TWN Info Service on Health Issues (Jul19/04)
16 July 2019
Third World Network

Access to medicines fundamental to enjoyment of health
Published in SUNS #8946 dated 15 July 2019

Geneva, 12 Jul (Kanaga Raja) - Access to medicines and vaccines is one of the fundamental elements for the full realization of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health and the correspondent objectives of universal health coverage and health for all without discrimination, with special attention to reaching those furthest behind first.

This recognition came in a resolution (A/HRC/41/L.13) adopted without a vote by the United Nations Human Rights Council on Thursday.

The Council is currently holding its forty-first regular session which concludes on 12 July.

In its resolution, the Human Rights Council requested the High Commissioner for Human Rights to convene, before the forty-sixth session of the Human Rights Council, a full-day inter-sessional seminar on good practices, key challenges and new developments relevant to access to medicines and vaccines as one of the fundamental elements of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, in coordination with the World Health Organization.

The draft resolution was co-sponsored by Algeria, Bangladesh, Bolivia, Brazil, China, Ecuador, Egypt, Eswatini (formerly Swaziland), Ethiopia, Haiti, India, Indonesia, Iraq, Kuwait, Mongolia, Peru, Philippines, Qatar, Saudi Arabia, Senegal, South Africa, Thailand, Tunisia, Turkey, United Arab Emirates, Uruguay, and the State of Palestine.

Introducing the draft resolution at the Human Rights Council on Thursday (11 July), Brazil said: "it is our duty to remember that no one should die before their time because they have no access to the needed medicines."

"It is our duty to protect and promote the human right to life. Since the adoption of the last resolution on this topic in 2016, a lot has changed in the field of access to medicines and vaccines."

Besides the growing recognition of its central role in all relevant public health discussions, there is a growing number of countries including developed countries that are adding their voices to ask for more transparency of markets and are concerned about the high prices for health products and services, which render their health services unsustainable, said Brazil.

It is also important to recall that specialised civil society organisations and patients' groups are more vocal and active than ever to guarantee that no one is left behind without medicines and vaccines and that progress in the field of science is enjoyed by everyone.

The draft resolution recalls that access to medicines and vaccines is one of the fundamental elements for the full realisation of the right to health, and the correspondent objectives of universal health coverage, said Brazil.

Although this is undoubtedly a human rights text, it reflects the multi-dimensional nature of this discussion, also encompassing public health concerns, trade rules and intellectual property parameters.

It recognises the important role played by the WTO and welcomes the entry into force of the protocol amending the TRIPS Agreement.

Brazil said the expertise of the WHO in their field is also acknowledged, particularly the recently adopted road map on access to medicines and resolution WHA72.8 on transparency.

The inter-sessional seminar proposed by the draft resolution will be organised in close cooperation with WHO, therefore reinforcing the UN pledge to deliver as one, it added.

Egypt said that it believed that access to affordable, safe, effective and quality medicines and vaccines is an essential prerequisite for achieving universal health coverage.

Achieving universal health coverage ensures healthy lives and promotes well-being at all ages.

Furthermore, adequate access to medicines and vaccines limits out-of-pocket expenditure, therefore minimising social and economic hardships, said Egypt.

India said that the Council has made seminal contributions in recognising access to medicines as a fundamental component of the right to health.

However, barriers related to R&D needs and the full use of TRIPS flexibilities and medical innovations threaten the full realisation of the right to health for millions of people.

It has resulted in skyrocketing prices for lifesaving medicines and vaccines and the increase in healthcare costs have pushed hundreds of millions into impoverishment every year.

There is need to once again place the human rights dimension of access to medicines and vaccines at the centre of our efforts to create favourable conditions at the national, regional and international levels to ensure the full realisation of the right to health and health-related goals of Agenda 2030.

It will be timely for this Council to take into account recent developments and have a constructive discussion on reaffirming the importance of human rights while considering access to medicines and vaccines, said India.

The full-day inter-sessional seminar proposed in the draft resolution would be helpful in identifying practices, key challenges and new developments relevant to access to medicines and vaccines as one of the fundamental elements of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, it added.

South Africa said that poor access to medicines and vaccines constitute a major challenge threatening the lives and well-being of populations throughout the world particularly in developing countries, thus putting the most vulnerable in particular women and children at risk.

Access to safe, effective, quality and affordable medicines including vaccines is key to the enjoyment of the highest standards of physical and mental health.

The World Health Organisation, numerous national court cases and resolutions of the Human Rights Council and the Doha Declaration on TRIPS and Public Health reaffirmed access to essential medicines as a human right that must be available to all, said South Africa.

In the preambular part of the resolution, the Human Rights Council said it is seriously concerned about the high prices of some health products and the inequitable access within and among Member States, as well as the financial hardships associated with high prices, which impede progress towards achieving universal health coverage for all.

It recalled the Declaration on Primary Health Care, adopted in October 2018 in Astana, which recognizes the need to address the inefficiencies and inequities that expose people to financial hardship resulting from their use of health-care services by ensuring better allocation of resources for health, adequate financing of primary health care, and to work towards the financial sustainability, efficiency and resilience of national health systems, appropriately allocating resources to primary health care based on national context.

It noted with concern that, for millions of people throughout the world, the full and equal enjoyment of the right to the highest attainable standard of physical and mental health remains a distant goal.

