To the attention of the Trade Minister (cc to Health Minister)

The Head of the Diplomatic Delegation in Geneva (cc to the WTO Delegate)

SUBJECT: Call for some changes at WTO TRIPS Council on "TRIPS agreement and Public Health"

Dear Minister, Dear Ambassador,

The World Heart Federation is particularly worried with the outcomes of the next TRIPS Council on Friday December 13, in which WTO members will discuss the solution to the problem posed by the paragraph 6 of the Doha Declaration on TRIPS and Public Health. The TRIPS Council has to find an "expeditious solution" to the threat posed by article 31(f) of the TRIPS agreement to access to essential medicines, in countries which have "insufficient or no manufacturing capacities in the pharmaceutical sector".

Public health problems should not be dealt as a trade issue only. The voice of public health professionals and health ministries should be heard. Nonetheless, we call for the solution due to be reached by the TRIPS Council before the end of 2002 to satisfy a number of important conditions.

The World Heart Federation cannot agree with the solutions proposed so far; some changes should be implemented.

• The solution should be extended to non-communicable diseases. It is necessary to reiterate that cardiovascular disease is the world's leading cause of death. Worldwide, cardiovascular disease and strokes kill about 17 million people every year, it means one death out of three. Any measure to protect public health, including measures concerning non-communicable disease, should fully benefit from the outcomes of next TRIPS Council.

• The developing world is not safe from the cardiovascular disease epidemic and 78% of deaths linked to cardiovascular diseases occur in low and middle-income countries. So, the definition of 'public health threats' should be enlarged to include these types of conditions that will more and more affect developing country healthcare systems.

• Medicines should not be the only solution, medical devices and vaccines should also be mentioned. Many actions in Public health could be covered by prevention and health education.

• The solution should benefit all developing countries.

• The solution should be permanent, sustainable and economically viable. In this respect, it will have to be fair, quick and simple for countries to implement.

• The World Heart Federation calls upon you to put public health above trade and to find an immediate solution.

Professor Mario Maranhão
President, World Heart Federation