By Tove Iren S. Gerhardsen
A World Health Organization (WHO) director has taken the unusual step of writing a memorandum directly to the head of the WHO, seeking clarity on the organisation’s handling of a United States complaint involving WHO staff, according to anonymous sources.

The memo was prompted by concern that the organisation is handling new US criticism in a less transparent way than it has in the past. In a previous case, the office of the WHO director general consulted and informed relevant officers within the organisation, but has not done so this time, sources said.

The WHO would not comment on the issue, and has said in the past that the organisation normally does not discuss letters from member countries (IPW, Public Health, 28 September 2006).

Separately, two key Democratic members of Congress have begun investigation of the US government’s behaviour in trade and public health, including questioning the US complaint from this case. Democrats this week regained control of congressional committees (which conduct investigations), and one source said the two members plan to step up their oversight.

The internal memo was sent to the WHO director general on 4 September by Germán Velásquez, the assistant director general of the Department of Technical Cooperation for Essential Drugs and Traditional Medicine, a source said. This department oversees intellectual property issues at the WHO.

At the time of the memorandum, the director general role was filled by Anders Nordström, who since the death of Director General Lee Jong-wook in May has acted as director general. He will be succeeded by Margaret Chan, who was elected in early November.

The memo, according to the source, says Velásquez accidentally learned about an August letter to Nordström written by William Steiger, a senior US health official, taking issue with the WHO co-sponsored publication, “The use of flexibilities in TRIPS by developing countries: Can they promote access to medicines?”

This publication was written by Sisule Musungu of the intergovernmental organisation, the South Centre, and a WHO staff person, Cecilia Oh, who left the WHO in October. Oh said that she had made the decision to leave before this complaint was filed. But a source close to the issue told Intellectual Property Watch that afterward, a WHO official indicated that Oh should discontinue working on intellectual property issues, despite it being her field of specialty.

Nongovernmental sources said it appears to be unusual timing for the WHO to let its IP experts go at a time when it should be stepping up such efforts in relation to its role on the intergovernmental working group on public health, innovation and intellectual property, created in May. This group will have its first meeting in Geneva on 4-8 December (IPW, Public Health, 2 October 2006).

In his letter, Steiger said that the US government asserts the publication “spuriously characterises 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.” Steiger asked Nordström to review the WHO publication policy and withdraw the publication in question, the letter said.

The memo asserted that relevant officers would typically be informed but that those in the department in which Oh was working, including Velásquez and Director Precious Matsoso, were not informed about the letter from Steiger (which was not marked confidential), nor about a potential reply from Nordström, the source said.

When asked about the memo, Velásquez told Intellectual Property Watch that Nordström neither officially informed nor consulted him about the letter from Steiger. He is still not aware of any reply letter from the WHO, nor whether Steiger has sent a follow-up letter to Nordström.

1998 Case Was Handled Differently

In contrast, in July 1998, key officers were informed within hours by former WHO Director General Gro Harlem Brundtland when she received a similar letter from the US government as well as one from the pharmaceutical industry complaining about a publication that also criticised US trade policy.

The 1998 publication in question was entitled, “Globalization and access to drugs: Implications of the WTO/TRIPS [World Trade Organization Agreement on Trade-Related Aspects of Intellectual Property Rights] agreement,” and was written by Velásquez and Pascal Boulet, who worked for WHO. It was nicknamed “the red book.”

The red book was ordered by a World Health Assembly resolution adopted in 1996, which mandated the WHO “to report on the impact of the work of the WTO with respect to national drug policies and essential drugs and make recommendations for collaboration between WTO and WHO, as appropriate,” according to a 2004 book on the history of TRIPS and public health, edited by Jorge Bermudez and Maria Auxiliadora Oliveira.

The US government “prepared a 17-page paper ‘pointing out the inaccuracies and false implications with which the document is riddled’,” the book said. Separately, a letter from the Pharmaceutical Research and Manufacturers of America (PhRMA), dated 30 June 1998, stated that this is: “ … a deeply flawed document that misleads its readers and creates a false impression of how the WTO TRIPS agreement will affect pharmaceuticals.”

Brundtland immediately briefed the WHO officials involved and set up an independent expert committee, according to the 2004 book. “WHO revised a revision of the monograph [the red book] with independent external reviewers and input from the WTO,” it said, adding that this was after publication in January 1999 of the revision, which was referred to as the “blue book.”

The WHO’s intentions remain unclear. In his letter, Steiger said he expects a “full review” of the WHO’s publication policy at the Executive Board meeting scheduled for January 2007. Steiger also indicated that he would follow with a letter providing the specifics of his complaint. It is not clear whether the WHO has received such a letter.

US Democrats Plan Pressure On Administration

Separately, there also has been US congressional pressure regarding the Steiger letter. Senator Edward Kennedy (Massachusetts) and Representative Henry Waxman (California), both Democrats, “have requested that the Government Accountability Office investigate the administration’s trade negotiations and their negative effects on developing countries’ access to medicines,” according to a joint press release.

In a 13 October letter to US Secretary of Health and Human Services Michael Leavitt, Kennedy and Waxman decry the behaviour of the Bush administration through the Steiger letter.

“Attempting to suppress a report because it is critical of US trade policy is unacceptable,” they wrote. “Instead, the United States should seriously assess the impact of our trade policies on access to medicines and public health.”

The senators also requested copies of past correspondence between the United States and the WHO mentioned in Steiger’s letter, as well as subsequent communication made by Steiger. Intellectual Property Watch was unable to confirm with the senators’ offices by press time whether this request had been met.

Separately, Switzerland sent a letter to the WHO to clarify a reference made in the Musungu-Oh publication. Switzerland has adopted a TRIPS amendment on public health.

US government officials were not reached for this story.

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