[Ip-health] Stat: State Department accused of interfering with efforts for affordable medicines

Andrew S. Goldman andrew.goldman at keionline.org
Mon Jul 25 11:48:49 PDT 2016


By ED SILVERMAN @Pharmalot

JULY 25, 2016

The US Department of State is being accused of inappropriately interfering
with efforts by the United Nations and two countries to ensure access to
affordable medicines for poor people.

In a blunt letter sent on July 20, dozens of patient advocacy groups
charged that State Department officials questioned the premise of a UN
panel devoted to exploring wider access, pressured the Colombian government
not to sidestep the patent on a Novartis cancer drug, and pressed India to
adopt policies that could result in higher drug prices and eliminate the
production of lower-cost generics.

And so they asked US Secretary of State John Kerry to detail “whether the
State Department sees these incidents as coherent with US government policy
and (to clarify) State Department commitments and position on the right of
governments to use (World Trade Organization treaties) to protect public
health and access to medicines.”

We asked the State Department for comment and will update you accordingly.

The move comes amid rising tension over the cost of prescription medicines
around the world. Beyond the United States, where the issue has become a
talking point in the presidential election, patient advocacy groups
regularly charge that the pharmaceutical industry relies on Washington to
persuade other countries to improperly enforce patent rights and trade
policies that would diminish access.

Novartis, Colombia face off over cancer drug cost

The letter, however, is an attempt to ratchet up criticism of US policy.
For the most part, complaints about moves by Washington have been largely
confined to specific incidents involving specific government agencies,
usually the US Trade Representative’s Office. The advocacy groups are now
trying to gain wider notice by directing their ire at top administration

In their letter, the groups say this heavy-handed approach was on display
this past spring, when the Colombian health minister signaled plans to
sidestep the patent on Gleevec, a Novartis cancer drug, because the company
refused to lower its price. Patient advocates say the per-patient cost of
the drug in Colombia is roughly twice the Colombian gross national income
per capita.

Leaked memos showed that staffers from both the US Senate Finance Committee
and the US Trade Representative’s office met with Colombian embassy
officials in Washington D.C., and suggested the Obama administration might
pull support for a free trade agreement and $450 million in backing for a
peace initiative between the Colombian government and Marxist rebels.

And after the Colombian health minister last month indicated he would
proceed with his plans, Colombian news outlets aired remarks by the US
Ambassador to Colombia Kevin Whittaker, who told reporters that it is “very
important” that the Colombian government consult with the US on this
decision (go to the 12:20 mark).

“We were surprised and dismayed by Ambassador Whittaker’s remarks, which
were interpreted, in Colombia and elsewhere, as unwanted interference with
a domestic dispute over the price of a drug” sold by Novartis, the groups
wrote. Among the groups signing the letter were Public Citizen, Oxfam, the
National Physicians Alliance, and the AFL-CIO.

“The United States State Department should not interfere with the
government of Colombia’s efforts to increase access to affordable
medicines. Colombia is under no obligation to consult the United States on
a decision to use its national law, when its actions are consistent with
trade agreements binding both the United States and Colombia,” according to
the letter.

Similarly, the groups are upset with the State Department reaction to the
creation last fall of the UN High-­Level Panel on Access to Medicines. In
remarks this past February, State Department official Ann Blackwood argued
the panel review will be “narrow” and questioned the “premise that the
rights of inventors, international human rights law, trade rules, and
public health are ‘misaligned.’”

“Such a sentiment is out of touch with the reality faced every day by
patients in developing countries around the world and here in the United
States faced with rising drug prices and lack of innovation for critical
medical needs, such as antibiotic resistance and Zika,” the groups wrote to

“Policies that lead to higher prices create barriers for access. If
governments rely upon high prices to fund innovation, then they have to
accept limited and unequal access to new medicines, as well as no
innovation when high prices through sales are not an option to recover R&D
costs. In what sense does the Department of State see that as coherent and
good policy?”

The advocacy groups also complained that the US administration is leaning
heavily on India to alter policies and laws that the pharmaceutical
industry maintains do not sufficiently protect intellectual property. One
example cited is ongoing debate over compulsory licensing, which a WTO
treaty allows countries to use to override patents so lower-cost generics
can be produced.

The letter notes, however, the US Embassy in New Delhi “regularly provides
a forum” for industry officials to address Indian policymakers and
stakeholders and works with the US Patent and Trademark Office to
“coordinate pressure on key officials, and delivers speeches designed to
publicly push the Indian government to adopt restrictive intellectual
property policies.”

India will not restrict licenses for making generic drugs

“Any policies or practices that India adopts to expand patent rights on
medicines, restrict the use of compulsory licensing or other exceptions to
patent rights, or introduce new exclusivity rules for data would have
dramatic and negative implications for people across the globe that
desperately need access to affordable life­saving medicine,” the groups

And in case Kerry might have missed the significance, the letter noted such
moves may affect US patients, too. An estimated 88 percent of all
prescriptions that are filled in the US are now written for generics,
according to the IMS Institute for Healthcare Informatics.

Andrew S. Goldman
Counsel, Policy and Legal Affairs
Knowledge Ecology International
andrew.goldman at keionline.org // www.twitter.com/ASG_KEI
tel.: +1.202.332.2670

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