Thank you very much for allowing me to give evidence at this hearing. I represent the International Federation of Pharmaceutical Manufacturers and Associations, which is based in Geneva. We're a global not-for-profit NGO that represents the research-based industry. I am from the biotech and vaccine sectors. It has over 25 leading pharmaceutical companies and 46 national and regional associations from around the world.
I'll start my comments by really focusing on what we are trying to achieve with the access to medicines agenda, that is, certainly a sustainable access to quality and effective medicines. I think it's something you have heard, no doubt, before, but we really do need to have a useful picture of where this compulsory licensing provision, if you like, fits into the wider framework.
In order for us to achieve our shared goal, there are certain key components that need to be in place in order for us to get access to medicines. We know well about the importance of health care systems in countries. When I was working in government, I frequently worked on this area during the EU negotiations, and it was agreed to in the U.K.
A senior health official from Botswana made quite a stark comment by saying that you could drop all the medicines in the world in Botswana and it would make no difference to the situation there, because he realized the lack of infrastructure—and I know there are numerous comments that we could draw to there. As an example, the director of the WHO HIV division publicly said in 2006, and I quote:
Africa has been hardest hit by the AIDs epidemic…it is very obvious that the elephant in the room is not the current price of drugs. The real obstacle is the fragility of the health systems. You have health infrastructure that is dilapidated, and supply chains that don’t exist.
When we talk about access to medicines, we really do need to make sure we have effective health care systems and infrastructure in place, and health care officials are able to administer those medicines effectively and appropriately.
When we look at the actual medicines, this of course is a key part of the access puzzle. Some 95% of the medicines on the WHO essential medicines list are not covered by patents. That's not to say that the other 5% is not very important, but that really does put, if you like, this debate into context. We're talking about a small number of medicines. That could increase over time, of course.
What I'd like to do now is focus on the successes there have been over the last number of years that have not relied upon compulsory licensing provisions at all. The number of patients treated for HIV/AIDS went from 500,000 patients in 2003 to 1.57 million patients in January 2005. For example, the 3,140% increase between 2004 and 2006 was not achieved by any use of the compulsory licensing provisions.
Just to draw my thoughts to a conclusion, as the WTO director general has said, “Measure of success should not be the number of compulsory licences issued. But in our view it should be exactly what is happening on the ground in the access to medicines area.”
There's been a massive expansion of new initiatives for global funds, like the Bill and Melinda Gates Foundation, just to name one example. This increase in access to medicines does not rely upon compulsory licensing provisions. So we need to manage expectations that any amendment of a Canadian bill will not result in increased access to medicines.
But certainly, from a Geneva perspective, Canada manufactures high-quality generics, of course, but they are expensive. It is thought that for many of the countries in the Geneva context, the prime routes to get these patented medicines, which are necessary in generic form, you'd go to India or even China or other markets.
Certainly, when I was negotiating the EU regulation that implemented the same provisions across the EU, it was a well-known public fact that we thought at that time that the use of this provision would not be extensive, given the commercial considerations and the cost of medicines in Europe.
Thank you very much.