Access to affordable medicines and trade policies

The Minister of Health of South Africa, Dr. Tsabalala Msimang
The Minister of Health of Belgium and president of the European Union Health Council, Ms. Magda Aelvoet
26 October 2001


  1. We are concerned that medicines remain largely unaffordable to the majority of people living in countries from the South where the burden of disease is greatest. The criteria for access to drugs should not only depend on income but must also seriously consider need and burden of disease.

  2. It is not enough for the drug industry to practice cherry-picking or choose a few drugs which they will offer at a discount or as donations to countries from the South, such as selected drugs against HIV, TB or malaria. All essential drugs should be accessible and affordable to those in need.

  3. Whilst we respect the investments made by the pharmaceutical industry in the development of new drugs, we advocate for a balance between profit-making and access to affordable drugs, in a manner that ensures that public health interests remain paramount and above profits.

  4. We must reverse the situation where only 10% of research and development on new drugs is spent on new drugs that are common in countries from the South, and yet 90% of the burden of disease is found in countries from the South. We must provide a package of incentives to reverse this situation and build technological capacity in countries from the South. We must ensure that the industry does invest in the search for new drugs against diseases that are found in countries from the South.

  5. Access to affordable drugs must go hand in hand with the strengthening of national health systems in countries from the South. The availability of drugs at affordable prices should be ensured, amongst others, by good procurement, distribution and logistical systems. This must guarantee universal access to basic health care.

  6. The TRIPS agreement (Trade Related Intellectual Property Rights) of the WTO allows developing countries to use various flexible clauses, albeit in a limited nature, within this agreement to ensure access to affordable medicines. But the pharmaceutical industry continues to intimidate and penalize those countries that explore the use of these legitimate clauses that are permitted within the TRIPS agreement.

  7. We support the legitimate strategies that are available to countries from the South to use in order to increase access to affordable medicines. These include: generic substitution; compulsory and voluntary licensing; parallel importation; international tendering or bulk purchasing of medicines; price control; good dispensing practices; and the elimination of variables that contribute towards price escalation; etc. We consider that there are already enough measures at hand to prevent the reimportation of such cheaper medicines into industrialized countries.

  8. Because it is a crime against humanity for poor people to die because lifesaving medicines are too expensive, the Ministers of Health, therefore, strongly urge their Colleagues, the Ministers of Trade, to reach an agreement in Doha (Qatar) next month on the necessary revision of the application of the TRIPS Agreement. This must allow countries from the South to gain better access to affordable medicines to ensure universal health care is not a luxury but a human right.


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