US Investigators In Geneva To Review US Balance On IP, Public Health

By Tove Iren S. Gerhardsen
A team from the independent investigative arm of the United States Congress visited Geneva last week, interviewing insiders from the private sector, non-governmental and international organisations including the World Health Organization (WHO) regarding how the United States is balancing public health, intellectual property and market access, sources said.

The visit comes after a number of events raised questions about US government behaviour in Geneva, including a letter from a US health official to the WHO taking issue with its publication policy. The series of events have led to calls for a review of alleged undue US influence at WHO, sources said.

“We had a team there interviewing a range of experts on the subject of intellectual property and public health, an engagement we have underway,” Loren Yager, director of International Affairs and Trade at the US Government Accountability Office (GAO), told Intellectual Property Watch. The GAO was asked to undertake the review by Senator Edward Kennedy, a Massachusetts Democrat, and Representative Henry Waxman, a California Democrat, he said.

“The scope of the review has to do with how the United States balanced respect for the [World Trade Organization] Doha Declaration on TRIPS [Agreement on Trade-Related Aspects of Intellectual Property Rights] and public health with protecting IP rights and securing market access,” Yager said.

The Doha Declaration on the TRIPS Agreement and Public Health was agreed to at the WTO ministerial meeting in Doha, Qatar in 2001, and reinforced flexibilities countries have under TRIPS to act in the interest of their public health priorities.

In a 13 October 2006 press release accompanying their letter to US Secretary of Health and Human Services Michael Leavitt (IPW, Public Health, 10 November 2006), Waxman and Kennedy presented their reasons for requesting the investigation.

Senator Kennedy said, “We’ve requested this investigation to help understand how the administration has balanced commercial drug interests with the health needs of poor people living in developing countries. In this era of HIV epidemics, avian flu outbreaks, and other public health threats, it is essential that we promote good health and access to medicines in every nation,” the release said.

Representative Waxman said, “Administration trade agreements have numerous provisions that threaten access to affordable medicine. We have to recognise that the Bush administration’s single-minded pursuit of intellectual property protections for drug companies can have potentially devastating consequences for the public health in developing countries.”

It is not clear exactly who the team interviewed, but Yager said, “The GAO team had a full week of meetings in Geneva with international organisations, non-governmental organisations, as well as the private sector.” He could not provide details on GAO’s ongoing discussions and interviews under congressional protocols.

GAO is planning to complete this work “in the fall,” Yager said.

Concerns May Have Led to Investigation

In August last year, William Steiger, special assistant to the secretary for international affairs at the US Department of Health and Human Services (HHS), wrote to Acting WHO Director General Anders Nordström, charging possible organisational incompetence and calling for a full review of its publication procedures (IPW, Public Health, 28 September 2007).

Of concern was a report cosponsored by WHO and the intergovernmental South Centre on the use of TRIPS flexibilities in developing countries.

“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,” Steiger said in the letter.

In the meantime, Steiger has been appointed US ambassador to Mozambique (but he is still with HHS) and Nordström has been succeeded by Margaret Chan as director general. The authors of the report, Cecilia Oh and Sisule Musungu, have left WHO and the South Centre respectively.

This incident was one of the issues referred to in the 13 October letter. “Attempting to suppress a report because it is critical of US trade policy is unacceptable. Instead, the United States should seriously assess the impact of our trade policies in access to medicines and public health,” they wrote.

Last autumn, Musungu and others also raised some concern about the possibility of undue US influence from the appointment of WHO official Howard Zucker, a former HHS official who joined WHO in spring 2006, to head a WHO committee on IP, innovation and public health.

Separately, a WHO official sent an internal memo to the head of the health organisation prompted by concern that WHO is handling new US criticism in a less transparent way than it has in the past, sources said (IPW, Public Health, 10 November 2006).

Kennedy and Waxman also referred to the separate letter of request they sent to GAO on 27 September: “We have asked GAO to assess whether the formal and informal mechanisms of US trade policy conform to the congressional directive to respect the Doha commitment to public health.”

GAO is the non-partisan audit, evaluation, and investigative arm of Congress and was established as the General Accounting Office.

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