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"Fire in the Blood": Millions Die in Africa After Big Pharma Blocks Imports of Generic AIDS Drugs (Democracy Now)

(From Democracy Now) The new documentary, "Fire in the Blood," examines how millions have died from AIDS because big pharmaceutical companies and the United States have refused to allow developing nations to import life-saving generic drugs. The problem continues today as the World Trade Organization continues to block the importation of generic drugs in many countries because of a trade deal known as the Trips Agreement. We're joined by the film's director, Dylan Mohan Gray, and Ugandan AIDS doctor Peter Mugyenyi, who was arrested for trying to import generic drugs, and is

Some analyses of domestic regulation disciplines – compilation for MC11 (2017)

This is a recent analysis of proposed (by a number of countries) Disciplines on Domestic Regulation from Sanya Reid Smith of TWN, an NGO that has been involved in WTO matters for a long time. It was made before the recent WTO Ministerial Conference in Buenos Aires. You can see that its the WTO which is disciplining the countries domestic regulations. ------------------------------------------ Introduction Domestic regulation disciplines on services are being negotiated in a number of trade agreements including at the World Trade Organization (WTO), in the Trade in Services Agreement (TISA) 1 and in other free trade agreements (FTAs) such as the Regional Comprehensive Economic Partnership (RCEP) 2 and those being negotiated by the European Union (EU) 3 . It seems that domestic regulation disciplines (DRD) will also be negotiated at the Eleventh WTO Ministerial Conference (MC11) from 10-13 December 2017 in Buenos Aires, Argentina. 4 The European Union, Australia, New Zealand, Switzerland etc (‘EU et al’) released their DRD proposed text on 1 December 2017. 5 "These proposed DRD would restrict laws and regulations re services licensing etc, even non-discriminatory laws which apply to domestic and foreign companies equally. Yet, as United Nations Conference on Trade And Development (UNCTAD) staff note, services regulation is important for a number of reasons including: protecting consumers, ensuring universal access to essential services cultural diversity, quality, safety, correcting market failures (eg: information asymmetry where the service provider has more information than the consumer, natural monopolies, negative externalities (eg environmental degradation from transport) where those not directly involved suffer costs). 6 After highlighting that many regulatory frameworks are still at an emerging stage in developing countries the UNCTAD staff conclude that ‘it is key for developing countries that international rules for services trade preserve the right to regulate (RtR) and grant the necessary policy space to experiment in the search for those policies that best suit individual countries’ specific, developmental needs.’ Given this, the UNCTAD staff note that ‘one would expect developing countries to take a cautious, rather than an offensive approach towards the development of these disciplines, with their main goal to preserve the RtR.’ 7 This compilation includes excerpts from existing analyses of the same DRD proposed in the WTO or in TISA." ----------------------------------- Compiled by Sanya Reid Smith, Third World Network

U.S. is about to cripple the World Trade Organization’s dispute-settling system

Dec 9, 2019 "The governance of international trade is on track to suffer serious damage this week as the United States carries out a long-standing threat to cripple the World Trade Organization’s system for settling disputes. The WTO’s Appellate Body, which adjudicates on contested rulings over disputes between member countries, will become unable to function when Washington exercises a veto and blocks new judges from being appointed to replace two whose terms of office are expiring......"

Indian Company Offers to Supply AIDS Drugs at Low Cost in Africa (New York Times, Feb. 7, 2001)

