segunda-feira, outubro 15, 2007
OMS apela a acção urgente contra a TB Multi-Resistente
AidsPortugal 15.10.07
Na Coreia do Sul, na Quarta-feira, um oficial sénior da Organização Mundial de Saúde apelou às nações da Ásia-Pacífico para que ajudassem a combater os crescentes surtos de tuberculose resistente a múltiplos fármacos (MDR-TB) na região. Shigeru Omi, o director regional da OMS para o Pacífico Ocidental, disse também que as nações-membro devem agir imediatamente para prevenir a TB extensivamente resistente a fármacos (XDR-TB).
"Existe uma necessidade urgente de alargar a escala da manutenção da [MDR-TB], a qual emergiu por toda a região, incluindo o Pacífico", disse Omi durante a reunião regional anual da OMS.
(...)
Na Coreia do Sul, na Quarta-feira, um oficial sénior da Organização Mundial de Saúde apelou às nações da Ásia-Pacífico para que ajudassem a combater os crescentes surtos de tuberculose resistente a múltiplos fármacos (MDR-TB) na região. Shigeru Omi, o director regional da OMS para o Pacífico Ocidental, disse também que as nações-membro devem agir imediatamente para prevenir a TB extensivamente resistente a fármacos (XDR-TB).
"Existe uma necessidade urgente de alargar a escala da manutenção da [MDR-TB], a qual emergiu por toda a região, incluindo o Pacífico", disse Omi durante a reunião regional anual da OMS.
(...)
quarta-feira, maio 16, 2007
OMS propõe medidas para travar emigração de médicos
Lusa 16.05.07
A responsável da Iniciativa para a Migração de Pessoal da Saúde, Mary Robinson, assinalou terça-feira, numa conferência de imprensa, que regiões pobres como África, "não podem reforçar a sua assistência de saúde se os seus trabalhadores emigrarem".
(...)
| Um grupo de peritos da Organização Mundial de Saúde (OMS) apresentou hoje um projecto para desenvolver um código de práticas internacionais que mitigue a emigração de médicos formados nos países pobres para Estados mais desenvolvidos. |
(...)
Etiquetas: OMS
terça-feira, maio 15, 2007
Ministério da Saúde e OMS assinam acordo
DN 15.05.07
A migração, habitação e as distinções por sexos ao nível da saúde são algumas das prioridades assumidas pelo Ministério da Saúde e Direcção Regional da Organização Mundial da Saúde (OMS) para a Europa. Segundo o protocolo assinado ontem entre o ministério e a OMS, foram definidas cinco áreas prioritárias de colaboração para os próximos dois anos.
(...)
A migração, habitação e as distinções por sexos ao nível da saúde são algumas das prioridades assumidas pelo Ministério da Saúde e Direcção Regional da Organização Mundial da Saúde (OMS) para a Europa. Segundo o protocolo assinado ontem entre o ministério e a OMS, foram definidas cinco áreas prioritárias de colaboração para os próximos dois anos.
(...)
Etiquetas: OMS
domingo, maio 13, 2007
Durão destaca importância da livre circulação
DD 24.04.07
O presidente da Comissão Europeia, Durão Barroso, sublinhou hoje a importância da livre circulação de pessoas para tratamentos, lembrando que a saúde não é uma mercadoria, mas sim um direito social.
O presidente da Comissão Europeia, Durão Barroso, sublinhou hoje a importância da livre circulação de pessoas para tratamentos, lembrando que a saúde não é uma mercadoria, mas sim um direito social.
«A CE segue o princípio de não discriminação, pelo que quer garantir que nenhum paciente seja discriminado no acesso aos serviços de saúde. É por isso que uma das nossas principais preocupações é o direito da livre circulação, para que todas as pessoas tenham exactamente os mesmos direitos no acesso à saúde», disse Durão Barroso.
O presidente da CE falava durante a sessão de abertura do Fórum Europeu de Associações Médicas e da Organização Mundial de Saúde (OMS), que começou hoje em Lisboa.
Sobre a possibilidade de os tratamentos feitos por cidadãos de um Estado-membro em outro Estado poderem ser descontados nos sistemas do país de origem, Durão Barroso adiantou que se está a trabalhar nesse sentido.
Ressalvou, no entanto, que é preciso ver de que forma se poderá garantir esse direito, «uma vez que coloca questões complexas e sensíveis e levanta dificuldades práticas em alguns países».
Barroso assegurou que a CE está a trabalhar para permitir que o espaço europeu seja também um espaço de garantia de saúde.
Apontou a saúde publica como uma das prioridades e principais preocupações da Europa e lembrou que problemas de Saúde como as pandemias de VIH Sida, da tuberculose e da malária ultrapassam cada vez mais as fronteiras.
