Civil Society Calls on Candidates to Put Health Services at the Heart of Uganda’s 2016 Election Campaigns

PRESS STATEMENT
For Immediate Release: September 15 2015

Contact for more information: Sylvia Nakasi, UNASO: 0703 402 030 or nakasisylvia@gmail.com

 Civil Society Calls on Candidates to Put Health Services at the Heart of Uganda’s 2016 Election Campaigns: No Health No Votes!

Health Sector Manifesto defines 10 Actions Candidates Must Commit to in Order to Rebuild the Health Sector

A nation of sick Ugandans cannot benefit from economic development

(Kampala) A coalition of civil society organizations working for access to essential health services in Uganda today launched the “Uganda Election 2016 Health Manifesto,” a platform demanding all parties and candidates commit to correcting massive failings of the health sector in Uganda to deliver essential, quality prevention and treatment services. This marks the first time civil society organizations will join together to leverage Uganda’s general elections in order to prioritize the health needs and health rights of the Ugandan electorate.  

“Access to prevention and treatment are literally life-and-death political issues that should be taking center stage during our 2016 elections,” said Joshua Wamboga, Executive Director of UNASO. “As voters we will not stand by and allow candidates and political parties to be silent about the most vital issue facing our country—our health and our health rights. Using this Health Manifesto, we are demanding that all candidates commit themselves to investing in sufficient medicines, health workers, and in the political required to stop the epidemic of preventable death and disease in our communities.”

 The demands contained in the Manifesto include a demand to scale up per capita health financing from current levels (only USD 10.50) to the minimum recommended by WHO (USD 44) by 2021. Other priorities include increasing the remuneration of health workers and the budget for essential medicines as well as confronting high-level corruption that robs Ugandans of life saving health service delivery. “Lack of focus on our health needs by politicians is a disgrace, and we are here to say, ‘no more,’ “ said Rachel Nandelenga of the International Community of Women Living with HIV/AIDS Eastern Africa (ICWEA). “All candidates seeking elective positions should pronounce themselves on these 10 points. We commit to empowering citizens to choose leaders whose manifestos speak to these demands—we will hold them accountable from the national level right down to the grassroots.”

The coalition pointed out that the most repeated excuse—lack of funding—is not credible, since other priorities receive funding when considered politically beneficial. For example, Parliament received 2 billion shillings to debate during a recent 2-day special sitting; State House spends more than 600 million shillings each day. “As citizens of Uganda our fate is in our hands—every five years we have a special power to raise the bar on health service delivery by making our demands known and making use of our vote. We pledge to do that now,” said Lilian Mworeko, Executive Director of ICWEA.

“We are tired of politicians prioritizing infrastructure and telling us health must wait,” said William Kidega of PATH. “Health cannot wait—not when our public health facilities routinely report stock outs, pregnant women suffer and die of totally preventable causes, and drug-resistant TB is on the rise. Investing in health service delivery means investing in social infrastructure that is the only path to equitable economic development for ordinary Ugandans. This is non-negotiable.”

A recent poll conducted in August 2014 by Columbia University reported that healthcare is the most important issue for Ugandan voters. Across two large public opinion surveys conducted in 2011 and in 2014, voters said healthcare was the most important issue for Parliament to address of these data showed that health, according to voters, is far more important than joblessness, education, or crime (Source: Columbia University 2014).

Uganda’s general election campaigns start October 25. “Between now and the start of general elections we expect all candidates to adopt these 10 points in their manifestos,” said Dennis Odwe of AGHA Uganda. “We will meet with each party individually as well as Independent candidates to deliver this demand.” Civil society members intend to work in key constituencies to support grassroots health rights activists to demand accountability from political candidates, and engage on health crises that have too long gone ignored.

 

 


US Position on LDC Pharmaceutical Extension of TRIPS Transition Period

Health GAP, Public Citizen, KEI, MSF, and Oxfam America sent this letter to the United States Trade Representative and US Patent and Trade Mark Office demanding that the US disclose its position on WTO Least Developed Country Members request that their extension of responsibilities under the TRIPS agreement with respect to medicines be extended unconditionally until they are no longer LDCs.  The letter also criticizes several positions that the US is likely to take.  Unlike the US, the European Commission has publicly announced its support for the LDC request.


Will U.S. create barriers to LDCs' future access to medicines?

Professor Brook K. Baker, Health GAP and Northeastern U. School of Law

September 7, 2015

Earlier this year, WTO Least Developed Country Members requested an unconditional extension of the expiring WTO TRIPS transition period that exempts them from having to implement pharmaceutical patents and other intellectual property protections that constrain their ability to make or procure low-cost generic medicines.  Informed sources indicate that the U.S. is currently opposing the LDC draft extension. While the exact US government position has not yet been made public, it seems likely from past US positions that the US Trade Representative might be opposing several of the most important elements of LDC request that make the extension truly meaningful for access to medicines. 

