Category Archives: Access to Medicine Regimes

They Go to Die: A TB/HIV and Human Rights Film

“If we turn an epi­demic into an emo­tion, we moti­vate change.” – Jonathan Smith

In his film, Jonathan Smith – an epidemiologist and Director of the Visual Ethnography Project at Yale University – aims to put humanity back into research. He’s invited into the homes of four mine workers living with HIV/TB co-infection and, in the broader context of human life, he takes viewers beyond cold epidemiological data and into the lives of the men. They are not unlike many others seeking work in the South African mining industry. But not all work is created equal: poorly ventilated mines are perfect terrain for TB transmission, and mines, combined with HIV, are currently the two largest driving factors of the TB epidemic in South Africa.

The message is simple: mine workers become sick and they go home to die because they’re not provided with the essential health care or medicine required to keep them alive. But death is not inevitable: HIV/TB co-infection is largely preventable and treatable – so long as there’s the will to do it.

Jonathan is on a mission to do just that: he’s seeking to raise enough funds to complete post-production of the film with the hope that viewers, like you, will create the pressure and impetus necessary to improve the working conditions in mines and impact the lives of hundreds of thousands of workers looking to make an honest living.

Interested in meeting Jonathan in person? Join him in Vancouver at UBC for a viewing of the film!

Date: 4:00PM, Friday, October 21st
Location:  Norm Theatre, Student Union Building, UBC, 6138 Student Union Blvd.
Admission: Free

Gilead to license several HIV/AIDS drugs to the Medicines Patent Pool

On July 12th Gilead, a US-based pharmaceutical company, announced their plans to license four HIV drugs and one fixed-dose combination to the Medicines Patent Pool. This marks the first agreement between the Medicines Patent Pool and a pharmaceutical company. (woohoo!) Although this is a significant step toward increasing global access to affordable meds, a few concerns remain. The agreement limits manufacturing to one country – India – which in turn limits competition (an important mechanism to drive costs down) and people living in middle-income countries – including China and Brazil – are excluded. You can find a more detailed explanation here.

Wondering what a patent pool is? This animation explains it nicely.

Passing drug bill imperative: AIDS in Africa could be stopped in its tracks if medications were available

Here is a recent op-ed written by Craig and Marc Kielburger of the non-profit Free the Children. Reprinted from the Edmonton Journal. Definitely worth a read…

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We build schools in Kenyan villages where teachers die, but their students refuse to name the cause because of its potent stigma, even as coffins are lowered into graves.

We’ve seen husbands, mothers, and then their children, wither away from a mysterious illness rather than be ostracized with a diagnosis.

In North America, access to treatment makes it possible for people with HIV/AIDS to lead relatively comfortable lives. In developing countries, where antiretroviral drugs (ARVs) are prohibitively expensive, AIDS is a curse.

There’s still no cure, but Canada has a chance to save potentially millions of lives with a single legislation. Bill C-393 would reform Canada’s Access to Medicines Regime, a system so flawed it’s only been used to ship a single drug to Rwanda since it was first introduced six years ago.

Bill C-393 allows Canadian companies to manufacture generic versions of patented drugs, like ARVs, making it easier to deliver affordable medicine to developing countries. It passed the House of Commons on March 9, but stalled in the Senate, and then died on the order paper when the government fell.

When Parliament resumes June 2 there will be numerous pleas for the attention of Stephen Harper’s majority government. But this is more than a plea. Finally passing this bill is a moral imperative, and research released since its initial passing has made it an urgent one.

A few weeks ago, a major clinical trial found that treating HIV-positive people with ARVs led to 96 per cent reduction of transmission for the 1,763 participating couples in 13 sites all over the world, including Kenya.

The breakthrough was so great that results were released four years earlier than scheduled.

“We have a new vaccine and it’s called treatment,” Dr. Jennifer Cohn from Medecins sans frontieres, a medical relief organization with offices in Kenya, recently told the Nairobi Star. Advocacy organizations also predicted the virus could be eradicated in Kenya in just a few years.

