By 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 US trade policy, charging possible organisational incompetence and calling for a full review of its publication procedures.

“The WHO Secretariat’s decision to publish the South Centre report seriously undermines my confidence in the veracity and reliability of assurances I received from senior staff in the Office of the Director General,” William Steiger, special assistant to the secretary for international affairs at the US Department of Health and Human Services wrote to Acting WHO Director General Anders Nordström in August.

The letter, obtained by Intellectual Property Watch, asserts that the joint report of the WHO and the South Centre, the Geneva-based intergovernmental group of developing countries, “spuriously characterizes the trade policy of the United States as a threat to public health, and it makes unnecessarily inflammatory and prejudicial recommendations as to how the United States can improve its trade policies.” It also “singles out several member states for criticism,” Steiger said.

Steiger said he would address the specifics of his charge in a subsequent letter to Nordström. In the meantime, however, he asked Nordström to “withdraw this publication and remove the WHO logo from it.” The report has been in the public domain for a year but was only recently published in hard copy.

The study entitled, “The use of flexibilities in TRIPS by developing countries: Can they promote access to medicines?” was co-published by the WHO and the South Centre, the Geneva-based intergovernmental organisation. It was co-authored by the South Centre’s Sisule Musungu and WHO’s Cecilia Oh.

The WHO declined to comment, as it normally would not comment on a letter from a member state, a WHO spokesperson said. The department that Oh works in, which is responsible for intellectual property issues, said it had not been informed about the letter. Oh declined to comment for this story.

The study was published during the comment period of a WHO intellectual property rights commission that led to the creation of a new WHO intergovernmental group on IP rights and public health still being set up this autumn. The new group’s secretariat is now headed by Howard Zucker, the assistant WHO director general for health technology and pharmaceuticals, who also worked at the Health and Human Services Department where Steiger works, which has raised concern among some sources that possible undue pressure could be imposed on the IP project.

Musungu, one of the authors, told Intellectual Property Watch that the letter reveals US pressure that raises questions about whether Zucker “will be objective and stand the pressure that seems to be there and allow WHO experts on these issues to participate in the process. One hopes that he will be objective but there are obviously dark clouds now.”

Intellectual Property Watch tried to reach the HHS on numerous occasions but was not able to get a comment by press time. Zucker’s office said he is currently travelling.

US officials have in the past shown concern about the way WHO may be addressing trade issues. In expressing the United States’ “serious concerns” about the WHO’s decision to publish the report, Steiger said he has been pushing this issue for several years, as past publications contained “incorrect or misleading information about trade agreements.” He also previously cited the WHO’s “lack of competence in this area and its failure to consult with other relevant international organisations, such as the World Trade Organization and the World Intellectual Property Organization.”

Steiger said he wrote on 30 March 2004 to former WHO Director General Lee Jong-wook regarding his office’s “lack of review of the various reports and studies” the WHO publishes. He said he was then assured that a review process had been set up, which is why he is “dismayed to see the publication on flexibilities” that are available to developing nations to use for public health reasons under the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS).

Steiger said he expects a “full review” of the WHO’s publication policy at the Executive Board meeting scheduled for January 2007.

Study Requested by Independent WHO IP Commission

One source questioned Steiger’s argument that the WHO does not properly review what it publishes as the study was in fact commissioned by the WHO in October 2004. It was part of the consultation round leading to the WHO report by the Commission on Intellectual Property Rights, Innovation and Public Health (CIPIH), which was published in April 2006.

Twenty-two studies were commissioned by the CIPIH, and have been listed on the CIPIH’s website, although some of them are not linked.

A draft version of the study in question was presented at a workshop at the WHO in May 2005, first for an expert panel and later for all interested parties, two attendees said. It was also available on the CIPIH’s website. The four topics of the workshops were: disease burden, intellectual property, innovation and capacity building, according to the CIPIH website. The South Centre study was presented under “intellectual property” along with eight other expert presentations.

Two of the other presenters from that panel said that they had not been commissioned to do a study but had been given a topic by the CIPIH and provided an expert view. A member of the WTO secretariat chaired the IP session on these nine studies on 30 May, 2005, a source said. The final study was ready in August 2005.

Musungu, who said he had not been informed about the letter by the WHO, said the WHO commission asked the authors to analyse the use of TRIPS flexibilities by developing countries. They were further asked to examine the potential effects of bilateral and regional free trade agreements with regards to possible impact on public health, and analyse recent agreements.

The South Centre and the WHO split the publishing costs of the report, which was published under a South Centre report series, and 4,000 copies were made, Musungu said. He said the CIPIH secretariat had given the go-ahead to publish the study.

The study and the CIPIH report lead to a resolution which again has led to the setting up of an intergovernmental working group on intellectual property rights at the WHO (IPW, Public Health, 19 September 2006). It is expected to meet for the first time on 4 December.

Tove Iren S. Gerhardsen may be reached at tgerhardsen@ip-watch.ch.