From July 19-21, activists from across the globe gathered in Istanbul for the second edition of the Global Summit on Intellectual Property and Access to Medicines (GSIPA2M). This event is a biennial gathering organized by the International Treatment Preparedness Coalition (ITPC) and Make Medicines Affordable consortium to hold critical debates and discussions on ensuring that intellectual property rights don’t undermine equitable access to lifesaving medicines.
At the summit, one thing became crystal clear: the challenges of the Access to Medicines (A2M) movement are diverse and enormous. They include Big Pharma’s unstoppable greed and influence over governments, multi-stakeholder initiatives usurping the role of UN institutions, and insufficiency of national-level laws and institutions. The challenges expand to voluntary license initiatives being used to undermine investment in local Research and Development (R&D) and manufacturing, anticompetitive practices, using evergreening tactics to get patent term extensions, R&D focused on high income countries’ (HIC) needs and implementation capacities, a generalized lack of transparency, and a drift within civil society towards less radical and more professionalized tactics for engaging governments and pharma. All of this has been intensified by many ongoing armed conflicts, migration crises and the COVID-19 pandemic.
Reviving the movement’s radical demands
Considering the size and complexity of these obstacles, and the unequal power relations between social movements and the empire formed by HIC and their transnational corporations, a series of questions emerged during the meeting: How to face these challenges in a coordinated manner across different geographical regions? Has our fight changed to a bureaucratic and artificially technical level? Have funders’ demands shaped activities and aims of the A2M movement? In short: has our imagination been colonized by the immediatism imposed by the oppressors or are we still grounded in our history and in people’s everyday struggles? Shouldn’t we be more radical in setting our goals and bold in imagining our future?
Much of the discussion focused on the fact that these questions can only be answered through an honest reassessment of our political conjuncture. By going directly to the root of our problems – the unequal structure of the global political economy – we can demand more radical solutions to our peoples’ suffering. One example of such a radical solution would be the interventions proposed in the Declaration of the New International Economic Order (NIEO) and the Alma Ata Declaration’s acknowledgement of its importance for realizing health for all.
One of the suggestions emerging from the conference was that we increase pressure on our governments to “normalize compulsory licensing,” that is lawful government authorization to produce, commercialize and use a patented product without the consent of the patent owner. This is one way to shift the narrative from focusing on what developing countries cannot do, to what they can and must do to promote equitable access to medicines now. Normalizing compulsory licensing should be seen as a way of reclaiming political space in the areas of scientific and industrial policy, and ensuring they are shaped by local priorities and subject to democratic oversight.
While initiatives like voluntary licenses might make cheaper medicines available relatively quickly, they depend on the good graces and priorities of Big Pharma. Voluntary licenses describe a situation where patent holders voluntarily give other manufacturers permission to produce the patented product. Such licenses have been extensively used as a tool to maximize the commercial interests of patent owners. Historically, they have been part of a broader strategy which, among other things, aims at blocking compulsory licenses, segmenting markets, and enabling the exploitation of under-served patents, all strategies that limit the space governments have when it comes to establishing control over the production of essential medicines. The effects of such a process can be observed right now when it comes to many medicines, such as nirmatrelvir/ritonavir (Paxlovid), used in the treatment of COVID-19, and the long-acting cabotegravir, used in the prevention of HIV/AIDS.
Beyond this, current circumstances demand more imaginative proposals and radical solutions from the A2M, and broader right to health movements. Even in the midst of a global pandemic, the unjust TRIPS regime continues to protect profits and a privatized ownership of life-saving public goods. Instead of fighting for crumbs at the “end of history,” we have to go back to our principles and state clearly that health is not for sale. We must demand removing all essential goods and services from the scope of the World Trade Organization’s (WHO) authority and from all Free Trade Agreements. We must insist that the WHO be recognized as the only legitimate body to lead the coordinated global response to health emergencies. Its authority should not be usurped by multi-stakeholder initiatives like Covax that treat WHO like a junior partner.
More than that, from the summit’s debates, it was blatantly clear how we have to abandon a reactive position, recover our sense of urgency and dare to positively imagine a way of living that has solidarity at its core.
Lauren Paremoer is a senior lecturer at the Political Studies Department, University of Cape Town and a member of People’s Health Movement South Africa.
Alan Rossi Silva is a PhD candidate in Law at the State University of Rio de Janeiro, Brazil, and an activist in the People’s Health Movement.
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