Kenya is our second home -we’ve spent the past 15 summers there. We love the untouched beauty of its landscapes and the warmth of its people, but we’re sick with the knowledge that AIDS devastates the country.

Mary was a nurse in Kenya’s Rift Valley. She knew her husband had been unfaithful, and that she was in danger. But he refused to wear condoms -he’d paid her dowry, she was his property. When Mary was diagnosed with HIV, her husband abandoned her while she was pregnant with their second child. Women are more likely to be identified as carriers because of prenatal testing. Her child, who we will call Abby, was born HIV-positive.

Mary couldn’t afford proper treatment. When she died, none of her close relatives would adopt Abby for fear of “catching” the virus. The now two-year-old has little hope of receiving the medicine she desperately needs to survive.

Canadian pharmaceutical company Apotex Inc. has promised to make a generic duplicate of a pediatric ARV should bill C-393 pass. Dr. James Orbinski, founder of the medical humanitarian organization Dignitas International and staunch supporter of C-393, has said this alone would save millions of lives, since generic drugs reduce treatment costs from $10,000 to $100 a year -even less for children, like Abby.

We wonder how many people were infected while Canada’s unelected Senate stalled a bill that passed in the House of Commons with a vote 172 to 111 -including support from the Bloc and NDP, all but two Liberals and a handful of Conservatives.

But not a single Conservative cabinet minister supported the bill, and brand-name drug companies, threatened by the prospect of lost business, lobbied against it.

Ideally, competition on the global market would increase with added competition from generic companies better able to compete on price, driving costs down for poor people dying preventable deaths. This is a humanitarian aid bill meant to save lives, not money.
After years battling opposition and regulatory quirks in the House, only to be stalled to death in the Senate, Bill C-393 isn’t guaranteed a swift pass through this Parliament.

Canada’s political landscape has changed. The NDP say they will reintroduce the private member’s bill that was first passed in the minority Parliament.

Canada has two choices.

The Conservative government could bolster the country’s reputation on the world stage at no cost to taxpayers. In fact, passing the bill would make Canada’s foreign aid dollars go further because we, and developing countries, could purchase more medicine for less.

Or, our government could fail to act, leaving countless people to die needless deaths.

Drop a beat: Grannies rap about access to medicines

Canadian grannies and their families rap to K’naan’s Wavin Flag to demand that Canada make good on its promise to provide affordable medicines to countries in need. A child dies every 6 seconds in developing countries because of a lack of affordable, lifesaving medicines. Some 17 million children in Africa have been orphaned because of HIV/AIDS. Most are being raised by their courageous, desperately poor grandmothers. You can help–take action at http://www.aidsaction.ca/ and contact your local politicians today!

Access 101: Introduction to Compulsory Licensing

If you’re new to the issue of access to medicines, you’ll see us talk often of intellectual property and how these laws and rules affect people’s ability to obtain life-saving medicines. Today I’ll discuss compulsory licensing but before I do, I need to talk a bit about intellectual property.

What is intellectual property? Well, intellectual property is a branch of law that deals with the rights and ownership of ideas–properties of the mind, so to speak. It’s grounded in the belief that individuals should be able to protect their ideas and profit off of them and in turn, the financial returns will also drive economic development. We usually see intellectual property in the form of:

  • Copyright (the expression of ideas say in a textbook or journal article)
  • Trademarks (think of Microsoft’s floating window logo and McDonald’s golden arches) or
  • Patents (which applies to inventions like cameras or chemical compounds)

So this is all very well and good we might say–if I come up with some original work, I ought to be able to take ownership and make money to recoup the time and resources I spent coming up with that valuable idea. For the most part I would agree with that. But what about when this idea means the difference between life or death, sickness and health? What happens when people don’t have the means to afford the prices someone else sets? That’s where compulsory licenses (CL) come into light. CL’s are a legal means to force a patent-holder to grant use of a patent to the government or another party. Historically, CL’s are used in extraordinary situations to protect health and human safety, situations like:

  • World War II, where the allies needed to manufacture a large number of specific engines in airplanes for minimum cost.
  • 2001, where the Anthrax bacteria scare in the U.S. led their government to issue a compulsory license to maximize production of the antibiotic ciprofloxacin.
  • The HIV/AIDS pandemic, where the cost to treat one patient for one year in the early 1990’s was well over $10,000.

