From Poverty to Power Green, Oxfam 2008 - weman

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5 THE INTERNATIONAL SYSTEM TRADINGThe TRIPS agreement allowed some flexibility for developingcountries to override patent rules to protect public health, but thispromptly degenerated into a legal battleground as rich corporationsand countries turned to the courts in an effort to restrict them fromdoing so. In 2001, a group of 39 of the world’s largest pharmaceuticalcompanies took the South African government to court over the termsof its 1997 Medicines Act. At that time around 4.5 million people inSouth Africa were infected with the HIV virus, but the vast majority ofthem did not have access to effective treatment, in part due to theextremely high prices of ARVs. Other problems included the highlyunequal health infrastructure inherited from the apartheid period,lack of finance, and lack of political will in some sections of thegovernment to tackle HIV and AIDS.The companies decided to pursue legal proceedings despite thedevastation caused by South Africa’s public health crisis, sparkinginternational condemnation. They argued that the Medicines Act,which allowed ‘parallel imports’ (imports of cheaper patentedmedicines), breached the TRIPS agreement, when in fact TRIPS isneutral on this issue. Citizen campaigns (spearheaded by the TreatmentAction Campaign and including a global campaign by Oxfam andMSF) and public uproar became such a serious threat to the drugcompanies’ reputations that they dropped the lawsuit.The case also helped to galvanise the passage of the DohaDeclaration on TRIPS and Public Health, agreed upon by all WTOmembers prior to the start of a new round of global trade negotiationsin November 2001. The Doha Declaration unequivocally recognisedthat the TRIPS agreement ‘can and should be interpreted and implementedin a manner supportive of WTO members’ right to protectpublic health, and in particular, to promote access to medicines for all’.The legal clarity of the Doha Declaration, combined with the badpublicity from the episode, motivated some drug companies to stopopposing the import or local production of generic antiretroviralmedicines, and to offer some of their ARVs and other medicines atlower or ‘no-profit’ prices in sub-Saharan Africa. Yet such ad hocinitiatives have mostly been limited to a few high-profile diseases(in addition to HIV and AIDS, TB and malaria), and even for thosediseases have fallen short.329
FROM POVERTY TO POWERPrices for some key medicines, including first-line ARVs, have fallensharply in recent years. But newer antiretroviral medicines, neededbecause they are more effective or to overcome toxicity or resistance tofirst-line medicines, are often ten times more expensive. In addition,developing countries face an increasing burden of non-communicabledisease – according to WHO, over 80 per cent of deaths from noncommunicablediseases today occur in developing countries.New medicines to treat cancer, heart disease, and diabetes, patentedaggressively by the industry, are priced out of reach of poor people.The pharmaceutical industry continues to aggressively seek toenforce patents and to charge high prices for medicines in low- andmiddle-income countries across Asia and Latin America, keepingmedicines unaffordable for millions of poor people. When countriesrecently tried to use TRIPS safeguards, it again jumped all over them,even returning to the aggressive legal tactics that had earned it such ablack eye a few years previously. Novartis and Pfizer becameembroiled in legal disputes in India and the Philippines respectively,while Thailand’s decision to issue a compulsory licence for its secondlineHIV medicine Kaletra prompted Abbott Pharmaceuticals tode-register seven new medicines from the Thai market. Abbott wascharging patients nearly $2,200 per year for the drug. 71Rich countries are also working to render the public healthsafeguards in TRIPS meaningless by including more stringent patentrules in bilateral agreements. The US–Jordan FTA, signed in 2000,required Jordan to agree rules on so-called ‘data exclusivity’, whichblock the registration and marketing approval of generic medicinesfor five or more years, even when no patent exists. Data exclusivity hasdelayed generic competition for 79 per cent of medicines launchedby 21 multinational pharmaceutical companies between 2002 andmid-2006 that otherwise would have been available in an inexpensive,generic form.Partly as a result of such TRIPS-plus rules, medicine prices in Jordanhave increased drastically, threatening the financial sustainability ofgovernment public health programmes. Stricter levels of intellectualproperty protection have conferred few benefits with respect to FDI,domestic R&D, or accelerated introduction of new medicines.330
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OXFAM INTERNATIONALOxfam Internatio
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First published by Oxfam Internatio
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PART 4 RISK AND VULNERABILITY 197Li
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LIST OF ACRONYMSAIDSARTARVASEANAUCA
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ACKNOWLEDGEMENTSThe word ‘editor
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FOREWORDGeorge Bernard Shaw argued
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FOREWORDThis book, which I hope wil
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PART ONE
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1 INTRODUCTION THE UNEQUAL WORLDEnd
