Paris

The United States clashed with developing countries over the impact of global trading rules on the distribution of medicines, at a special meeting of the World Trade Organization (WTO) in Geneva, Switzerland.

Crisis point: countries facing killer diseases such as malaria want freedom from drug patent rules. Credit: ANDY CRUMP, TDR, WHO/SPL

The meeting on 20 June, called by the WTO's African members, looked at whether the agreement known as TRIPS (trade-related aspects of intellectual property rights) should be modified to allow poorer countries better access to affordable drugs. TRIPS is aimed at protecting intellectual property rights internationally.

Officials said afterwards that, despite broad differences on the issue between developing countries and the United States in particular, further discussions would be held in the hope that global trade ministers can produce a clear statement on the issue when they meet in Qatar this November.

Pharmaceutical companies have argued, for example, that the TRIPS agreement entitles the United States to charge Brazil with breaching WTO rules by manufacturing its own generic AIDS drugs. The United States has so far refrained from taking such action.

According to the current TRIPS agreement, with which all WTO members must comply by 2006, compulsory licensing — the production of cheaper, generic versions of a drug — can take place without the prior consent of the patent holder only “in national emergencies or other circumstances of extreme urgency”.

The developing countries want the WTO to state clearly that this allows them to act freely in responding to AIDS and other health crises. Otherwise, they say, TRIPS may have to be changed. They also want more time to comply with the agreement.

Delegates from European Union countries also urged clarification on some points of TRIPS. They called for more discussion to produce a consensus on how it should be interpreted.

The US delegation said that it “would not object” if WTO member countries used the flexibility within the agreement to tackle major health crises. But it warned against the use of practices such as compulsory licensing “in the normal course of doing business”. The delegation denied that the TRIPS agreement is not sufficiently clear or flexible.

David Earnshaw of Oxfam International says the outcome of the meeting was “entirely satisfactory” and has “shown up the United States as completely isolated in its position”. Francisco Cannabrava, the Brazilian delegate, although critical of what he regards as the United States' inflexible reading of the TRIPS agreement, welcomed the fact that they were participating in the discussion.

But Harvey Bale, director-general of the International Federation of Pharmaceutical Manufacturers Associations, warned that developing countries, and not the pharmaceutical companies, could be the biggest losers if changes were made to TRIPS. “The world needs to decide where it wants pharmaceutical companies to put their R&D,” he says. “There are lots of diseases with currently ineffective treatments where they could put their money instead.”

Many countries and non-governmental organizations now hope that a declaration will be agreed in Qatar stating that the TRIPS agreement should not stand in the way of public-health agendas. They say this will help to stave off growing public criticism that the WTO is indifferent to the needs of poor countries. As a result of last week's meeting, two further WTO meetings on access to medicines have already been planned for between now and November .

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