Breaking news from IP Watch's excellent Tove Iren S. Gerhardsen. "A senior United States health official in Washington is urging the head of the World Health Organization to withdraw a WHO-sponsored publication that is critical of U.S. trade policy, charging possible organisational incompetence and calling for a full review of its publication procedures."
Ignore the accusations of incompetence. This is about one thing and one thing only: the pharmaceutical industry's steadfast opposition to efforts by developing nations to bend international intellectual property rules for public health purposes.
The World Trade Organization's TRIPs agreement (Trade Related Aspects of Intellectual Property) is a bad deal for developing nations in the first place, but it does provide "flexibilities" in the event of public health emergencies. In such cases, developing nations can issue "compulsory licenses" that allow them to manufacture generic versions of patented drugs. They can also engage in "parallel trade" -- the importation of generic versions of still-patented drugs from other nations. But United States trade negotiators have been working very hard to ensure that no developing nations actually get the chance to take advantage of these flexibilities, or otherwise make their own decisions on how to best ensure public health.
The WHO-sponsored report at issue, "The Use of Flexibilities in TRIPS by Developing Countries: Can They Promote Access to Medicines?" is just one of many papers commissioned by the WHO's Commission on Intellectual Property Rights, Innovation and Public Health that represent all sides of the debate. But it has earned the ire of the Department of Health and Human Services by taking direct aim at U.S. efforts to limit the use of TRIP flexibilities through bilateral trade agreements with individual countries.
(This isn't the first time the U.S. has pushed the WHO around. Earlier this year, a WHO official in Thailand who had the temerity to write an Op-Ed criticizing a proposed free trade agreement's likely impact on public health in Thailand was summarily transferred to a lower-ranking job halfway across the world after complaints from the U.S.)
Somewhere on this planet, it's possible that impartial economists and health experts are having a substantive discussion on how best to design intellectual property rules so as to balance the interests of pharmaceutical companies and public health concerns. But that's not what is going on here. To understand that, all you need to know is a little bit more about the man who is attempting to bully the WHO, the director of the Office of Global Health Affairs and special assistant to the secretary for international affairs at the Department of Health and Human Services, William Steiger.
In September 2004, Science Magazine reported a growing upswell of criticism by scientists upset by Steiger's iron hand at HHS. According to the Science article, Steiger is the son of a Republican congressman from Wisconsin who gave Dick Cheney his first political job. He is also the godson of George H.W. Bush. He was an education advisor to Wisconsin Gov. Tommy Thompson, and followed him to Washington when the ex-governor was appointed director of HHS. He had no background in health issues prior to his appointment.
The Science article details numerous concerns by scientists on how Steiger has pushed partisan political issues during his tenure. He has opposed global treaties aimed at restricting tobacco advertising. He appointed a nurse from the National Right to Life Committee to the U.S. delegation to the World Health Assembly. Mother Jones reported in June 2004 that, in response to a WHO report on nutrition and obesity that was criticized by industry groups (notably, the sugar lobby), Steiger noted in a 28-page letter to WHO that the Bush administration "'supports personal responsibility to choose a diet conducive to individual energy balance, weight control, and health.' The letter goes on to criticize the WHO scientific report's 'linking of fruit and vegetable consumption to decreased risk of obesity,' along with many of its other scientific findings. In response to these and other objections, the WHO decided to revise its guidelines."
According to Science, Steiger has also "been a hard-nosed enforcer of the Administration's controversial emphasis on sexual abstinence in HIV prevention programs and its prohibiton on using generic AIDS drugs for treatment until they are approved by the U.S. Food and Drug Administration." And in April 2004, "Steiger decided that for the first time in 30 years HHS would not contribute funding for the annual meeting of the nonprofit Global Health Council, after conservatives complained that two participating groups supported abortion."
Are we surprised that a Bush appointee is making ideologically driven decisions at the expense of public welfare? No, of course not. But we are, once again, impressed at the sheer arrogance of this administration. It takes a lot of chutzpah to define the airing of views that contradict pharmaceutical industry ideological orthodoxy as "incompetence."
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