218. The representative of the UNAIDS noted that the work of the UNAIDS and its co-sponsoring agencies was guided by the health-related Millennium Development Goals (MDGs) with special attention to MDG 6 which was "to halt and reverse the spread of HIV, Malaria and other epidemics by 2015". With AIDS being the leading cause of death worldwide among women of reproductive age, and with the possibility of virtually eliminating mother-to-child transmission of HIV, an integrated approach to the AIDS response was central to improving maternal and child health.
219. This TRIPS Council discussion was timely for a number of reasons, not least because of the increasing number of people living with HIV in need of antiretroviral treatment, and concerns about increasing costs. Antiretroviral treatment for HIV infection was significantly reducing mortality for people living with HIV. At the end of 2009, 5.2 million people were on HIV treatment, a twelve-fold increase from 2003 when the WHO and UNAIDS had first launched the historic 3-by-5 Initiative. According to estimates, the number of additional people for whom antiretroviral treatment would be needed could soon reach 15 million. The global economic crisis had begun to adversely affect prospective commitments to AIDS from both donors and low- and middle income countries. For the first time in a decade, disbursements from donors for HIV/AIDS actually fell in 2009 from a high of USD 7.7 billion one year earlier. The 2009 report of the inquiry of the United Kingdom's All-Party Parliamentary Group on AIDS into long-term access to HIV medicines had reported that "we are sitting on a 'treatment time bomb.'" The cost of the least expensive first generation regimen had dropped to less than USD 70 per patient, per year. But as increasing numbers of people moved towards more efficacious and tolerable treatment regimens, some experts projected drug prices to double compared to first generation regimens. As patients developed drug resistance and required more expensive and more highly patent-protected second- and third-line antiretroviral medicines, some projections saw treatment costs escalating as much as twenty-fold.
220. In addition to the important work being undertaken by the WHO, under the UNAIDS division of labour, UNDP had been given a mandate to serve as the lead cosponsoring agency within the UNAIDS in providing support to governments to incorporate public health-related TRIPS flexibilities into domestic legislation. In cooperation with the WHO and on behalf of the UNAIDS, the UNDP had provided policy and technical support to countries reforming domestic intellectual property legislation in this area. As part of its capacity building activities on the System, the UNDP had recently provided assistance to civil society organizations advocating for a revised Access to Medicines Regime in Canada. Canada had been the first country to amend its law to give effect to the Decision. Bill C-393 had been proposed to streamline the practicability of CAMR. Together with the Canadian HIV/AIDS Legal Network, UNDP had co-organized consultations to explore opportunities to strengthen the CAMR in February 2010. The focus of the discussions had been on ensuring compliance of Bill C-393 with the TRIPS Agreement and on giving more flexible and rapid effect to the Decision. In addition, a the UNDP staff member had been invited by and had appeared before the Canadian Parliament to provide technical information.
221. In 2003, the UNAIDS had welcomed the multilateral consensus among WTO Members regarding access to affordable medicines for countries without sufficient manufacturing capacity in the pharmaceutical sector. We had appreciated that the consensus covered other public health problems in addition to AIDS, since people living with HIV were prone to a host of opportunistic infections, such as tuberculosis, cancers, fungal infections and others, and these diseases were important health problems in themselves. The UNAIDS had urged that the arrangements under the Decision be implemented in the most flexible manner possible, so that countries could utilize the System easily and efficiently in their efforts to ensure greater access to HIV medicines for their peoples. In reality, very few importing countries had introduced provisions that would facilitate the System's use. In 2007, the UNDP had provided assistance for the introduction of such provisions to the legislator in Zanzibar, United Republic of Tanzania. The Industrial Property Act 4 of 2008 had come into operation in the second half of 2008 and contained a number of important TRIPS flexibilities, including the exclusion of pharmaceutical patents until 2016 or such other time as might be agreed by WTO Members. Similar technical assistance had been provided by the UNDP to other sub-Saharan African countries in the process of amending legislation.
222. The UNDP had provided technical and policy support on the utilization of non-voluntary licences under Article 31 TRIPS. In partnership with the Intellectual Property Institute of Ecuador, UNDP had held stakeholder consultations on compulsory licensing in Quito in March 2010. Similar assistance had also been provided to the Government of Thailand through a WHO mission in 2008 in which resource persons from the UNDP, UNCTAD and WTO had participated to provide technical information with regard to the TRIPS Agreement. The UNDP had provided capacity development activities to assist States to implement their intellectual property commitments made either through the process of acceding to the WTO or during negotiations on free trade agreements. Examples of such technical co-operation had included a regional conference on access to essential medicines, HIV and intellectual property, held in Kiev in September 2009, organized by the UNDP and the Open Society Institute. The UNDP had supported capacity development trainings for patent examiners focusing on the examination of pharmaceutical patents. Those had been carried out in Africa, the Arab States and Latin America. He noted that the UNDP, WHO and UNAIDS would soon be issuing a joint briefing paper on the use of TRIPS flexibilities to improve access to HIV treatment.
223. The UNAIDS and UNDP had also provided technical and policy support to recipients of Global Fund Grants in using public health-related TRIPS flexibilities to increase the availability of affordable antiretroviral medicines. The procurement policy of the Global Fund called for its beneficiaries to obtain quality medicines at the lowest possible price and encouraged grantees to utilize the TRIPS flexibilities to this end. As donors faced a period of extended financial uncertainty and understandably heightened their focus on accountability and value for money, the UNAIDS expected continuing and even heightened interest in TRIPS flexibilities, including the System.
