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Winnie Byanyima attended the 2016 UN General Assembly (UNGA) in New York between 19 - 23 September. Ms Byanyima joined colleagues from across the Oxfam confederation to represent Oxfam at high-level engagements, hold bilateral meetings, and participate in media interviews.
The UN Secretary-General's High-Level Panel (HLP) on Access to Medicines published its report in September 2016. Ms Winnie Byanyima was appointed to the Panel by the UN Secretary-General in late 2015.
On September 23 at UNGA71, a side event, "Breakfast Dialogue: The Role of Health Technology Innovation & Access in the 2030 Agenda for Sustainable Development," was held to focus on ways that UN Member States, the private sector and civil society can promote health technology research and development. The event highlighted the research and recommendations made in the United Nations Secretary-General's High-Level Panel on Access to Medicines Report.
The UN Secretary-General established the High-Level Panel to propose solutions for addressing the incoherencies between international human rights, trade, intellectual property rights and public health objectives. The report recommendations come at the end of a ten-month process for the Panel under the leadership of Ruth Dreifuss and the former President of the Swiss Confederation and Festus Mogae, the former President of the Republic of Botswana.
Ms Byanyima's remarks for the event are provided below. Ms Byanyima was joined by Professor Joseph E. Stiglitz (Professor at the Graduate School of Arts and Sciences and the School of International and Public Affairs, Columbia University), Professor Sakiko Fukuda-Parr (Professor of International Affairs at the New School, New York), Yusuf Hamied (Non-Executive Chairman, Cipla) and Ms Malebona Precious Matsoso (Director-General Department of Health, South Africa) on the panel, which was chaired by Mr Magdy Martínez-Solimán (UNDP Assistant Administrator & Director at the Bureau for Policy & Programme Support).
A video recording of the panel can be found here: https://www.youtube.com/watch?v=NNg-DMD5cfQ
Further information about the report can be found here: http://www.unsgaccessmeds.org/final-report/
Panel members: http://www.unsgaccessmeds.org/new-page/
Oxfam's reaction to the report: https://www.oxfam.org/en/pressroom/reactions/governments-must-act-new-un-report-bring-down-cost-medicines-says-oxfam
REMARKS AS PREPARED
Thank you for inviting me to this event on the High Level Panel on human rights and medicines.
The High Level Panel Report’s discussion about accountability and especially transparency is a critical one. As you know most decisions around medicines are shrouded in secrecy. Let me present to you the four key aspects of secrecy that the report discusses, which increase policy incoherence. And then I have an essential fifth area to add.
First: the cost of research and development:
How can a national authority decide if a price is fair if it does not know the real cost of making that medicine?
It remains the case that pharmaceutical companies want us to believe the figure they tell us without questioning.
When Oxfam started campaigning on access to medicines in 2001, we were told by the industry that it costs $ 500 million to bring a medicine to the market.
Recently the same study group – a group that is funded by pharma – which does the estimation told us it is $ 2.7 billion.
Yet other studies – as the report rightly mentions – estimate the cost to be much much cheaper.
Figures on medicine development in reality account for spend on other aspects such as marketing.
And we also do not know government’ funding in various forms like grants or tax breaks.
Therefore the report recommends that all the cost details should be made available to the authorities in order to assess prices.
Prices vary across countries with little rationale except being set at the maximum a market can bear.
If countries do not know prices in other jurisdiction, they cannot decide appropriate prices for themselves.
So the report recommends expanding the existing World Health Organization (WHO) price database to all medicines in all counties.
For this to happen, we need both governments and companies to provide WHO with accurate price information and that the WHO is funded to do this work
Third: Patent information:
It is very difficult to get information on who holds what patent in which country on any medicine!
This secrecy has a chilling effect on generic manufacturers for fear of infringing on a patent, if they were to produce a generic version.
Similarly, studies have shown that patents can also deter further research for the same reason.
The report – boldly – recommends transparency on patents information. This means that companies and other patent holders must make patent information public.
In theory, the World Intellectual Property Organization should hold a public database of all patents on health technologies in all countries.
Fourth: clinical trials:
Studies have shown that trials that have positive results have much more chances of being published than those that show neutral effect or even side effects.
Medical guidelines and prescriptions depend on test results.
Therefore the report recommends that all trials irrespective of results must be publicly available. The WHO has a website but pharma companies have not populated it yet!
But there is a fifth too Oxfam wants to bring to this debate on transparency. And that’s on Trade agreements.
Normally trade agreements include measures that tie government’ hands from adopting pro health policies.
Yet these agreements are negotiated in secret – take TPP that still remains on the table that involves the US and eleven other countries.
The public, media, civil society and even parliamentarians get to see agreements like these only when they are finalised. And we have to rely on leaked drafts to find out what is in and what is out.
This is not acceptable.
The report recommends an impact assessment of the potential effects of trade and investment measures on access to medicines. Myself and two fellow panellists (Jorge and Shiba) presented a commentary recommending a ban on inclusion of intellectual property in trade agreements.
We already have the WTO-TRIPS agreement- why should we have more restrictions?
So we have a report that we can work with. But how now can we ensure that the report’s recommendations are implemented and monitored?
This brings me to accountability and putting in place the mechanisms to ensure accountability of various actors.
These should exist in government’s domestic public policies, at the international level and of course with the private sector. Let me take each one by one.
On government commitments:
First, I strongly agree with the recommendation that commit governments to assess the situation of access to medicines in the light of human rights.
Civil society must be encouraged and supported to submit shadow reports. It works. We saw in the follow up to the Beijing conference on women. But getting this right means ensuring civil society has the resources to work effectively.
And second, governments must ensure coherence on national policies between all relevant authorities.
Civil society need needs a seat at the table to be able to advocate on behalf of people, and monitor progress on government’s policy coherence to enhance access to medicines
And the private sector must too play their role – yes, in terms of transparency and responsible ways of doing their work that I mentioned already.
But they must too stop doing what we see time and time again: putting pressure on governments to prevent them from adopting pro-health policies.
Yes we can monitor the policies and practices of governments, companies, international organisations if we have enough resource. But the challenge is –what if they do not perform?
The report recommends some accountability measures such as recording political and commercial pressure on countries behaving badly.
We recommended that any pressure is considered a violation of the TRIPS agreement itself and that the WTO enact strong punitive measures against governments that are exerting pressure on other countries trying to implement pro health policies.
And finally, at the international level:
We urge the Secretary-General the recommendation of creating an independent body that is tasked with monitoring and measuring progress towards access to medicines. Again civil society should be part of that monitoring system.
And the UN has a critical role too, a recommendation Oxfam agrees with. Measuring progress on human rights and access to health technologies and to assessing behaviour of all actors should be the subject of the recommended UN session on medicines in 2018.
This means that the Secretary General, the UN and its relevant agencies, and countries must start to adopt mechanisms to start implementing the recommendations without delay.
We trust in the Secretary-General’s enduring commitment to leave no one behind. This report is vital to achieving this mission.