Ralph Nader P.O. Box 19312 Washington, DC 20036 James Love Consumer Project on Technology P.O. Box 19367 Washington, DC 20036 http://wwww.cptech.org 202.387.8030; love@cptech.org April 8, 1999 Vice President Albert Gore Washington, DC Dear Vice President Gore, We are writing to express our outrage that you have used your office to pressure the South African government to repeal its statutory authority for providing for compulsory licensing of patents for essential medicines. This comes in the beginning stages of the largest new public health crisis of our generation. The United States Surgeon General has likened the HIV/AIDS epidemic in Africa to the plague which decimated Europe in the 14th century. Public health officials estimate that one in five pregnant women in South Africa are HIV positive, and that more than 45 percent of the South African military personnel are infected. As Chairman of the United States/South Africa Binational Commission (BNC), you have engaged in an astonishing array of bullying tactics to prevent South Africa from implementing policies, legal under the rules of the WTO, that are designed to expand access to HIV/AIDS drugs. We are attaching several documents. Appendix A is a report prepared by the United States Department of State and provided to the House Committees on Ways and Means, Appropriations and International Relations, on February 5, 1999. Appendix B is a copy of Article 31 of the WTO/TRIPS agreement, which sets out the rules under which nations can use compulsory licensing of patents to achieve public interest objectives. Appendix C is a four page section from a 1999 World Health Organization (WHO) report that explains how compulsory licensing of essential medicines is done under the WTO/TRIPS agreement. Appendix D is a copy of the presentation to the Executive Board of the World Health Assembly by Peter Goosen, Charge d' Affairs at the South African Permanent Mission in Geneva. Appendix E is a background paper on compulsory licensing prepared by the Consumer Project on Technology (CPT) for a March 26, 1999 meeting in Geneva on compulsory licensing. Appendix F is a US government position paper on compulsory licensing that was presented by Lois Boland from the US Patent and Trademark Office. Appendix G is a presentation by Adrian Otten, the Director of the Intellectual Property Division for the World Trade Organization (WTO), for a meeting of the World Health Assembly's ad hoc working group on the Revised Drug Strategy, held in Geneva on October 13, 1998. Taken together, these documents provide a chilling account of the US government's abuse of its superpower status. Let us start with the February 5, 1999 Department of State report to Congress on the Clinton/Gore Administration's efforts to undo the South African Medicines Act. It begins with this statement: The intellectual property rights protection issue surrounding Article 15(c) of the December 1997 amendments to the South African Medicines and Related Substances Act of 1965 ("Medicines Act") is a top priority for the United States Government's (USG's) economic relations with the Republic of South Africa. Resolving this bilateral trade conflict has been and remains a vital component of our bilateral commercial relationship. All relevant agencies of the U.S. government the Department of State together with the Department of Commerce, its U.S. Patent and Trademark Office (USPTO), the Office of the United States Trade Representative (USTR), the National Security Council (NSC) and the Office of the Vice President (OVP) have been engaged in an assiduous, concerted campaign to persuade the Government of South Africa (SAG) to withdraw or modify the provisions of Article 15(c) that we believe are inconsistent with South Africa's obligations and commitments under the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). This 10 page single spaced report provides chapter and verse of a two year campaign to use the weight of US power, short of military warfare, on South Africa to prevent that country from implementing policies to obtain cheaper sources of essential medicines. What is particularly brazen is the suggestion that the South African government is acting outside of its obligations under the WTO/TRIPS agreement. This is untrue and US trade negotiators know this is untrue. The two disputed issues in 15(c) of the South African medicines act are parallel imports and compulsory licensing. These are unambigously legal under the WTO/TRIPS. Indeed, with respect to parallel imports, the United Kingdom and several European Union countries have extensive trade in parallel imports of pharmaceutical drugs, and there have been countless cases before the European Court of Justice that have upheld this practice. If the US government is so concerned about parallel imports, why doesn't it bring a trade action against EU countries? The reason is simple. Under Article 6 of the TRIPS, parallel imports are perfectly legal. The Department of State even acknowledges this briefly on page three of its own report to Congress when it notes "On the parallel imports issue, however, US government attorneys note that under the terms of the TRIPS agreement, disputes related to parallel importation are not subject to WTO dispute settlement procedures." The reasons that this is the case are that parallel imports are legal under the TRIPS agreement and are commonly used throughout the world. Recent Supreme Court and legislative actions in Japan, New Zealand, Australia and even the United States have all supported this, as your trade officials fully know, and which has been pointed out by CPT on several occasions. Yet your own staff continues to pillar Minister of Health Dr. Nkosazana Zuma and the South Africa government as if they were outlaws on international scene. This is a form of political slander that should deeply offend all who respect the rule of international law. The other primary issue concerns compulsory licensing of patents. As is described in the attached background paper on compulsory licensing, the United States government uses compulsory licensing frequently for a wide variety of purposes. South Africa has never issued a compulsory license on a pharmaceutical product. The United States has done this several times in the past three years. And the United States employs compulsory licensing in countless other cases. For example, in November of 1998 the US Department of Justice obtained more than 150 compulsory licenses to a Monsanto biotech patent. Kenneth Starr was involved in a compulsory licensing dispute involving Hughes Aircraft company. The US maintains compulsory licensing statutes for government use, for clean air, for nuclear power and for other purposes. A federal district court recently ordered compulsory licenses that involve Intel, and the US Justice Department is considering compulsory licensing that involves Microsoft. It is gross hypocrisy to act as if South Africa is an outlaw in the world community because it is considering the use of compulsory licensing for essential medicines. But this is far worse than hypocrisy. Africa is confronted with a