medical Systems.


Thiru Balasubramaniam
Geneva Representative
Knowledge Ecology International (KEI)

thiru at keionline.org

Tel: +41 22 791 6727
Mobile: +41 76 508 0997

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