As the next TRIPS Council meeting is on October 15, it is likely that the USTR has begun bilateral negotiations with LDCs with respect to their request for an unconditional extension from the requirements of the TRIPS Agreements with respect to pharmaceutical patents, data protections, marketing exclusivity, and mailbox requirements.  LDCs are seeking an extension for as long as they remain LDCs.  They ground their request both on the language of the Doha Declaration on the TRIPS Agreement and Public Health and Article 66.1 of the TRIPS Agreement.  These binding, unanimous-consent documents grant LDCs the right to seek further extensions of their TRIPS transition period and require that such extensions "shall" be accorded upon properly motivated request. 

The USTR is continuing its traditional silence on its formal position with regard to the LDC request.  It has reportedly consulted on the request, but has not done so extensively with public health and human rights groups that are on record that the US should accede to the LDC request without conditions.

Reading the tea leaves of past US positions in negotiations on earlier transition periods and their extension and the US position on the August 30 Decision on Paragraph 6 of the Doha Declaration concerning compulsory license supply to countries with insufficient domestic manufacturing practice, it is easy to identify policy positions that the USTR must avoid.

First, the US may but must avoid efforts to shorten the time limit of the proposed extension as short extensions do not allow LDCs the policy space to secure durable sources of lower cost generic medicines nor a sufficient time period to develop sustainable local pharmaceutical capacity.  LDCs made a request two years ago for a transition period from their basic TRIPS-compliance obligations for as long as they remained LDCs.  The US and EU opposed this rational request and instead insisted on no more than the eight year extension granted (2013-2021).  The need for a transition period for pharmaceuticals as long as a country remains an LDC is even clearer than for the general TRIPS compliance, as the health needs of LDC populations requires paying the lowest possible prices for medicines of assured quality.  Surely the US will not once again oppose an extension for countries that remain trapped in an LDC development quagmire and to force them to return every few years for an additional time-limited extension.  

Second, the US may but must not tie the granting of pharmaceutical extension to a declaration, express or implied, that intellectual property protections are unequivocally good for development.  In the 2013 extension process, the USTR insisted on a IP fundamentalist clause genuflecting to the magical development elixir of patent monopolies.  It required a clause from LDCs expressing "their determination to preserve and continue the progress towards implementation of the TRIPS Agreement."  Regrettably, the best evidence is that increased IP protections and continued efforts towards TRIPS compliance do not create favorable conditions for accelerated development in low-income countries and instead that such polices increase prices and thereby reduce access to global public goods like medicines.  Questions about the negative impacts of easily granted and over-enforced patents are growing even in the U.S. where government programs and private insurers cannot afford some of the astronomically over-priced medicines that have recently hit the market.

Third, the US may but must not demand that LDCs restrict their pharmaceutical capacity, if and when they develop it, to non-commercial purposes only and in particular to serving domestic needs only (See, Chairman's Statement to the August 30 Decision requiring non-commercial purpose).  LDC countries like Lesotho, population 2 million, can simply not build viable pharmaceutical capacity that solely serve small and poor populations.  Viable pharmaceutical enterprises in LDCs, especially in the generics context, need to achieve efficient economies-of-scale and should at least reach regional markets.  More to the point, such industries need time and policy space to develop as existing capacities are non-existent or weak.  Finally, to impose export limits on commercially oriented pharmaceuticals would create a perverse carve out for medicines that is totally inconsistent with technological development rights affirmed in the 2013-21 TRIPS-compliance extension.

Fourth, the US may but must not impose conditions that require LDCs to maintain existing degrees of IP protection.  The first general LDC extension 2006-2013 unfortunately contained a stay-put provision that locked LDCs into the levels of IP protection imposed by their colonial masters or unwisely adopted because of flawed technical assistance from WIPO.  Fortunately, LDCs succeeded in reversing this stay put clause in their 2013-2021 extension with the following provision:  "Nothing in this decision shall prevent least developed country Members from making full use of the flexibilities provide by the [TRIPS] Agreement to address their needs, including to create a sound and viable technological base and to overcome their capacity constraints supported by, among other steps, implementation of Article 66.2 by developed country Members [relating to technology transfer]."  This provision grants LDCs the policy space - free from exclusive, monopoly rights - to advance their development project and to fulfill their human rights obligations including the right to health.

The USTR should immediately disclose its LDC pharmaceutical extension negotiation position.  To the extent that its position includes any of the above retrograde policies, they should be reversed.  Instead, the US should join the emerging global consensus, supported even by the European Union, that the LDC pharmaceutical extension should be granted on requested terms.  Allowing LDCs unfettered access to more affordable generic medicines will also advance the US policy objectives of halting and reversing the global AIDS pandemic where the US has saved billions of dollars in its PEPFAR program by purchasing over 90% of its antiretroviral supplies from generic sources.

 


Eminent scientists, researchers and activists call on world leaders to act on new advances in HIV science to end the AIDS crisis

July 19, 2015

Policy and funding must now follow evidence that shows that all people with HIV should receive antiretroviral treatment regardless of stage of disease

 Vancouver, BC – At the opening of the International AIDS Society annual conference in Vancouver, Canada on Sunday July 19, scientists, researchers and activists issued a joint-call for an immediate increase in funding and marshaling of political commitment needed for world leaders to act decisively on new scientific evidence that all people with HIV should be treated with antiretroviral therapy, regardless of stage of disease, in order to maximize the clinical and prevention benefit of HIV treatment.