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1 INTRODUCTION THE UNEQUAL WORLDExt
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1 INTRODUCTION THE UNEQUAL WORLDPOV
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1 INTRODUCTION THE UNEQUAL WORLDSuc
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1 INTRODUCTION THE UNEQUAL WORLDACT
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1 INTRODUCTION THE UNEQUAL WORLDpeo
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1 INTRODUCTION THE UNEQUAL WORLDcom
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PART TWOThe political roots of deve
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2 POWER AND POLITICS THE POLITICAL
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2 POWER AND POLITICS THE POLITICAL
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I HAVE RIGHTS, THEREFORE I AMThe hi
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2 POWER AND POLITICS I HAVE RIGHTS,
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FROM POVERTY TO POWERThe attitudes
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FROM POVERTY TO POWERJain: ‘A man
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FROM POVERTY TO POWERI READ, THEREF
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FROM POVERTY TO POWEREven where pub
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FROM POVERTY TO POWERplayed a pivot
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FROM POVERTY TO POWERDespite some p
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FROM POVERTY TO POWERof sub-Saharan
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FROM POVERTY TO POWERIn water servi
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FROM POVERTY TO POWERI SURF, THEREF
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FROM POVERTY TO POWERDespite the hy
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FROM POVERTY TO POWERresearch effor
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FROM POVERTY TO POWERWE ORGANISE, T
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FROM POVERTY TO POWERreinforce disc
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FROM POVERTY TO POWERThe bedrock of
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FROM POVERTY TO POWERwith imperviou
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FROM POVERTY TO POWERgovernments an
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FROM POVERTY TO POWERCASE STUDYand
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FROM POVERTY TO POWERI OWN, THEREFO
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FROM POVERTY TO POWER‘breathe lif
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FROM POVERTY TO POWERLAND REFORM‘
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FROM POVERTY TO POWERled to the cou
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FROM POVERTY TO POWERthese things.
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FROM POVERTY TO POWERwhile Benin an
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FROM POVERTY TO POWERWhere flawed d
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FROM POVERTY TO POWERstarted to att
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FROM POVERTY TO POWERI STEAL, THERE
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FROM POVERTY TO POWERTHE CURSE OF W
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FROM POVERTY TO POWERI RULE, THEREF
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FROM POVERTY TO POWERthe turn of th
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FROM POVERTY TO POWERBOX 2.2ARE EFF
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FROM POVERTY TO POWER‘embedded au
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FROM POVERTY TO POWERIn the face of
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FROM POVERTY TO POWERcost incurred
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FROM POVERTY TO POWERIn the Horn of
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FROM POVERTY TO POWERFROM POVERTY T
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FROM POVERTY TO POWER106
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FROM POVERTY TO POWERAN ECONOMICS F
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FROM POVERTY TO POWERpicture it off
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FROM POVERTY TO POWERthe work of wo
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FROM POVERTY TO POWERWhile the envi
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FROM POVERTY TO POWERcan be broaden
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FROM POVERTY TO POWERbut are largel
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FROM POVERTY TO POWERaltogether. Ru
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FROM POVERTY TO POWERFIGURE 3.2: MO
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FROM POVERTY TO POWERin their relat
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FROM POVERTY TO POWERliving from lo
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FROM POVERTY TO POWERenvironments.
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FROM POVERTY TO POWERthem farming o
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FROM POVERTY TO POWERThe jury is al
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FROM POVERTY TO POWERor credit to i
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FROM POVERTY TO POWERplanned mill.
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FROM POVERTY TO POWERto begin with.