(...)
domingo, abril 08, 2007
OMS aprova circuncisão como meio de prevenir vírus da Sida
28.03.07
A circuncisão foi hoje considerada como um meio suplementar de prevenir e reduzir o risco de transmissão heterossexual do vírus da Sida (HIV), anunciou a Organização Mundial de Saúde, após consulta a um painel de especialistas.
Segundo a OMS e a agência especializada das Nações Unidas ONUSIDA, milhões de vidas poderiam ser salvas, sobretudo na África Negra, se a circuncisão se generalizasse, desde que fossem também reforçados os cuidados de saúde e que os homens circuncidados não adoptem comportamentos de risco por acreditarem estar totalmente protegidos.
(...)
Etiquetas: circuncisão, OMS, prevenção
sexta-feira, março 23, 2007
Lancet sobre OMS e Abbott na Tailândia
Lancet, 24 March 2007
Comment
WHO must defend patients' interests, not industry
Paul Cawthorne a, Nathan Ford a, Jiraporn Limpananont b, Nimit Tienudom c and Wirat Purahong d
Is WHO's Director-General, Margaret Chan, more concerned about the needs of patients or the interests of industry? Addressing an audience in Bangkok in February, she stressed the need to negotiate with drug companies over access to medicines, and that the use of compulsory licensing to import and manufacture generic versions of patented drugs must be "balanced".1
Her statement was in reference to the Thai government's recent issuing of compulsory licences for efavirenz, lopinavir/ritonavir, and clopidogrel. Thailand is one of the few developing countries that have achieved universal access to antiretrovirals, but access to efavirenz (needed by around 15% of people on treatment) and lopinavir/ritonavir (for the increasing number of people who need second-line) are limited because of high price.
There are several reasons why Chan's comments are misplaced. First, the Thai Government does not need to be advised to negotiate: it has been in regular contact with the industry over high prices of its drugs in Thailand, but these negotiations have led nowhere. The best price for originator's efavirenz is still twice the price available from Indian generic sources (US$500 per patient a year vs $224). The best offer for originator's lopinavir/ritonavir is $2000 per patient a year, five times more than WHO's estimate of manufacturing costs.2 The Thai Ministry of Health estimates that the price of clopidogrel would fall by over 90% if made generically. These are substantial price differences in a country where the average annual wage is $1400 a year.
Second, direct negotiations with companies are not as successful as Chan thinks. She cited Brazil as a positive example where negotiations with drug companies have led to price reductions. However, the prices negotiated by Brazil for antiretrovirals are up to four times more expensive than prices available on the international market, and treatment costs are rising. In 2003, three patented drugs (lopinavir/ritonavir,nelfinavir, and efaviren) took up 63% of the total antiretrovirals budget. In 2005, imports accounted for 80% of Government expenditures on antiretroviral drugs.3
Company deals have also stunted the development of local generic manufacturing capacity, which is reflected by the fact that no new generic AIDS drug has been produced in Brazil since 2002.
Third, it is up to a government to decide when to issue a compulsory licence. World Trade Organization agreements nowhere state that negotiations are a precondition to use of a compulsory licence by a government,4 and even the US Government is not questioning the legality of the Thai compulsory licence.5
The need for "balance" presumably refers to industry's claim that patents are required to reimburse the costs of innovation. We cannot say precisely how much it costs to research and develop these drugs, but we do know that they have already made billions of dollars: last year alone sales of efavirenz, were $791 million,6 while sales for lopinavir/ritonavir were over $1.1 billion.7
The US Government and the multinational drug industry have put pressure on the Thai Government over its intellectual property laws since 1985, and as a result Thailand has implemented patent protection sooner and stronger than required by the World TradeAgreements.8 During this time, past WHO Director-Generals were silent over the need to find a balance to protect public health. We do not believe it is the role of the Director-General of WHO to be protecting the interests of industry the moment there is a challenge - a legitimate and legal challenge - to their drug monopolies.