(This is the story depicted in the Fire in the Blood film) By Donald G. McNeil Jr. In a move that could force big drug multinationals to cut the prices of their AIDS drugs in poor countries, an Indian company offered today to supply triple-therapy drug ''cocktails'' for $350 a year per patient to a doctors' group working in Africa. The Indian company, Cipla Ltd. of Bombay, a major manufacturer of generic drugs, made the offer to Doctors Without Borders, which won the Nobel Peace Prize in 1999 for its work in war-torn and impoverished areas. In Africa the group sets up small pilot programs to develop models for broader approaches to combat AIDS, and would distribute the Cipla drugs free. As part of its program, Cipla would also sell the drugs to larger government programs for $600 a year per patient, about $400 below the price offered by the companies that hold the patents. ''This is the way to break the stranglehold of the multinationals,'' said Dr. Yusuf K. Hamied, chairman of Cipla, who will meet with the doctors' group on Feb. 15 to discuss strategy. For two years, Doctors Without Borders has led an aggressive campaign to force multinationals to cut prices on life-saving drugs for the world's poorest patients. Other parties in the campaign are the Philadelphia and Paris chapters of the AIDS Coalition to Unleash Power, and the Consumer Project on Technology, a Washington group started by Ralph Nader. The normal cost of the AIDS cocktail in the West is $10,000 to $15,000 a year. Last May five multinationals, backed by the World Health Organization and other United Nations agencies, offered to sell their components to poor nations at sharply reduced prices. But Cipla and other makers of generic drugs in Brazil, Thailand and other countries have not been part of the talks with W.H.O., a situation that Cipla hopes to change with its aggressive entry onto the scene. The country-by-country negotiations about how the multinationals distribute the drugs have gone slowly, and so far only Uganda, Senegal and Rwanda have agreements. The companies refuse to release figures, but the cost of a typical cocktail in Senegal is $1,000 a year, according to Doctors Without Borders. Dr. Bernard Pecoul, director of the Access to Essential Medicines project for Doctors Without Borders, said the Cipla offer, which he learned of only today, ''will let us start up our pilot projects on a larger scale.'' The doctors' group has 40 AIDS projects around the world, about half in Africa, where the infection rate reaches as high as 36 percent. Only five of these pilot programs are giving out antiretroviral cocktails. With the Cipla offer, or matching ones from other companies, up to 20 could be distributing the drugs by the end of year. Cipla is offering to sell the agency as many doses as it is wants at $350 a year. Dr. Hamied said that his company would lose money at that price, but that he would supply ''10,000 doses or 20,000 or 30,000, however many they want.'' The $600 price to governments is near Cipla's break-even point, he said, but costs could drop with greater production. If that happens, he would cut prices further. In India he sells the same cocktail for about $1,100 a year. But he denied that he was trying to grab market share in Africa. ''What do I want with market share?'' he asked. ''I don't have a monopoly, and the only way to make real money in drugs is with a monopoly. In this disaster, there is room for everybody.'' Wide distribution of the drugs in Africa is not without critics, given the attendant need for careful monitoring. Some experts argue that it would be better to spend the money on providing clean water, controlling malaria and increasing the use of condoms. But Doctors Without Borders says that the dangers and side effects of the drugs pale beside the immensity of the epidemic itself, and that Western testing standards are overcautious. The typical AIDS cocktail is a combination of any three of about nine protease inhibitors or reverse transcriptase inhibitors. The chemicals suppress the human immunodeficiency virus but, as with any chemical therapy, they are toxic and can damage the liver. In the West, doctors carefully monitor the levels of the drug in the blood, test for organ damage and check the levels of the virus in the bloodstream. If the virus mutates to resist the therapy, the combinations are changed. Careful monitoring may not be possible in many African settings. But with 25 million Africans infected with the AIDS virus, Doctors Without Borders and other agencies argue, imperfect treatment is better than none. Dr. Pecoul pointed out that large numbers of infected Africans live in urban areas where, ''with a quite simple clinic, you can deal with anti retrovirals.'' He is also ''not convinced'' that the batteries of tests routinely ordered for Western patients are really necessary. ''Some people suggest that H.I.V. testing and clinical followup can be enough,'' he added. The Cipla drug combination is two tablets of 40 milligrams of stavudine, two tablets of 150 milligrams of lamivudine and two tablets of 200 milligrams of nevirapine. In the United States and many other countries, the Bristol-Myers Squibb Company holds the patent on stavudine, also known as Zerit or d4T; Glaxo-Wellcome of Britain holds the patent on lamivudine, also known as Heptovir or 3TC, and Boerhinger Ingelheim G.m.b.H. of Germany holds the patent on nevirapine, or Viramune. Western drug companies have shown themselves determined to defend their patent rights to be sole distributors throughout the world, and Dr. John Wecker, head of Boerhinger Ingelheim's efforts to negotiate cheaper prices in Africa, said he did not yet know what his company would do if Cipla undercut its prices. ''We offer a standard quality from the original manufacturer and can meet any demand that exists out there that can be delivered with safe procedures,'' he said. He refused repeatedly to say at what price Boerhinger Ingelheim sells nevirapine to Senegal or Uganda, saying, ''Affordability is an issue, but not the major issue.'' Representatives from Glaxo-Wellcome and Bristol-Myers did not return phone calls, but the three companies can be expected to wage a hard fight against the distribution of generic versions of their drugs. Late last year, Glaxo-Wellcome threatened to sue Cipla when it tried to sell Duovir, its generic version of Glaxo's Combivir, a lamivudine/zidovudine combination, in Ghana. Cipla offered the drug for $1.74 a day; Glaxo had cut its price to $2, from $16. But even though the African regional patent authority said Glaxo's patents were not valid in Ghana, Cipla backed down and stopped selling Duovir. Asked what he would do if the three drug companies sued to stop him, Dr. Hamied said: ''We won't fight it. I don't look at it as a fight. There's room for everybody. This is a holocaust in Africa. It's like the earthquake in India right now -- everybody is helping out. I'm not looking to pick anybody's business; there's room for the multinationals at their price and room for us at our price, a partnership.''