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FROM POVERTY TO POWERprogrammes (SA
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FROM POVERTY TO POWERfertilisers to
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FROM POVERTY TO POWERDomestic and r
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FROM POVERTY TO POWERHOW CHANGE HAP
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FROM POVERTY TO POWERTHE CHANGING W
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FROM POVERTY TO POWERThe nature of
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FROM POVERTY TO POWERNOBODY’S FOR
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FROM POVERTY TO POWERFordist mass p
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FROM POVERTY TO POWERand Palau have
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FROM POVERTY TO POWERA similar situ
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FROM POVERTY TO POWERMany unions ha
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FROM POVERTY TO POWERBOX 3.5INDIA
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FROM POVERTY TO POWERrather than di
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FROM POVERTY TO POWEROne trade agre
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FROM POVERTY TO POWERPRIVATE SECTOR
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FROM POVERTY TO POWERothers see the
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FROM POVERTY TO POWERlocal producer
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FROM POVERTY TO POWERWhile China’
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FROM POVERTY TO POWERcountries rock
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FROM POVERTY TO POWERLocal NGOs and
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FROM POVERTY TO POWERbetter off eve
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FROM POVERTY TO POWERTwenty years o
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FROM POVERTY TO POWERcompanies (for
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FROM POVERTY TO POWERhigh- and midd
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FROM POVERTY TO POWERtheir comparat
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FROM POVERTY TO POWERchange is such
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FROM POVERTY TO POWERCASE STUDYThe
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FROM POVERTY TO POWERseason, or whe
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FROM POVERTY TO POWERLIVING WITH RI
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FROM POVERTY TO POWERInsecurity and
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FROM POVERTY TO POWERand withstand
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FROM POVERTY TO POWERcomprehensive
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FROM POVERTY TO POWERFIGURE 4.2: CA
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FROM POVERTY TO POWER(although deli
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FROM POVERTY TO POWERfailure, notab
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FROM POVERTY TO POWERhave a dignifi
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FROM POVERTY TO POWERStandard beare
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FROM POVERTY TO POWERWhile more exp
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FROM POVERTY TO POWERCASE STUDYtwo
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FROM POVERTY TO POWERFINANCE AND VU
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FROM POVERTY TO POWERas the insuran
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FROM POVERTY TO POWERHUNGER AND FAM
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FROM POVERTY TO POWERfirewood for s
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FROM POVERTY TO POWERthe 1973 droug
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FROM POVERTY TO POWERA human securi
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FROM POVERTY TO POWERof the Black D
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FROM POVERTY TO POWEREveryone has a
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FROM POVERTY TO POWERstate-of-the-a
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FROM POVERTY TO POWER24-hour advice
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FROM POVERTY TO POWERTherefore when
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FROM POVERTY TO POWERgovernment to
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FROM POVERTY TO POWERwhether in the
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FROM POVERTY TO POWERIn regions pro
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FROM POVERTY TO POWERThe key to suc
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FROM POVERTY TO POWERBOX 4.5:CUBA V
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FROM POVERTY TO POWERdisaster-drive
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FROM POVERTY TO POWERIn enhancing h
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FROM POVERTY TO POWERhigher confide
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FROM POVERTY TO POWERIn Africa’s
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FROM POVERTY TO POWERtheir source:
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FROM POVERTY TO POWERcommunity and
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FROM POVERTY TO POWERfrom this have
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FROM POVERTY TO POWERLIVING ON THE
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FROM POVERTY TO POWERLike Australia
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FROM POVERTY TO POWERA positive fut
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FROM POVERTY TO POWERcome out all s
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FROM POVERTY TO POWERareas or among
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Page 303 and 304: FROM POVERTY TO POWERSHOCKS AND CHA
Page 305 and 306: FROM POVERTY TO POWERMajor changes
Page 307 and 308: FROM POVERTY TO POWERpassed from be
Page 309 and 310: FROM POVERTY TO POWERWHO RULES THE
Page 311 and 312: FROM POVERTY TO POWERPowerful state
Page 313 and 314: FROM POVERTY TO POWERThroughout the
Page 315 and 316: FROM POVERTY TO POWERinflationary p
Page 317 and 318: FROM POVERTY TO POWERWhen critics r
Page 319 and 320: FROM POVERTY TO POWERFund now both
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Page 323 and 324: FROM POVERTY TO POWERcrisis consist
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Page 329 and 330: FROM POVERTY TO POWER• Sudden inf
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Page 333 and 334: FROM POVERTY TO POWERto reduce the
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Page 337 and 338: FROM POVERTY TO POWERPatents: Intel
Page 339 and 340: FROM POVERTY TO POWERdumping on wor
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Page 343 and 344: FROM POVERTY TO POWERprotectionism
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Page 349 and 350: FROM POVERTY TO POWER• Establish
Page 351 and 352: FROM POVERTY TO POWERborder, or at
Page 353 and 354: FROM POVERTY TO POWERBOX 5.1MIGRANT
Page 355 and 356: FROM POVERTY TO POWERnumber of‘fr