WHO is well aware of the high cost of new drugs for Thailand. A recent WHO evaluation9 projected that second-line therapy for a quarter of all HIV-infected patients will be absorbing three-quarters of the treatment budget by 2020, and the cost of antivirals with second-line regimens could reach $500 million a year if current prices remain. In response to these rising drug costs, the World Bank has recommended that Thailand should use compulsory licensing.10
Improving access to expensive medicines is not just an issue for people with HIV/AIDS. The Thai Minister of Public Health recently announced that he is considering issuing compulsory licences for up to 11 more AIDS, cancer, heart and cardiovascular, and neuropathic drugs and antibiotics.11
Not surprisingly, the drug industry is pressuring the Thai Government to reverse its position. Abbott Laboratories, which resisted all efforts by Government and health groups to negotiate an affordable price for lopinavir/ritonavir, has taken steps that show little regard for public health in Thailand. The company withdrew all pending drug-registration dossiers and announced that it will not register any new drugs in Thailand until the Government reverse its decision to issue compulsory licences.12
Thailand, indeed all developing countries, need WHO to put patients first, and encourage and support member states to use flexibilities in patent laws to improve access to drugs. In a recent letter to the Minister, Chan clarified that WHO unequivocally supports the use of compulsory licensing.13
This is a welcome clarification that should be followed up by WHO's active technical and political support for Thailand's efforts. In particular, WHO should denounce the actions of Abbott. Protecting the high price of one new drug by withholding access to all others is an unacceptable and unethical practice that no-one concerned about public health should stay silent about.
We declare that we have no conflict of interest.
References
1. Treerutkuarkul A. WHO raps compulsory licensing plan: Govt urged to seektalks with drug firms. Bangkok Post. Feb 2, 2007:http://www.bangkokpost.com/020207_News/02Feb2007_news15...(accessed Feb 14, 2007)..
2. Pinheiro E, Vasan A, Kim JY, Leed E, Guimier J-M,Perriens J. Examining the production costs of antiretroviral drugs. AIDS 2006; 20: 1745-1752.MEDLINE
3. Okie S. Fighting HIVlessons from Brazil. N Engl JMed 2006; 354: 1977-1981.
4. World Trade Organization. Declaration on the TRIPS agreement and publichealth. Nov 20, 2001:http://www.wto.org/english/thewto_e/minist_e/min01_e/mi...(accessed Feb 14, 2007)..
5. Letter from Ambassador Susan Schwab. United States Trade Representative, to Congressman Allen. Jan 17, 2007:http://www.cptech.org/ip/health/c/thailand/letter.pdf(accessed Feb 14, 2007)..
6. Bristol-Myers Squibb. Bristol-Myers Squibb company reports financial results for the fourth quarter and twelve months of 2006 and announces EPS guidance for 2007http://newsroom.bms.com/index.php?s=press_releases&item...(accessed Feb 14, 2007)..
7. Abbott. Abbott reports strong fourth-quarter results and record operating cash flow in 2006. 2006:http://www.abbott.com/global/url/pressRelease/en_US/60....(accessed Feb 14, 2007)..
8. Wilson D, Cawthorne P, Ford N, Aongsonwang S. Global trade and access to medicines: AIDS treatments in Thailand. Lancet 1999; 354: 1893-1895. Full Text Full-Text PDF (58 KB) MEDLINE CrossRef
9. World Health Organization. External review of the health sector response to HIV/AIDS in Thailand. August, 2005:http://searo.who.int/LinkFiles/News_and_Events_Thailand...(accessed Feb 14, 2007)..
10. Revenga A, Over M, Masaki E, et al. The economics of effective AIDS treatment: evaluating policy options for Thailand. Jan1, 2006:http://www-wds.worldbank.org/external/default/main?page...(accessed Feb 14, 2007)..
11. Treerutkuarkul A. Ministry pushes ahead with patent breaking. BangkokPost. Feb 13, 2007:http://www.bangkokpost.com/130207_News/13Feb2007_news16... (accessed Feb 14, 2007)..
12. Zamiska N. Abbott escalates Thai patent rift: firm pulls plans to offer new drugs in spat with regime. Wall Street J March 142007;.
13. Letter from Dr Margaret Chan to Dr Mongkoi NaSongkhla. . Feb12, 2007:http://www.cptech.org/blogs/ipdisputesinmedicine/index....(accessed Feb 14, 2007).
Affiliations
a. Médecins Sans Frontières, Bangkok 10240, Thailand
b. Faculty of Pharmaceutical Sciences, ChulalongkornUniversity,Bangkok,Thailand
c. AIDS Access Foundation, Bangkok, Thailandd. Thai Network of People Living with HIV/AIDS,Bangkok, Thailand
Comment
WHO must defend patients' interests, not industry
Paul Cawthorne a, Nathan Ford a, Jiraporn Limpananont b, Nimit Tienudom c and Wirat Purahong d
Is WHO's Director-General, Margaret Chan, more concerned about the needs of patients or the interests of industry? Addressing an audience in Bangkok in February, she stressed the need to negotiate with drug companies over access to medicines, and that the use of compulsory licensing to import and manufacture generic versions of patented drugs must be "balanced".1
Her statement was in reference to the Thai government's recent issuing of compulsory licences for efavirenz, lopinavir/ritonavir, and clopidogrel. Thailand is one of the few developing countries that have achieved universal access to antiretrovirals, but access to efavirenz (needed by around 15% of people on treatment) and lopinavir/ritonavir (for the increasing number of people who need second-line) are limited because of high price.