It recognized that universal health coverage implies that all people have access without discrimination to nationally determined sets of the needed promotive, preventive, curative, palliative and rehabilitative essential health-care services, and essential, safe, affordable, effective and quality medicines and vaccines, while ensuring that the use of these services does not expose users to financial hardship, with special emphasis on the poor, vulnerable and marginalized segments of the population.

The Council regretted the high number of people still without access to affordable, safe, effective and quality medicines and vaccines.

It underscored that improving such access could save millions of lives every year, and noted with deep concern that, globally, two billion people have no access to the medicines they need, while recognizing that the lack of access to medicines and vaccines is a challenge that affects people not only in developing countries but also in developed countries, even though the disease burden is disproportionately high in developing countries.

It recognized the need to appropriately address challenges, gaps, market failures and opportunities regarding the research and development of health technologies, availability and affordability to treat, inter alia, rare and neglected diseases, and to respond to the growth of emerging challenges, such as antimicrobial resistance, among others, with a view to addressing adequately public health needs and protecting, respecting and fulfilling human rights, and taking into account the necessity to promote frameworks that meet public health needs, while adequately rewarding innovation.

In the operational part of the resolution, the Council stressed the responsibility of States to ensure access for all, without discrimination, to medicines and vaccines, in particular essential medicines, that are affordable, safe, effective and of quality.

It called upon States to promote access to safe, effective, quality and affordable medicines and vaccines for all, including through the use, to the full, of the provisions of the Agreement on Trade-Related Aspects of Intellectual Property Rights, which provide flexibility for that purpose, while recognizing that the protection of intellectual property is important for the development of new and innovative medicines and vaccines, and the concerns about its effects on prices and public health.

It also called upon States to take steps to implement policies and plans to promote access to comprehensive and cost-effective prevention, treatment and care for the integrated management of non-communicable diseases, including, inter alia, increased access to affordable, safe, effective and quality medicines, vaccines and diagnostics and other health products, including through the full use of Trade-Related Aspects of Intellectual Property Rights provisions and flexibilities.

The Council reiterated the call upon States to continue to collaborate, as appropriate, on models and approaches that support the delinkage of the cost of new research and development from the prices of medicines, vaccines and diagnostics for diseases that predominantly affect developing countries, including emerging and neglected tropical diseases, so as to ensure their sustained accessibility, affordability and availability and to ensure access to treatment for all those in need.

It called upon the international community to continue to assist developing countries in promoting the full realization of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, including through access to medicines, in particular essential medicines, vaccines, diagnostics, medical devices and other health products that are affordable, safe, effective and of quality, and through financial and technical support, training of personnel and other capacity-building measures, while recognizing that the primary responsibility for respecting, protecting and fulfilling all human rights rests with States, and while recognizing the fundamental importance of the transfer of environmentally sound technologies on favourable terms, including on concessional and preferential terms, as mutually agreed.

The Council recognized the innovative funding mechanisms that contribute to the availability of vaccines and medicines in developing countries, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Gavi Alliance and UNITAID.

While safeguarding public health from undue influence by any form of real, perceived or potential conflict of interest, it called upon all States, United Nations agencies, funds and programmes, in particular the World Health Organization, and relevant intergovernmental organizations, within their respective mandates, and encouraged relevant stakeholders, including companies involved in the research and development, manufacture, importing, distribution and supply of pharmaceuticals, to further collaborate to enable equitable access to quality, safe and effective medicines and vaccines that are affordable to all, including those living in poverty, children and other persons in vulnerable situations.

The Council encouraged engagement between Governments, international organizations, non-governmental organizations, academic and research institutions, philanthropic foundations and the private sector, and greater policy coherence and coordinated actions through whole-of-government and Health in All Policies approaches, to find solutions to health challenges, such as the need for public health-driven research and development, improved existing and alternative frameworks to adequately reward innovation, pricing and affordability of health products, and leveraging innovative technologies, including digital technologies, and solutions for health.

It encouraged States, in cooperation with other stakeholders, to redouble efforts to achieve a continuous supply of quality, safe, effective and affordable health products through research and development that meets public health needs, for the efficient application and management of intellectual property standards, to carry out evidence-based selection of health products and to seek fair and affordable pricing, to adopt good procurement and supply chain management and to promote appropriate prescribing, dispensing and rational use of health products.

The Council recognized the importance of adequately training the health workforce, including community health workers, and of improving health literacy in order to achieve the highest attainable standard of physical and mental health and strengthen universal health coverage.

It urged all States, United Nations agencies and programmes and relevant intergovernmental organizations, especially the World Health Organization, within their respective mandates, and encouraged non-governmental organizations and relevant stakeholders, including pharmaceutical companies, to promote innovative research and development to address health needs in developing countries, including access to safe, effective, quality and affordable medicines and vaccines, and in particular with regard to diseases disproportionately affecting developing countries, and the challenges arising from the growing burden of non-communicable diseases, taking into account the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property of the World Health Organization.

It invited the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, while considering the many ways towards the full realization of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, to continue to focus on the human rights dimension of access to medicines and vaccines when discharging his or her duties, in accordance with the mandate.

The Council also invited Member States and all stakeholders, including relevant United Nations bodies, agencies, funds and programmes, treaty bodies, special procedure mandate holders, national human rights institutions, civil society and the private sector, to promote policy coherence in the areas of human rights, public health, intellectual property and international trade and investment when considering access to medicines and vaccines