public health crisis of historical proportions. Of course South Africa should use compulsory licensing to expand access to essential medicines! This is an emergency, and millions of lives are at stake. Why should President Nelson Mandela, Deputy President Thabo Mbeki and Dr. Nkosazana Zuma permit their population to be defenseless simply because Glaxo Welcome and Bristol-Myers Squibb want the power to set prices for US taxpayer funded and government developed HIV/AIDS drugs in Africa? Compulsory licensing is not an attack on the patent system, it is part of the patent system. Compulsory licensing of patents is not an attack on the TRIPS agreement, it is part of the TRIPS agreement. (Article 31) The WTO itself is quite clear that countries can use compulsory licensing for whatever purposes they choose, so long as they abide by Article 31 conditions, including payment to patent owners. These are the comments of Adrian Otten, the Director of the Intellectual Property Division at the WTO, in an October 13, 1998 presentation to the ad hoc working group on the WHA's Revised Drug Strategy. Speaking of the TRIPS, Mr. Otten said: [T]he Agreement also allows Members to authorize use by third parties (compulsory licenses) or for public non- commercial purposes (government use) without the authorization of the patent owner. Unlike what was sought by some countries in the negotiations, the grounds on which this was done are not limited by the Agreement, but the Agreement contains a number of conditions that have to be met in order to safeguard the legitimate interests of the patent owner. [emphasis added] At the same meeting, Richard Wilder, an American working for World Intellectual Property Organization (WIPO) who previously worked for the pharmacuetical industry, said quite plainly, "the right to exclude others from using a patented invention may be subject to limitations in some countries, including by the right of the government to use the invention or by the grant of compulsory licensing." [emphasis added] There are many examples where countries set out specific criteria for compulsory licensing. French law authorizes compulsory licensing when medicines are "only available to the public in insufficient quantity or quality or at abnormally high prices." Many countries have similar provisions, including the United States as part of the Bayh-Dole Act, which specifically singles out cases where compulsory licensing is needed to "alleviate health or safety needs which are not reasonably satisfied." In 42 USC Sec 2183, the United States permits the compulsory licensing of patents for nuclear energy that are "affected with the public interest." As the United States Federal Trade Commission has recently pointed out, the new era of biotechnology will create a number of areas where compulsory licensing will be essential to permit innovation in new high technology fields of medicine. Consider, for example, this commentary by Michael Kern on a recent compulsory licensing decision in Germany: [W]e now are confronted with the situation that plaintiffs and defendants may employ their respective patents to block each other from exploiting interferon as a therapeutic agent against rheumatoid arthritis. If the market does not rectify this `patent failure,' the public may have to wait twenty years before gaining access to this therapeutic agent. A compulsory license in situations involving dependent patents, as provided for in various countries, is a means to correct patent failure coupled with market failure. One should not forget that patents represent a interventionist instrument, ultimately for the sake of community welfare. [emphasis added] The fact that compulsory licensing is legal under international trade law and under the TRIPS agreement is acknowledged by US officials in other settings, such as when they are in the presence of informed persons. For example, in a March 26, 1999 meeting in Geneva on compulsory licensing, US PTO official Lois Boland acknowledged that countries have the right to use compulsory licensing under international law and under the WTO/TRIPS agreement. But she added: The fact that [the current US] view is not reflected in the TRIPs agreement, in the multilateral context, is fully acknowledged. In our bilateral discussions, we continue to regard the TRIPs agreement as an agreement that establishes minimum standards for protection and, in certain situations, we may, and often do, ask for commitments that go beyond those found in the TRIPs agreement. This is the key point. The US is seeking something more than what is required by the TRIPS. The US government's bullying of South Africa has been justified to poorly informed reporters and Members of Congress as if it was simply a matter of getting South Africans to abide by international law. But once one understands that South Africa is seeking to live with the terms of the TRIPS agreement and that it is the US government that is unhappy with the TRIPS, one has to confront fundamental questions. Why is the US doing this? Does it make any sense given the AIDS epidemic in South Africa? Like the Americans, the French, the Germans, the Japanese and virtually all OECD countries, the South African government has the authority and the responsibility to implement intellectual property laws that serve the interests of its own citizens. South Africa is acting according to international law. It is the United States government that refuses to follow WTO dispute resolution mechanisms, and seek a legal judgement on the South African compulsory licensing practices. It is the United States government that is taking matters into its own hands and deploying an astonishing assault on South African sovereignty and critical public health responsibility. It is the United States government that is literally asking South Africa to abandon the lives of millions of infected citizens in order to receive reductions in US barriers to trade or economic aid. What kind of Vice President are you if you cannot take time out from frantic political fundraising and today recognize the immorality of US policy toward the South African people on this issue? We have written your office and other officials in the Clinton/ Gore Administration calling for consultations with public health groups on US government policies on intellectual property rights and the international AIDS crisis. This has not occurred. Today we are asking that you reverse US policy toward South Africa. We ask that you instruct Secretary Madeleine Albright, Under Secretary Stuart Eizenstat at the Department of State, Secretary William Daley at the Department of Commerce, United States Trade Representative Charlene Barshefsky, Stuart Nightingale at the US Food and Drug Administration and others to stop their opposition to South African policies on compulsory licensing and parallel imports of pharmaceutical drugs. We and the HIV/AIDS and public health communities who are increasingly concerned about this issue await your response. Sincerely, Ralph Nader James Love Director Consumer Project on Technology
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