January 18, 2000

The Honorable Donna Shalala
Secretary of Health and Human Services
Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201

Dear Donna:

I am writing in connection with the upcoming World Health Organization (WHO) Executive Board meeting in Geneva, beginning on January 24. We have corresponded over the past years on the Revised Drug Strategy (RDS) resolution, and its attack on industry intellectual property. We were pleased that the compromise RDS text was approved without amendment at last year's World Health Assembly (WHA), and appreciated the interventions and support of the U.S. delegation on this issue.

We understand that one of the agenda items at the upcoming Executive Board is "Confronting the HIV/AIDS Epidemic," and are concerned with the draft resolution contained within the WHO background materials. In particular, the WHO Executive Board is asked to request the WHO Director-General:

"To pursue dialogue with the pharmaceutical industry with a view to reducing the costs of HIV/AIDS-related drugs and making them increasingly affordable to Member States and their populations;

on their request, to advise governments on their options under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS)to increase their capacity to negotiate for more affordable HIV/AIDS-related drugs."

Such a resolution would not seem to be consistent with the position recently articulated by Vice President Gore at the U.N. Security Council Session on AIDS in Africa. In his remarks, Vice President Gore noted that the first line of defense against this disease is prevention, and that we must do much more to provide basic care and treatment to patients. The latter requires more and better training of health care personnel, and the development of clinics and community-based organizations to deliver care. In addition, Mr. Gore emphasized the need for initiatives to expand public-private partnerships in the battle against AIDS.

We believe that the approach presented by Vice President Gore appropriately recognizes the complexity of the challenge facing the global community. Pharmaceuticals are certainly part of the effort to overcome AIDS in Africa as well as the rest of the world: however, it would be short-sighted to imagine that they alone will solve the problem. Moreover, given the shortcomings in health care infrastructure prevalent in the least developed countries, pinpointing the price of drugs as the barrier to access is a mistake. In that sense, the suggestion that WHO focus its efforts on negotiating lower prices for drugs, and on lowering intellectual property protection under the TRIPS Agreement, are misguided.

The research-based pharmaceutical industry maintains its commitment to work with the World Health Organization to find solutions to the problems of access to health care and medicines in developing countries. Indeed, we have been working collaboratively with WHO staff over the past 15 months on the issues of improving access, drug development, and quality and counterfeiting. We believe that such a cooperative effort, which could be expanded to include developed and developing country governments, multilateral development agencies and financial institutions, and non-governmental organizations, can present positive steps towards overcoming this global problem.

I hope that the U.S. Government will be prepared to support a positive and productive approach to resolving the HIV/AIDS crisis during the WHO Executive Board meeting in Geneva next week. As always, if I or my staff can be of any assistance, please do not hesitate to contact me.

Sincerely,

Alan F. Holmer