114. The representative of the United States said that his delegation strongly supported the System as established under the 2003 Decision and the Protocol. He encouraged other Members to notify their acceptance of the amendment so that it could enter into force.
115. As noted previously (IP/C/M/67, paras.202-203), his delegation viewed the System as one of many tools to address the issue of access to medicines. Among others, tariffs were applied to medicines, to the components of those medicines, such as active ingredients, and medical products. Tariffs imposed by governments were, however, borne by patients. During the Uruguay Round negotiations, his delegation had therefore joined several other Members (Canada; the EU; Japan; Norway; Switzerland; and Macao, China) in an agreement to eliminate tariffs on medicines and active ingredients in order to liberalize trade, lower costs, and increase access to these essential products. Since then, the participants in the pharmaceutical zero-for-zero agreement had updated it four times in order to include additional inputs for medicines, thereby further reducing the costs of production for medicines.
116. According to a paper by the WTO Economic Research and Statistics Division entitled "More Trade for Better Health, International Trade and Tariffs on Health Products", which had been released on 18 October 2012, several countries continued to maintain relatively high tariff rates on medicines, active ingredients and medical products, despite a general trend toward tariff reduction on these goods. The report concluded that "the question to ask is why countries even maintain tariffs on health products. Imposing tariffs typically translates into higher product prices, especially in the presence of long supply changes. Maintaining tariffs ultimately means taxing the sick and creating additional costs for the health system." To exemplify this point, the representative of the United States drew attention to a report by the Assistant Minister for Public Health and Sanitation of Kenya in 2011, according to which the removal of taxes and tariffs for malaria products had led to a 44% decline in the rate of infant mortality and disease, and a 50% reduction on infant mortality in one region. He said that, as demonstrated by a 2005 WHO study, the impact of tariffs on medicines extended beyond consumers, as tariffs also adversely affected local industries that often relied on the import of active ingredients.
117. He noted that voluntary licensing and policies that promote such licensing also provided important tools to promote access to medicines. A good example was the US National Institute of Health (NIH). It was the first contributor to the Medicines Patent Pool (MPP) in the voluntary licensing of US government-owned patents related to the use of ARV protease inhibitor drugs. The MPP promised to enhance access to ARV treatment for people living with HIV/AIDS in developing countries and facilitated the development of new combinations of ARVs and adapted formulations for developing countries. While the NIH was only one owner of intellectual property in the area of public health, the actions undertaken demonstrated the partnerships that were occurring internationally, as well as the trend towards voluntary licensing. These practices were helping to enhance access to medicines. He urged other Members to consider participating in this effort.
