Michael Bailey, OXFAM

Doha is a big step forward in the battle for affordable medicines. The huge profile given to the issue changes the political climate, building on the victories in the South Africa and Brazil cases. It will now be much harder for the US and the drug companies to bully poor countries over their patent policies. We would have liked to see a stronger declaration but there is a clear political statement that the agreement must be implemented in a way that promotes access to medicines. The next step is to ensure that next year’s scheduled review of the TRIPS agreement takes a hard look at the length and scope of pharmaceutical patents in developing countries, which remains the heart of the problem.

Cecilia Oh, Third World Network

The declaration (as it stands) is a good first step. The developed countries, in agreeing to the declaration, have committed themselves to this process. We want to see a commitment on their part, and their pharmaceutical lobbies, to stop pressures on developing countries. The developing countries can get down to the work of implementing and enacting domestic measures, with the guarantee that there will not be pressures or legal threats. ..

Zafar Mirza, Health Action International and The Network for Consumer Protection in Pakistan.

It is a definite step forward though it could be stronger. The declaration explicitly recognizes the issues as well as sovereignty of the governments to take appropriate measures to get around to the issues. A lot depends upon the countries now how they live up to the expectations of the poor patients. The declaration also recognizes the problems of countries with insufficient or no pharmaceutical manufacturing capacity and also the limitation of the compulsory license as solution to these problems. We hope General Counsel come up with a clear solution to this issue next year. Our challenge now is to get this declaration translated into action, which can save lives.

James Love, Consumer Project on Technology

The Doha declaration on TRIPS is the strongest and most important international statement yet on the need to refashion national patent laws to protect public health interests. It is a road map for using the flexibility of the TRIPS to protect the public health, and sets a standard to measure any new bilateral or regional trade agreement. The declaration is a political statement that did not modify in any way the TRIPS agreement, and the decision to settle for a political statement was controversial in the negotiations. The developing countries had asked for legally binding interpretations of the agreement, including a solution to the single most obvious problem with the TRIPS, the Article 31.f limitations on exports of medicines manufactured under a compulsory license. We were disappointed the European and American negotiators blocked agreement to use Article 30 of the TRIPS to export medicines to countries that do not have domestic capacity for manufacturing, but pleased this issue will be examined by the TRIPS council in 2002. The negotiation over the export of medicines provisions in the TRIPS will be the next battleground in term of trade policy.

Daniel Berman, MSF

Since Seattle there has been a seismic shift. Two years ago many developing countries felt they were powerless against the will of the wealthy countries and their drug companies. Here in Doha more than 80 countries came together and negotiated in mass. It was this solidarity that led to a strong affirmation that TRIPS “can and should be interpreted and implemented in a manner …to protect public health.” In practical terms it means that countries are not at the mercy of multinationals when they practice price gouging. The threat of punitive action against a country that attempts to address its health needs has been dramatically reduced. With this declaration it is doubtful that a wealthy country would dare file a dispute against a developing country for using one of the safeguards such as compulsory licensing. Now patent holders either offer prices that make their drugs accessible or risk losing their monopoly rights. The victory in Doha is really for people who need or will need access to life-saving or extending medicines.

Khalil, Elouardighi, Paris Act Up!

Like at the Health Ministerial in May 2001, The EC and the EU again fell into this apparently spontaneous good cop/bad cop mode, with the US opposing everything and the EU claiming to have no position of its own on the issues and to only want to help the opposed parties find a middle ground, while in truth intensively watering down the developing countries’ proposals. Then the political need to come back from Doha with some semblance of success made the Brazilian delegates cave in to the rich countries' position and agree to forget legally binding wording as well as clarification of exports for generic versions of patented drugs. India and the Africa group resisted a bit, but were not imparted with enough political commitment to the issue to make this a deal-breaker. The Africa group representative, and the African delegates, did not realize the role and value of press work for negotiation purposes, both in terms of contradicting rich countries' propaganda and of holding North public opinions ransom for North government's predictable efforts to renege on the spirit and/or letter of the Doha Declaration. They waited until the last day to talk to the press, instead of crying foul at the first immoral positions insisted upon by developing countries. The chairman of the Africa Group did not answer when asked in press conference whether it should be expected that the hard-won right to effectively use compulsory licensing provisions would be exercised by African countries in the short term, in the context of the health crises currently obtaining on the continent, and after the US and Pharma had told the press in the morning that the Declaration didn't mean anything in the sense that it was purely political, and that it did not really say anything about how WTO would react should patents broken. Where relation with the media is concerned, developing countries seem to show surprising naiveness about the influence of the pharmaceutical industry over richest country governments and their duplicity with regard to international agreements. They should be briefed about negotiation techniques and the role of the press therein.

Ellen ‘t Hoen, Medecins Sans Frontieres

This declaration is a major step forwards in the quest to ensure access to medicines for all. The text that has been agreed upon now was unthinkable 6 months, 6 weeks, even 6 days ago. It states clearly that there are serious conflicts between the obligations under the TRIPS Agreement and countries need to protect public health including providing access to medicines, it states that countries have the right to take measures to overcome patent barriers to public health and the statement outlines clearly how countries can do this. It is a missed opportunity that this ministerial conference did not offer a solution for countries without production capacity that want to make use of compulsory licensing . But we are confident that this issue will be resolved in the next year in the TRIPS Council. Countries can ensure access to medicines without fear of being dragged into a legal battle. Now its up to governments to use this power to bring down the cost of medicines and increase access to life-saving treatments.

Asia Russell, Health Gap Coalition and Act Up Philly

Developing countries came to Doha to extract a clear declaration that public health and access to medicines are more important than protecting the commercial interests of pharmaceutical companies. At the end of the day, opposition from rich countries crippled the legally binding language sought by the majority of WTO countries.”

Gaelle Krikorian, ACT UP Paris

Wealthy countries and drug companies refuse to compromise patent monopolies in poor countries that have no domestic capacity. The declaration does nothing to remedy this barrier. The majority of people with AIDS and other treatable diseases live in these countries, so a solution is critical. The Ministerial Declaration merely acknowledges the problem of exporting drugs to poor countries—rich countries stood in the way of taking the actions that are desperately needed.

Sharoann Lynch, Health Gap and Act Up NYC

Countries levying formal or informal pressure on poor countries that are taking strides to increase drug access should face condemnation from WTO members, because such pressure violates the spirit and terms of this agreement. Doha did not end the battle over poor country access to drugs,” Lynch continued. “Against the pressure of rich countries and drug companies, the fight must continue to complete the unfinished work of this Ministerial—millions of lives are at stake. We demand that the WTO clarify during the first meeting of the TRIPS Council that nothing in the TRIPS Agreement should stand in the way of countries exporting cheap drugs to poor countries.

Jacques ARBI AKEREKORO, ARAMBE / KAFU-ATA- BENIN

The Doha declaration on TRIPS is a big step to Access to drugs for poor countries. Now all African consumers are waiting to its real application by our governments not only in term of access to HIV drugs but in order to let their people have access to the others drugs chiefly those which will be discovered…..The struggle for LIFE and Justice continues.