The race to patent the SARS virus: the TRIPS agreement and access to essential medicines

by Matthew Rimmer. "[This article considers the race to sequence the Severe Acute Respiratory Syndrome virus (‘the SARS virus’) in light of the debate over patent law and access to essential medicines. Part II evaluates the claims of public research institutions in Canada, the United States, and Hong Kong, and commercial companies, to patent rights in respect of the SARS virus. It highlights the dilemma of ‘defensive patenting’ — the tension between securing private patent rights and facilitating public disclosure of information and research. Part III considers the race to patent the SARS virus in light of wider policy debates over gene patents. It examines the application of such patent criteria as novelty, inventive step, utility, and secret use. It contends that there is a need to reform the patent system to accommodate the global nature of scientific inquiry, the unique nature of genetics, and the pace of technological change. Part IV examines the role played by the World Trade Organization and the World Health Organization in dealing with patent law and access to essential medicines. The article contends that there is a need to ensure that the patent system is sufficiently flexible and adaptable to accommodate international research efforts on infectious diseases.]"

Like with healthcare, Brexit's influence on higher education and public colleges and universities in the UK is quite uncertain at best, because of an intentionally ambiguous WTO definition of what can be considered "public".

See the "governmental authority exclusion", "GATS Article I:3" and "Annex on Financial Services" keywords for more on this huge gotcha which also blocks proposals for free college and Medicare for All in the US (and threatens to dismantle the US's Medicare and Social Security unless they remain restricted to the retired only). How will these changes impact social mobility in the UK?

A long discussion on the captured state (of affairs) for working people in the US, UK and a case in the WTO, DS503 that could pull the rug out from underneath developed country workers worldwide.

A few days ago I was reading British news where they were reporting on the expectations of Leave voters for what would be done with Brexit. It seemed so very far off the mark from what I knew was happening I almost wanted to scream. The same woeful situation exists in the US, where people who have everything to lose are gleefully voting for Biden and Trump clearly unaware of the agendas they represent. When my primary rolls around, I'm voting for Sanders, fully aware, however, unlike many people, I've been fully aware that Sanders signature issue(s) - 8single payer* *was officially "decided" by the WTO >20 years ago*. However, single pater, pure single payer is exempt from GATS so it could conceivably work, except for the little problem of it being 2020, not before the WTO existed, or perhaps the standstill may have even begun as early as the early 80s or formally, September 20, 1986. So frankly, the entire situation is bizarre and doesn't add up. That is unless you realize that the system is very close to 100% captured, Only then - it all makes perfect sense. What a major mess.