So we see that there are very good reasons to use compulsory licensing when human safety is threatened and there is a clear precedent of its use and value. When faced with the rising problem of access to medicines in the developing world, the World Trade Organization incorporated means to address these imbalances by implementing mechanisms to use CL in the international trade agreement, TRIPS. Critics of the WTO have argued however that these measures are insufficient and do not allow CL to be effectively used by populations in need (read more in the links below).

Initially TRIPS only allowed a country to obtain a compulsory license for domestic markets, that meant if you’re a country like Rwanda that has no pharmaceutical industry, you will need someone industrialized (like Canada) to export medicine to you. TRIPS was updated to reflect this gap in something called the ‘August 30th Decision’–it allowed member countries to develop a legal mechanism for manufacturers to obtain a CL so they could export a life-saving medicine to developing countries. Canada was the first to do so by creating Canada’s Access to Medicines Regime; however, this is far from a functional solution which Dave Ng writes more about here.

Compulsory licensing is but one solution for a variety of problems that constitute the challenging in providing medicines for the 1-in-3 people around the world who still lack access. We have much to talk about the limitations of compulsory licensing, other mechanisms for improving access in terms of IP management and other logistical problems that prevent medicines reaching points of care from points of manufacturing.

For more readings on compulsory licensing in general and in practice, visit:

Comments are always welcome below.

A chance for Canada to make good (for a change).

Here’s an interesting press release regarding Canada’s reputation as a do-gooder. It seems that it’s taken a hit over the last few years, but that there’s still opportunities to improve our image: a big one being our possible actions on the Access to Medicine front.

Anyway, here’s the just released press release. And don’t forget: If you’re a reader from Canada, don’t forget to check out aidsaction.ca. Here, you can look up your candidates and send off an email to support the Call to Action to reform Canada’s Access to Medicines Regime and help save lives!

For immediate release

NEW POLL SHOWS CANADIANS CONCERNED ABOUT GLOBAL REPUTATION, BUT CONFIDENT IT CAN BE IMPROVED BY MAKING AFFORDABLE MEDICINES AVAILABLE TO DEVELOPING COUNTRIES

Grassroots campaign begins to build support for quick passage of bill after election

Toronto, April 26, 2011 – A new public opinion poll shows twice as many Canadians (35%) believe the country’s international reputation has declined in the last few years rather than improved (17%), with a third (37%) believing it has just remained the same. But according to the same poll, seven in 10 Canadians (71%) feel that it would improve the country’s reputation if Canada were to pass a bill making it easier to supply less expensive, generic medicines to people in developing countries for diseases such as AIDS, tuberculosis and malaria. Canada was on the verge of passing such a law – Bill C-393 to reform Canada’s Access to Medicines Regime (CAMR) – before it was delayed in the Senate and thus died on the order paper when the election was called.

“This poll confirms the tremendous opportunity presented to Members of Parliament and Senators willing to fix Canada’s broken Access to Medicines Regime,” said Richard Elliott, Executive Director of the Canadian HIV/AIDS Legal Network. “Not only will such a bill help get desperately needed medicines to people dying of treatable diseases, it will also improve Canada’s reputation as a good global citizen.”

With Canada’s foreign aid now frozen and the loss of a seat at the UN Security Council seen by some as a setback for the country’s international reputation, humanitarian initiatives such as legislation to fix CAMR – which will cost taxpayers nothing – presents a compelling rallying point.

