NEWS

WHO supports EU proposal for cheap drugs

WHO would not like a fixed list of diseases to break the WTO deadlock [see adjacent story], as it is too inflexible, says Jonathan Quick, of WHO's Essential Drugs and Medicines Policy department. The Organization already publishes a priority list of its own — the Essential Medicines List, already in its tenth edition, but, Quick told the Bulletin "It was never intended to be a global standard — it's a model that's meant to be adapted. It contains some 325 drugs, about the number least-developed countries can buy; middle-income countries typically use 600; high-income countries 1200. The bottom line has to be flexibility."

"The way WHO operates, ultimately countries decide what is of importance to them; we provide advice, the best possible data, top-flight key data. Last April for example we said these are the best 12 antiretrovirals for HIV/AIDS, and these the first, second and third most effective combinations; but we would not say: 'Therefore these are the only drugs you can buy."'

If a country considered it needed to import generics for some condition, according to the European Union (EU) proposal WHO's role would be to provide evidence and advice on the magnitude of the disease, and to recommend treatment — "on or off patent". The legal steps would then be up to WTO.

There had been discussions with the EU but "some of the specific phrasing" of the EU proposal "can be read differently from what we'd intended. For example, we were not involved in that list of diseases. But we are completely behind this effort to bring this business to a harmonious closure."

Speaking to BioMed Central (www.biomedcentral.com) Quick added "We'd like a solution that's sufficiently robust to be good 10, 20, 30 years from now". Disease patterns shift with time. No one was predicting AIDS 25 years ago. So "from a public health point of view you'd like a flexible agreement."

"It's important to step back and ask what's the dynamic" of the [WTO] problem, said Quick. "Basically the concern of some countries is that it is an open door to break all patents, and what's needed is an assurance that it won't be. And the European Union's hope is that WHO could provide enough reassurance that things can proceed."

RW