Thank you, Mr. Chair, honourable members, for giving Médecins Sans Frontières the opportunity to appear here today.
I thank you for allowing us to appear before your committee today.
I am here representing MSF as a humanitarian. I'm not an intellectual property lawyer or a patent specialist. I've worked in Rwanda, Sudan, East Timor, and Peru with MSF, and I've witnessed the devastation of AIDS and other untreated infectious diseases firsthand. I've also seen the consequences of monopoly pricing of medicines. I was involved in the early consultations of Bill C-9, or the JCPA, in 2006.
Today MSF is working in 70 countries worldwide, providing independent medical assistance. In 30 of those countries, we're treating 80,000 people with antiretroviral medicines, as well as providing integrated HIV treatment, prevention, and care programs, so we also see firsthand the reality of drug procurement and the need for reliable access to affordable drugs. Every year we're spending many millions of dollars on drug procurement, some of which comes from the $22 million donated by the Canadian public last year.
The Doha declaration on TRIPS and public health by the World Trade Organization in 2001 recognized the problems many countries experience with accessing newer medicines. While Doha clarified countries' rights to take measures to overcome patent barriers to access medicines for all, it left the issue of exporting medicines produced under compulsory licence unresolved, which is what we're discussing today.
When the solution was announced in 2003, MSF and others said that the August 30 decision was too onerous and cumbersome. It was wrapped in red tape. Still, MSF committed to seeing if it could somehow be workable and urged: “Countries must act now to use the Doha Declaration to access the best priced medicines for their populations. The experience they gain by doing so will test the limits of the WTO rules and be invaluable to revising WTO patent rules after Cancun.” And we still have that opportunity.
Laudably, Canada was the first country to try to implement the solution. I worked very closely on this process, urging Canada to set a workable precedent, and many others here today did--and internationally.
My colleague Michael O'Connor mentioned that in February 2004 MSF testified before this committee. We stated that we foresaw that the Canadian bill in its existing state could not work unless fundamental flaws, indeed some fatal limitations beyond what TRIPS required, were removed. Some were removed and some remain.
In good faith, we tried to place a drug order under the Canadian access to medicines regime. We have spent over two years with other stakeholders holding in the Canadian government, trying to make it work. In short, we've liaised with a Canadian generic pharmaceutical company that rather quickly developed a fixed-dose combination--FDC--antiretroviral medicine that at the time did not exist in an approved state. We have received notification from both Health Canada and the World Health Organization that this drug is approved. They've approved the quality of the drug, but not a single developing country has notified the TRIPS of its desire to use this regime.
It's been mentioned by Stephen that it's a drug-by-drug, country-by-country solution with so many bureaucratic hurdles. In the meantime, the same FDC has come out by Indian generic companies. These products have also been pre-qualified by the WHO.
To purchase these products, no additional procedures exist, no notification to the WTO is demanded, and logically, countries are preferring to take this route. Recent developments in Thailand and India illustrate painfully why this is, and we've heard a few points on that already.
So I wish to make two main points.
For the past three years, MSF has tried in earnest to deliver medicines using the Canadian access to medicines regime. Not a single pill has left Canada or any other countries that have implemented the August 30 decision. We've concluded, therefore, that the WTO decision is not expedient and is therefore not a solution, but we also think that it can be changed.
Today, sources of generic medicines still exist in India, but in the years to come these sources will dry up as India starts granting pharmaceutical product patents. At that point it will be crucial that production for export under compulsory licence becomes as easy as it is now.
We urge Canada to implement TRIPS-compliant, workable solutions in Canada--some examples have been given--to improve the legislation and make a better model to the world, and also to remind us here today that it's to take it back to the WTO. We have commitments that we've made to the Canadian public, but we have commitments that we made at Doha as one of the WTO members, this idea of medicines for all that was adopted.
So secondly and lastly, access to medicines is a continued serious daily concern to MSF. People must be prioritized over patents, as in this poster that was referred to earlier, both in the Canadian legislation and at WTO. In our experience, generic competition has been one key way to provide access to medicines for millions. Over 80% of the patients we're treating are on Indian generic medicines, and those medicines risk drying up because of TRIPS compliance and global patenting. Since Doha we've seen that commercial interests are able to trump facilitating access to medicines.
I would just mention to you that we have talked about second-line medicines, and the urgent need for second-line medicines. Canada can play a part in making second-line medicines in pediatric formulations.
We encourage you to take the logical next steps to fulfil your promises.
Thank you.