What is "Services Liberalization", and what does it mean for our way of life?

Bluntly, as they describe it, the high cost of labor in the developed countries is acting like a huge weight around corporations necks, forcing capital to invest in developing countries, not in us. What is really happening is the system has become less and less dependent on any one workforce. Increased profits are motivated by both greed and increased competition for jobs.

Celebrating Fair Trade in Cancun

This PDF flyer from 2003 was published by IATP and distributed during the WTO Ministerial in Cancun, Mexico. In just a few words it does a good job of explaing some key concepts about the WTO. It also introduces for beginners some of the core concepts of the concept of Fair Trade, a non-exploitative alternative to market totalitarianism.

Rough trade: A critique of the draft Cancun ministerial declaration (2003)

The history of the WTO shows that millions of poor people all around the world have paid a huge price for its capture and hijacking of democracy. It's naive to think that that the big countries or the WTO would somehow change their behavior and restore democratic rule when it was their own poor people who were paying that price.

2016 Bridges Article "G-7 Leaders Warn of "Brexit" Risks to Trade, Investment Ahead of June Vote"

I'm trying to help readers learn how to read between the lines here. Come on, you all can't be that naive. You have to teach yourself to think like an oligarch. Its not about you and your suffering, its about them and their money, their investments. The addiction to "Growth" is cited but in a way that's a cover up. What they want is to kill the hope that sprung up in the last century for a better tomorrow. Kill it and nail a stake into its heart. But they can't just say that. .

In speech in UK in June 2016 WTO Director-General Roberto Azevêdo told Britons they are in for a major ordeal by forcing themselves to go through the arduous re-accession to the trade body, but the Britons pretend he never said this.

Here he is talking about services, for example, the NHS, which has violated WTO rules for 25 years, (Like the US the UK is supposed to phase out non-conforming measures and replace them with market based measures). and one doesn't have to read through the lines much. Notice also that he starts the speech off by talking about comparative advantage.. ----cut here------ "And there could be an impact on services trade as well. In addition, the UK would also need to re-establish its terms of trade within the WTO. The UK, as an individual country, would of course remain a WTO member, but it would not have defined terms in the WTO for its trade in goods and services. It only has these commitments as an EU member. Key aspects of the EU’s terms of trade could not simply be cut and pasted for the UK. Therefore important elements would need to be negotiated". "There is no precedent for this — even the process for conducting these negotiations is unclear at this stage".

Carrying a Good Joke Too Far: TRIPS and Treaties of Adhesion

"A small, unindustrialized country enters into an agreement with a significantly larger, more industrialized country. The agreement must be signed before the small country is permitted to join an exclusive, wealth- generating organization. The small country is facing an epidemic of epic proportions. Already, twenty-two million of its citizens have died as a result of a deadly virus and over thirty million of its citizens are infected. Almost three million die every year. Thirteen million children are orphaned; 15,000 new people acquire the virus every day. The average fifteen-year-old citizen has more than a fifty percent chance of dying of the virus and is more likely to die of the virus than all other causes combined. Finally, while the virus attacks indiscriminately, it impacts the country's economic driving force-its farmers, teachers, blue-collar workers, young adults, and parents -particularly hard. The disease is treatable, but at a cost well out of reach of the country's citizens. The country attempts to address this crisis by implementing two methods, parallel importation and compulsory licensing, which will drastically reduce prices and ensure the supply of drugs at affordable prices. Upon enactment, the larger industrialized country demands that the smaller country halt implementation because the methods violate its obligations under the agreement." (Sound familiar? It should.)

