G8 Summit has unique opportunity to fix

Misaligned policies at global, regional and national levels delaying access to low-cost medicines in poor countries

July 4, 2008

Waterloo, Canada - New research from the Centre for International Governance Innovation (CIGI) shows how the Group of Eight (G8) Summit in Hokkaido Toyako, Japan, on July 7-9 can play a unique role in improving policy coherence in global health governance.

Global Health Governance and Multi-Level Policy Coherence: Can the G8 Provide a Cure? describes opportunities available to the G8 leaders to remedy weaknesses in the current global health governance regime. Specifically, the paper focuses on the need for increased coherence among international trade policies and practices as they relate to development and public health. It is authored by Dr. Heidi Ullrich, an independent trade consultant and G8 policy specialist.

Health is one of the top three priority issues for the G8 leaders at the Hokkaido Toyako Summit, which is occurring against a backdrop of insufficient progress in meeting the United Nations Millennium Development Goals (MDGs). In her paper, Ullrich cites evidence of slowness in achieving the key health goals of reducing child mortality, combating HIV/AIDS and other infectious diseases, and building a global partnership measured by such indicators as access to affordable, essential drugs.

"With the proliferation of bilateral and regional free trade agreements (FTAs), the relationship between trade, development and public health has become increasingly complex," writes Ullrich. "Policy coherence in the global health governance system is not evolving fast enough to ensure that trade and development issues related to public health, particularly concerning access to medicines, are effectively aligned at the national, regional and multilateral levels."

The question of access to medicines is closely related to intellectual property rights, specifically patents on pharmaceutical products. Ullrich points out in her paper that bilateral and regional free trade agreements negotiated in recent years by the United States have reduced the flexibility available to developing countries under the World Trade Organization (WTO) Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and the 2001 WTO Declaration on TRIPS and Public Health.  Provisions in these FTAs have delayed access to low-cost medicines for some developing countries by effectively prohibiting the importation of cheaper drugs or delaying the production of lower-cost generics. The U.S. Congress recently moved to reverse some offending provisions; however, the U.S. government is not complying fully with either the spirit or the letter of the 2001 Declaration, which it signed.

Because the G8 meets at the level of head of state or of government, it provides critical political leverage for policy actions by other political actors and key international institutions and organizations, Ullrich says.

"Since its membership includes the majority of the most developed countries in the world, the G8 must use its unique governance mechanisms as a catalyst to achieve more coherent policy in public health in a more consistent and effective manner," says Ullrich.

These mechanisms include mutual accountability for each other's domestic policies, delegating follow-on activities to other bodies and stakeholders, and increasing momentum on specific topics of global concern at the annual meetings of key international organizations such as the World Bank, World Economic Forum and Organization for Economic Co-operation and Development. As well, adds Ullrich, the G8 Summit should focus on increasing mutual compliance with previously agreed policy and financing commitments, and on providing innovative ideas and initiatives to ensure that multi-level policy coherence in trade, development and public health leads to stronger global health governance.

To download this working paper and other CIGI publications, please visit: www.cigionline.org/publications

The opinions expressed in this article/multimedia are those of the author(s) and do not necessarily reflect the views of CIGI or its Board of Directors.