 This call to action—referred to as the Vancouver Consensus by its supporters—has already been endorsed by the leadership of the U.S. President’s Emergency Plan for AIDS Relief, UNAIDS, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the International AIDS Society and the International Association of Providers of AIDS Care.

 “The question no longer is whether life saving HIV treatment should be offered to all people with HIV but how to ensure treatment for all becomes a reality—through increased funding, higher quality programs, and laws and policies that defend the human rights of people with HIV and communities at greatest risk of infection,” said Asia Russell, Executive Director of Health GAP. “AIDS cannot be defeated if world leaders refuse to act on the science. Many countries facing massive burden of untreated HIV are still implementing outdated paradigms, waiting until people are sick before offering them treatment—because governments are breaking their funding promises.”

 “Achieving the global target set in 2011 of reaching 15 million people with treatment by 2015—a target many dismissed as unrealistic--shows that ambitious treatment scale up goals are achievable,” said Matthew Kavanagh, Senior Policy Analyst at Health GAP. “The challenges are real—19 million people do not know their HIV status. Many treatment programs do not invest in community based follow up for HIV positive patients that is needed to ensure people are retained and supported in care. These challenges can be overcome—but only if our leaders act.”

 Investment by some major donors, including the US government, in the AIDS response has flat-lined or been cut in recent years. This is leading to rationing of treatment in heavily impacted countries, and resulting in significantly reduced donor investments in middle-income countries with concentrated epidemics.

 The impact of the lack of sufficient donor support and political priority is that countries are not able to act on the compelling new evidence about how best to address the epidemic.

 “The Government of Malawi has already made a commitment to providing immediate access to treatment for all people living with HIV. However, we are told that this can not be implemented until 2017 and that it will not be possible without significant help from bi-lateral and multilateral donors,” said Safari Mbewe, Executive Director of the Malawi Network of People Living with HIV/AIDS (MANET+).

 “The global call to end AIDS is a false promise without sufficient funding and political will,” said Maureen Milanga, Health GAP’s Kenya National Organizer.

 Health GAP is calling on world leaders, donors and Ministry of Finance representatives from key affected countries, to convene an urgent meeting to review the latest science on the sidelines of the United Nations Summit to adopt the post-2015 development agenda, taking place in New York City in September this year.

 Early signatories of the Vancouver Consensus include United States Global AIDS Coordinator Ambassador Deborah Birx, UNAIDS Executive Director Michel Sidibé, UN Secretary General’s Special Envoy on HIV/AIDS in Eastern Europe and Central Asia Michel Kazatchkine, and President of the International AIDS Society Chris Beyrer, Editor-in-chief of The Lancet, and renowned economist Jeffrey Sachs among others.


AIDS Activists Applaud Defeat of Fast Track, Caution that Access to Lifesaving Medicines is Still At Risk in Vote Scheduled for Next Week

HEALTH GAP (Global Access Project)

Media Release • 12 Jun 2015

Contact: Paul Davis: +1 202 817 0129

Washington DC] The global health advocacy organization Health GAP applauded a vote today in the U.S. House of Representatives that dealt a major setback to the pharmaceutical industry’s policy agenda of extending monopolies over life-saving medications. The 126-302 vote rejected the Senate-passed combined Trade Assistance Authority (TAA) and fast track Trade Promotion Authority package, which would have paved the way for the adoption of dangerous trade deals, most imminently the Trans-Pacific Partnership. The vote signals a major, but potentially temporary victory for people in need of access to medicines throughout the Pacific region.

Even though House Republicans subsequently “passed” a largely symbolic stand alone Trade Promotion Authority bill, without the companion worker retraining provisions adopted by the Senate, the bill cannot be sent to the President’s desk for signature. Unless enough Republican and Democratic votes are changed over the weekend to pass the full package of bills passed in the Senate, Fast Track will be stuck in limbo.

After the failure of the TAA and symbolic passage of Fast Track, Speaker John Boehner passed a last-minute “motion to reconsider” vote scheduled for next week, effectively giving leaders from both parties the weekend to persuade Members of Congress to change their votes on TAA--a bill that supports workers displaced by the impacts of “free trade” agreements. House Minority Leader Nancy Pelosi summed up the strong views of many across the United States and around the world when she said, “people would rather have a job than assistance."

“Trade agreements should be responsible, but leaked text from the Trans Pacific Partnership has shown us that the deal is harmful,” said Heath GAP’s Amirah Sequeira. “The Fast Track bill contains negotiating objectives that will hurt patients. We urge Members of the House to resist arm twisting over the weekend and vote against the TAA when they return next week. Members who vote in favor of the passage of fast track will be hurting millions of people with HIV around the world. These deadly votes will be remembered.”

Health GAP and other public health organizations call on House members to reject the entire Fast Track package.

 


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