Transnational mercantilism and the emergent global trading order

Jean-Christophe Graz ABSTRACT It is often argued that the problems currently facing the World Trade Organization stem from an important shift in the trade agenda from tariff reduction to the harmonisation of domestic regulations considered as non tariff barriers. From this perspective, the lack of harmonisation of domestic regulations severely impairs the capacity of the WTO to fulfil its mission. This article argues, in contrast, that the underlying problems facing the contemporary trade agenda are different, and are caused by a lack of differentiation in the regulatory framework of the WTO. To substantiate this claim, a conception of transnational mercantilism is derived from recent scholarly revisions of classical mercantilism. This clarifies a continuity between the external dimension and the comprehensive pattern of social organisation involved in the political economy of international trade. This framework is used to appraise four structures upon which trade policy is predicated: the implementation of market mechanisms, the embeddedness of trade in state-society relations, the link between trade and the natural environment, and special and differential treatment for developing countries. KEYWORDS World Trade Organisation; new trade agenda; Doha development agenda; international political economy; transnational mercantilism.

The "Prudential Exception" In The GATS After The Case Argentina – Financial Services

Alexandre Marques da Silva Martins - "Experience has shown there has been a need for prudential measures to be imposed on financial services. The global financial crisis of 2007-08 is quite an emblematic example. Therefore, states and financial institutions have united to establish standards as for financial services like the Basel Committee. Only one case about prudential measures in the realm of financial services has been decided thus far at the WTO. In this case, adjudicators heavily utilized the recourse to the ordinary meaning of the main GATS expressions surrounding the prudential measures. This recourse may limit the aid that international norms other than the WTO legislation may provide when resolving issues related to the GATS prudential exception. Still according to the adjudicators, the prudential exception at issue is of evolutionary nature, evolving over time to adapt to particular situations. Besides, there has to be a rational relationship between the measures and their reasons."

WTO Secretariat. Health and social services: background note by the Secretariat S/C/W/50, 18 September, 1998 (98-3558)

“The hospital sector in many counties . . . is made up of government-owned and privately-owned entities which BOTH operate on a commercial basis, charging the patient or his insurance for the treatment provided. Supplementary subsidies may be granted for social, regional, and similar policy purposes. It seems unrealistic in such cases to argue for continued application of Article I:3, and/or maintain that no competitive relationship exists between the two groups of suppliers of services.” In other words healthcare "public options" like the UK's NHS must be subject to WTO globalization rules such as GATS' rules on services liberalization and competition.

Sanya Reid Smith explains what TISA does in a way people should be able to see blocks Medicare For All

A new Medicare For All (as opposed to one that pre-existed GATS and the WTO) seems to conflict with everything TISA stands for. Note that TISA is also supposed to be merged with GATS in the future. Medicare For All would be a ""new monopoly" (forbidden by GATS) and a "state owned enterprise" that "affects trade in" "financial services" (health insurance for example) Altering the conditions of competition, and it also would potentially be trade distorting. It also would not be "no more burdensome than necessary" (to ensure the quality of the service) as the WTO GATS requires. The scope of those affected would likely also be seen as far too large for any government measure. As long as we are in these deals it would likely have to be the least possible.

2014 Story on St Louis TV station may have GATS lock-in implications

Midwestern TV channel does series on UK contractor "paying workers to do nothing" . Because the US made commitments under the GATS this may legally establish a binding entitlement under GATS to compensation, perhaps in jobs, because GATS is a one way street, unless a country is willing to pay for their policy freedom which gets more costly silently, when things like a foreign service provider entering a market happen.. I think this story may illustrate a big downside to GATS, or shall we say, a darker side to GATS.

The Interaction between European and International Liberalisation of International Trade in Banking Services

by Bart De Meester - This is a doctoral thesis, a quite substantial tome, written like a textbook, on banking and the WTO, its particularly useful it seems because the areas I am interested in have gotten examination in the European context - here in the US where the GATS is not well known to put it mildly, perhaps not so much, at least I have not found much. Plus I cant afford to go out buying books on the subject, as they are expensive, really expensive. Anyway, this looks very informative and its quite understandable as these kinds of books go. I'm sure Mr. De Meester will do very well. Thank you!