"The global privatization of public health is one of the biggest challenges facing the World Health Organization, as it is the only body whose absolute objective is to promote and protect health. ...

"One example is the need to dramatically increase access to affordable antiretrovirals for the estimated 5.7 million people with AIDS who currently need treatment but are left without. ... For a long time, WHO was absent from the debate surrounding the impact of trade agreements on access to medicines, and every attempt to involve itself in this issue met with fierce opposition from governments, whose first interest is the economic growth of their domestic industries. Thankfully this has changed in the past year and WHO has shown itself to be a powerful and necessary advocate for putting health concerns above trade.

"One of the most pressing issues in the health-trade arena today is that of the right of countries to produce generic medicines for export to other countries. Without an adequate solution, the poorest countries of the world that lack pharmaceutical production capacity of their own will be dependent upon the benevolence of multinational pharmaceutical companies. While others involved in the World Trade Organization negotiations tried to limit the scope of diseases that might benefit from generic imports, or even prevent any solution from being found, WHO spoke out in clear support for allowing medicine production and export as an exception to patent rights. This work must continue. ...

"There have been recent signs of WHO reasserting itself as an international standard-setting body, in spite of considerable resistance. The pre-qualification system for the procurement of medicines such as antiretrovirals, which would allow developing countries to find the best price for quality medicines was established in spite of enormous opposition, and needs to be supported and expanded and as a core activity of the organization's work. ...

"... In the face of rising infectious diseases such as AIDS, TB and malaria, and the increasing marginalization of health problems that do not affect the developed world, the importance of an international, independent organization that is brave, aggressive, and vocal in its defense of global public health has never been more important."

The authors are Médicins Sans Frontières' Access to Medicines Advisor Nathan Ford and Executive Director Jean-Michel Piédagnel.

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