This is especially true of those companies based in the center of the world of "free" enterprise, the United States of America. What is more, they are strongly supported by the government of George W. Bush despite the fact that the American people themselves have voiced their sentiments against these practices by shifting from branded patent medicines to generic drugs, forcing a dramatic change in the American drug market.

Next week, at the World Health Assembly, which is the World Health Organization’s highest governing body, the United States government delegation will once again attempt to sabotage emerging global consensus that public health interests take precedence over commercial concerns with regards to access to affordable medicines. Up for discussion at the Assembly is a document titled: "Draft global strategy on public health, innovation, and intellectual property." It is the product of over two years of work by the Inter-governmental Working Group (IGWG) on strategies to implement the recommendations of another global body, the WHO Commission on Intellectual Property, Innovation, and Health (CIPIH), whose report also took over three years of deliberations.

The long titles and prolonged discussions are themselves indicative of the tortuous ways in which the Bush administration has bullheadedly tried to protect American pharmaceutical interests despite global opposition especially from the developing countries. It all began with an American attempt to blunt the effects of the Doha Ministerial Agreement that recognized public health supremacy over commercial interests in the implementation of rules protecting intellectual property rights in the field of drugs and medicines.

With American support, the WHO-CIPIH was tasked to recommend ways by which intellectual property incentives would continue to stimulate innovation in drug development. Fortunately for the rest of the world, the Commission recognized the need to reform pharmaceutical markets globally to allow the world’s poor to benefit from emerging health technologies designed to alleviate human suffering. Thus, the CIPIH recommendations were not at all to the liking of the multinational drug lobbies of the developed world.

And so, the IGWG was created purportedly to develop strategies to implement the Commission’s wide-ranging recommendations. It is clear from a reading of the discussions so far that the American intention was really to thwart the intent of the recommendations. Of the dozen or so unresolved issues concerning the IGWG report, more than half deal with American objections to language that interferes with corporate abilities to override health concerns.

For example, American representatives have insisted on changing the wording of the principle on which the report is based from "the right to health takes precedence over commercial interests" to "the objectives of public health and the interests of trade should be appropriately balanced and coordinated." Such blatant disregard for world opinion has not been matched since the Reagan administration’s delegation to the World Health Assembly cast the only dissenting vote on the International Convention on the Marketing of Breast-milk Substitutes" in the early ‘80s.

The American representatives in the IGWG have also attempted to thwart any proposal to improve the competitiveness of poor countries in attaining pharmaceutical parity. By insisting on "data exclusivity," the multinationals effectively handicap Third World economies by forbidding them the use of clinical evidence, already in the public domain, in assessing products to be manufactured by local companies.

It is to be expected that at this year’s Assembly, the American delegation will once again attempt to browbeat small countries into accepting their version of what is in effect international "cheaper medicines" legislation. If they have their way, the international pharmaceutical environment will once again be ripe for multinational exploitation. The health of people in the developing world will be held hostage in the interest of incentives for innovation – which really translates into higher profit margins for investors in the western pharmaceutical industry.

As in the past, the Philippine delegation will be a prime target for lobbying by the American delegation. It is hoped that the Philippines’ past record as a pioneer in efforts to uphold the primacy of health concerns over commercial interests will be defended by its representatives in Geneva next month. If this does not happen, there will again be another reason for the country’s ongoing decline in stature in the eyes of its peers in the third world.

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In 1992, the Republican US Congress, under pressure by the Bush Administration, passed the Prescription Drug User Fee Act. The law imposes deadlines for the completion of drug reviews by the US Food and Drug Administration. The requirement effectively resulted in rushed approvals of new products which in turn has emergence of drug safety problems in recent years.

According to an article in the New England Journal of Medicine last month: "Critics have argued that the user-fee program makes the agency too dependent on the industry it regulates and has led the FDA to focus disproportionately on the needs of the manufacturers that now fund more than half of its drug-review budget and staff. Such criticisms have been heightened by the safety-based withdrawals of rofecoxib (Vioxx, Merck) and valdecoxib (Bextra, Pfizer), the delayed recognition of suicidality in children and young adults taking selective serotonin-reuptake inhibitors, and the addition of a black-box warning about congestive heart failure and controversy over the risk of myocardial infarction caused by rosiglitazone (Avandia, GlaxoSmithKline) eight years after it was approved."

This is another example of how preferential concern for commercial interests can pose dangers to public health and safety.