Page 357 and 358: FROM POVERTY TO POWERFor example, q
Page 359 and 360: FROM POVERTY TO POWERMotivated by a
Page 361 and 362: FROM POVERTY TO POWERIn the Uruguay
Page 363 and 364: FROM POVERTY TO POWERlong-term deve
Page 365 and 366: FROM POVERTY TO POWERimportance in
Page 367 and 368: FROM POVERTY TO POWERUN Global Comp
Page 369 and 370: FROM POVERTY TO POWERThe drivers of
Page 371 and 372: FROM POVERTY TO POWERMore broadly,
Page 373 and 374: FROM POVERTY TO POWERWhatever the m
Page 375 and 376: FROM POVERTY TO POWERThe heightened
Page 377 and 378: FROM POVERTY TO POWERThe aid optimi
Page 379 and 380: FROM POVERTY TO POWERThe aid optimi
Page 381 and 382: FROM POVERTY TO POWERand 2006/07, f
Page 383 and 384: FROM POVERTY TO POWERgovernment dow
Page 385 and 386: FROM POVERTY TO POWERpractice, but
Page 387 and 388: FROM POVERTY TO POWERWithholding ai
Page 389 and 390: FROM POVERTY TO POWER1950s and 1960
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Page 395 and 396: FROM POVERTY TO POWERand the UN pro
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FROM POVERTY TO POWERA decade on, t
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FROM POVERTY TO POWERCASE STUDYFebr
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FROM POVERTY TO POWERTHE INTERNATIO
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FROM POVERTY TO POWERThe humanitari
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FROM POVERTY TO POWERThe wrong kind
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FROM POVERTY TO POWERlead agencies
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FROM POVERTY TO POWERgovernment in
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FROM POVERTY TO POWERThe only probl
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FROM POVERTY TO POWERopportunity is
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FROM POVERTY TO POWERREFUGEESPeople
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FROM POVERTY TO POWERWest African S
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FROM POVERTY TO POWERdrivers of con
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FROM POVERTY TO POWERCASE STUDYgrou
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FROM POVERTY TO POWERCLIMATE CHANGE
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FROM POVERTY TO POWERwithout heavy
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FROM POVERTY TO POWERunless the wor
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FROM POVERTY TO POWERcap the aspira
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FROM POVERTY TO POWERreduce the qua
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FROM POVERTY TO POWERThe CDM is bes
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FROM POVERTY TO POWERAccused variou
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FROM POVERTY TO POWERemissions by 8
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FROM POVERTY TO POWERBangladesh and
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FROM POVERTY TO POWERGLOBAL GOVERNA
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FROM POVERTY TO POWERNew Zealand wa
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FROM POVERTY TO POWERA NEW DEAL FOR
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FROM POVERTY TO POWER430
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FROM POVERTY TO POWERHow change hap
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FROM POVERTY TO POWER• Family str
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FROM POVERTY TO POWERTHE DYNAMICS O
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FROM POVERTY TO POWERseeking change
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FROM POVERTY TO POWERWithin many de
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FROM POVERTY TO POWERSecond, becaus
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FROM POVERTY TO POWER15 For a more
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FROM POVERTY TO POWER41 WaterAid (2
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FROM POVERTY TO POWER121 UNDP (2007
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FROM POVERTY TO POWER46 R. Offenhei
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FROM POVERTY TO POWER106 M. Rama (2
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FROM POVERTY TO POWER172 P. Chaudhr
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FROM POVERTY TO POWER37 FAO (2007).
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FROM POVERTY TO POWER94 IPCC (2007)
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FROM POVERTY TO POWER155 UN OCHA (2
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FROM POVERTY TO POWER34 UN (2006)
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FROM POVERTY TO POWER101 M. Chen (2
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FROM POVERTY TO POWER168 D. Rodrik
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FROM POVERTY TO POWER215 UN Framewo
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FROM POVERTY TO POWERBIBLIOGRAPHYAc
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FROM POVERTY TO POWERBoko, M., I. N
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FROM POVERTY TO POWERCiconello, A.
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FROM POVERTY TO POWERDFID (2005)
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FROM POVERTY TO POWERGaleano, E. (1
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FROM POVERTY TO POWERHopkins Leishe
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FROM POVERTY TO POWERKeynes, J.M. (
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FROM POVERTY TO POWERMoran, T. (200
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FROM POVERTY TO POWEROxfam Intermó
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FROM POVERTY TO POWERRama, M. (2003
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FROM POVERTY TO POWERStockbridge, M
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FROM POVERTY TO POWERUNESCO (2007)
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FROM POVERTY TO POWERWorld Bank (20
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FROM POVERTY TO POWEROxfam Australi
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FROM POVERTY TO POWERGLOSSARYAccoun
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FROM POVERTY TO POWEREffective stat
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FROM POVERTY TO POWERNeoclassicalec
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FROM POVERTY TO POWERINDEXPage numb
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FROM POVERTY TO POWERfinancial inst
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FROM POVERTY TO POWER303, 304, 305,
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FROM POVERTY TO POWERgrowth 114, 18
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FROM POVERTY TO POWERIndia:access t
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FROM POVERTY TO POWERJapan:climate
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FROM POVERTY TO POWERPacific region
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FROM POVERTY TO POWERtransnational
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FROM POVERTY TO POWER241; human sec
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