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Canada Pledges to Fight HIV/AIDS in Africa
Key Initiatives to Canada Fight Against Aids in Africa
The Canadian government’s past record on HIV/AIDS has been
mixed. Under Prime Minister Chrétien, the Liberals were
criticized for freezing HIV/AIDS funding at levels established
by the former Mulroney government. A particularly sticky issue
for the Chrétien government, in this context, was the
whole matter of compensating Canadians who contracted HIV through
tainted blood transfusions in the later years of the 20th century.
In recent years, however, rising HIV levels among Canadian youth,
particularly young women, has led to a renewed commitment to
fight HIV/AIDS by the Canadian government. Further to this, former
Prime Minister Chrétien demonstrated a special interest
in Africa and African development – even making it Africa
and African issues the focus of G8 discussions hosted by Canada
in Kananaskis, Alberta, in the summer of 2002. Initiatives since
undertaken by the government of Prime Minister Paul Martin, such
as introducing and passing the Jean Chrétien Pledge
to Africa Act (to provide lower-cost pharmaceutical products
to least-developed and developing countries), suggest the Martin
government will continue working towards the same end.
Canada’s Formal Strategy for Fighting AIDS
In 1998, Canada established the Canadian Strategy on HIV/AIDS (CSHA).
Its goal was to move beyond treating HIV/AIDS merely as a disease,
by examining the causes of HIV and its impact on various communities.
Coordinated by Health Canada, the CSHA brings together federal,
provincial and territorial governments, Non-governmental Organizations
(NGOs), and community organizations in its work. A Ministry of
Council on HIV/AIDS – comprised of doctors, activists,
and other individuals with a stake in fighting the disease, advises
the federal Minister of Health on HIV/AIDS issues. While funding
levels for the Strategy remained fixed for a period of time,
in May 2004 the Liberal government announced that funding levels
would be doubled – to $84.4 million annually by $84.4 million
by 2008-2009. Many of the goals of the Canadian Strategy on HIV/AIDS – such
as developing an AIDS vaccine – would benefit HIV/AIDS
patients both in Canada and internationally.
To this end, it’s worth mentioning that Canada has implemented several
policies designed specifically to halt the spread of HIV/AIDS in developing
countries. Initiatives undertaken by the Canadian government include the
following:
- Contributing financial support for the Global Fund. Canada
played a major role in creating this Fund, and continues
to provide funding in this regard. Canada has committed
to donating $70 million in support of the Fund in the year
2005.
- Offering continued financial support for the World Health
Organization’s ‘3 by 5’ Initiative, to
provide antiretroviral drugs to three million people by
the end of 2005. Canada is one of the major donors to this
Initiative. In May 2004, Canada announced it was donating
$100 million.
- Supporting a number of other key HIV/AIDS initiatives. These
include the International AIDS Vaccine Initiative, and
the Global Coalition on Women and AIDS.
- Assuming the chairmanship of the Joint United Nations Programme
on HIV/AIDS (UNAIDS) for 2004–05.
Canada Passes Generic Drug Legislation
In May 2004, Canada became the first country to pass legislation
(better known as the Jean Chrétien Pledge to Africa
Act ) allowing drug manufacturers to export cheaper generic
versions of drugs to poorer countries to fight epidemics such
as HIV/AIDS and malaria.
The Bill’s main features are as follows:
- In the case of a medical emergency, the Canadian government
can authorize drug manufacturers to make low-cost generic
versions of patented drugs to developing and least developed
countries.
- The generic version of the drug must be clearly distinguished
from the patented version, through packaging or other measures.
- To be eligible, WTO member countries must meet the guidelines
set out in the 2003 agreement.
- Non-WTO countries must declare a state of national emergency
or other “extreme urgency,” state the specific
type, and the amount, of the drug needed, as well as verify
that it will not be used for commercial purposes.
- The patent holder must receive a royalty. While the details
are not spelled out in its legislation, through this Act,
the Government of Canada has committed to a formula that
links the royalty rate to the importing country’s
ranking on the United
Nations Human Development Index.
At this point it is unclear how much the generic versions of patented
drugs will cost. However, industry analysts say competition could
reduce the price to below $250 US annually per patient.
In developing this legislation, the Martin government considered
the views of a number of key stakeholders, including both generic
and patent holding pharmaceutical manufacturers, and activist
HIV/AIDS organizations such as the Canadian HIV/AIDS Legal Network.
Based on the input of these groups, several revisions were made
to the initial draft of the legislation. They included:
Expanding the list of countries eligible to receive generic versions
of the drugs. Originally, the government intended to limit eligibility
to WTO members and countries that the United Nations had classified
as least-developed countries (LDCs).
- Removing an extremely controversial “right of first
refusal” clause giving drug patent holders the right
to take over a contract to produce the generic version
of the drug. The Canadian Generic Pharmaceutical Association
argued there was no incentive for companies to develop
generic versions of patented drugs if they might lose the
manufacturing contract to the company holding the patent.
- Allowing Non-Governmental Organizations (NGOs) to contract
directly with generic drug manufacturers to purchase the
drugs.
Perspectives on the Legislation
Critics praised the revisions the Martin government made to the
legislation, but argued the final bill that was given Royal Assent
still contained several flaws. Namely:
- It limits the program to a list of 56 specific drugs cited
in the legislation. By contrast, the WTO agreement is not
restricted to certain drugs. Theoretically, Parliament
can amend the bill to add other drugs at any time. However,
attempts by the NDP to add two drugs used to fight HIV-related
pneumonia were defeated, primarily due to lobbying by patent
holding pharmaceutical companies.
- The process non-WTO countries must go through to obtain the
generic drugs is viewed as unnecessarily complicated.
- It requires that generic drugs meet the regulatory standard
of drugs sold in Canada, and makes it more difficult to
manufacture certain types of AIDS drugs that aren’t
normally produced by brand name manufacturers. This includes
fixed-dose combinations of antiretroviral drugs (known
as FDCs ).
- What NGOs must do to obtain the permission of the importing
government is not clearly defined.
Overall, NGOs and HIV/AIDS rights’ groups view this legislation
as a good first step in establishing parameters for the export
of cheaper drugs to needy countries. They don’t, however,
believe it should serve as a precedent. Instead, they hope other
WTO members will enact legislation that is less restrictive,
and more in keeping with the tenets of the 2003 WTO agreement.
By contrast, Canada’s patent holding pharmaceutical companies – many
of which have spent billions of dollars on research and development – support
the legislation as it stands.
To learn more about the reaction of pharmaceutical companies to
the Martin government’s legislation, see “Remarks
by Canada’s Research-Based Pharmaceutical Companies before
the Senate Foreign Affairs Committee on Bill C-9.” [PDF]
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