In fact, a grassroots movement made up of grandmothers groups, student organizations, and health and human rights activists have launched www.AIDSaction.ca. It asks every candidate from the major federal parties in every riding to indicate whether they support fixing CAMR to help those most in need. The website will track candidates’ responses online in an interactive chart so voters across the country can see which candidates in their riding have already stated their support for fixing CAMR. It also makes it easy for voters to e-mail the candidates in their ridings to ask them where they stand if they haven’t yet replied.

“Canadians were strongly behind a bill that would have saved lives,” said Andrea Beal, co-chair of the National Advocacy Committee of the Grandmothers to Grandmothers Campaign. “We’re asking candidates to listen to the will of the people and support making affordable medicines accessible to developing countries. This new poll is just further evidence of why they should act.”

Created unanimously by Parliament in 2004, CAMR has been rendered practically useless because of red tape. Only one order of one medicine was ever filled, and to just a single country. The one generic drug company that did use CAMR has said it will not attempt to use the cumbersome process again, nor will any developing countries try. Critical to the goal of cutting through this red tape is the “one-license solution”, a key part of any CAMR-reform legislation.

Before Bill C-393 died in the Senate last month, public momentum was behind efforts to make affordable medicines available to people who need them. The legislation – which included the “one-license solution” – had the support of many prominent Canadians including international aid workers, human rights leaders, physicians and faith leaders. It was also supported by more than 70 000 Canadians who signed a petition or sent letters calling on Parliament to pass the bill into law. When the House voted on March 9, Bill C-393 passed by a strong majority – 172 to 111 – with support from MPs representing all parties.

“Canadians have shown over and over that they get it when it comes to the rights of all people to have access to medicines that will save their lives,” said Aria Ahmad, coordinator of the University of Toronto chapter of the international student group Universities Allied for Essential Medicines (UAEM). “We urge candidates for Parliament to listen to them.”

More background information on efforts to fix Canada’s Access to Medicines Regime including detailed arguments by international legal and health experts in favour of previous legislative attempts to do just that can be reviewed at www.aidslaw.ca/camr.
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A Primer on the Subject of Access to Medicines

Here’s a piece I wrote for online reading at Scientific American. It basically tries to cover the main ideas and main challenges in Access to Medicines issues. Not a bad place to start to get into the swing of things. Also, If you’re a reader from Canada, don’t forget to check out aidsaction.ca. Here, you can look up your candidates and send off an email to support the Call to Action to reform Canada’s Access to Medicines Regime and help save lives!

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30 minutes, 70 fates.

You don’t know it, but as I write this piece, there is some serious procrastination going on. My attention span is weak and sidetracked constantly by a variety of diversions, and if you must know, it’s taken me close to half an hour to write these first two sentences. Still, one could argue that none of us are strangers to procrastination, and 30 minutes is relatively short – only a minor instance of time in the grand scheme of things.

But a lot can happen in thirty minutes. Earlier, I had been looking over some 2009 UNAIDS statistics, and noting the numbers issued in the report. They are all very big, big enough certainly to require the pressing of buttons on calculators. More to the point, I learn that during my thirty minutes, approximately 70 people died from HIV/AIDS in Sub-Sahara Africa. That’s 1.3 million victims each year – in Sub-Sahara Africa alone. Many of these were parents leaving orphans, and many were young children just leaving. Most troubling, however, is the fact that all of them suffered their fate with a loss of dignity.

Why do I say this? I say this because people shouldn’t have to die from HIV/AIDS. There are good medicines out there, and they can control the disease. In fact, for those in the developed world, HIV/AIDS is now considered a chronic disorder, not a death sentence. If you are diagnosed, you are no longer forced to take a shortcut to demise. You can still have a long life, you can still be productive, and you can still live with dignity.

Unfortunately, this wasn’t an option for those who passed away. For them, the medicines were out of reach. They were simply too expensive. And from this, you come to realize a cold hard fact in this narrative: that the fate of a person living or dying from HIV/AIDS is determined by their income. This statement is fairly straightforward, with no mincing of words, or confused rhetoric. But for most, it feels fundamentally wrong, and yet, it is a simple reality of how the world works today. Why it works in this way, however, is complicated.
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