There are several reasons why Chan's comments are misplaced. First, the Thai Government does not need to be advised to negotiate: it has been in regular contact with the industry over high prices of its drugs in Thailand, but these negotiations have led nowhere. The best price for originator's efavirenz is still twice the price available from Indian generic sources (US$500 per patient a year vs $224). The best offer for originator's lopinavir/ritonavir is $2000 per patient a year, five times more than WHO's estimate of manufacturing costs.2 The Thai Ministry of Health estimates that the price of clopidogrel would fall by over 90% if made generically. These are substantial price differences in a country where the average annual wage is $1400 a year.
Second, direct negotiations with companies are not as successful as Chan thinks. She cited Brazil as a positive example where negotiations with drug companies have led to price reductions. However, the prices negotiated by Brazil for antiretrovirals are up to four times more expensive than prices available on the international market, and treatment costs are rising. In 2003, three patented drugs (lopinavir/ritonavir,nelfinavir, and efaviren) took up 63% of the total antiretrovirals budget. In 2005, imports accounted for 80% of Government expenditures on antiretroviral drugs.3
Company deals have also stunted the development of local generic manufacturing capacity, which is reflected by the fact that no new generic AIDS drug has been produced in Brazil since 2002.
Third, it is up to a government to decide when to issue a compulsory licence. World Trade Organization agreements nowhere state that negotiations are a precondition to use of a compulsory licence by a government,4 and even the US Government is not questioning the legality of the Thai compulsory licence.5
The need for "balance" presumably refers to industry's claim that patents are required to reimburse the costs of innovation. We cannot say precisely how much it costs to research and develop these drugs, but we do know that they have already made billions of dollars: last year alone sales of efavirenz, were $791 million,6 while sales for lopinavir/ritonavir were over $1.1 billion.7
The US Government and the multinational drug industry have put pressure on the Thai Government over its intellectual property laws since 1985, and as a result Thailand has implemented patent protection sooner and stronger than required by the World TradeAgreements.8 During this time, past WHO Director-Generals were silent over the need to find a balance to protect public health. We do not believe it is the role of the Director-General of WHO to be protecting the interests of industry the moment there is a challenge - a legitimate and legal challenge - to their drug monopolies.
WHO is well aware of the high cost of new drugs for Thailand. A recent WHO evaluation9 projected that second-line therapy for a quarter of all HIV-infected patients will be absorbing three-quarters of the treatment budget by 2020, and the cost of antivirals with second-line regimens could reach $500 million a year if current prices remain. In response to these rising drug costs, the World Bank has recommended that Thailand should use compulsory licensing.10
Improving access to expensive medicines is not just an issue for people with HIV/AIDS. The Thai Minister of Public Health recently announced that he is considering issuing compulsory licences for up to 11 more AIDS, cancer, heart and cardiovascular, and neuropathic drugs and antibiotics.11
Not surprisingly, the drug industry is pressuring the Thai Government to reverse its position. Abbott Laboratories, which resisted all efforts by Government and health groups to negotiate an affordable price for lopinavir/ritonavir, has taken steps that show little regard for public health in Thailand. The company withdrew all pending drug-registration dossiers and announced that it will not register any new drugs in Thailand until the Government reverse its decision to issue compulsory licences.12
Thailand, indeed all developing countries, need WHO to put patients first, and encourage and support member states to use flexibilities in patent laws to improve access to drugs. In a recent letter to the Minister, Chan clarified that WHO unequivocally supports the use of compulsory licensing.13
This is a welcome clarification that should be followed up by WHO's active technical and political support for Thailand's efforts. In particular, WHO should denounce the actions of Abbott. Protecting the high price of one new drug by withholding access to all others is an unacceptable and unethical practice that no-one concerned about public health should stay silent about.
We declare that we have no conflict of interest.
References
1. Treerutkuarkul A. WHO raps compulsory licensing plan: Govt urged to seektalks with drug firms. Bangkok Post. Feb 2, 2007:http://www.bangkokpost.com/020207_News/02Feb2007_news15...(accessed Feb 14, 2007)..
2. Pinheiro E, Vasan A, Kim JY, Leed E, Guimier J-M,Perriens J. Examining the production costs of antiretroviral drugs. AIDS 2006; 20: 1745-1752.MEDLINE
3. Okie S. Fighting HIVlessons from Brazil. N Engl JMed 2006; 354: 1977-1981.
4. World Trade Organization. Declaration on the TRIPS agreement and publichealth. Nov 20, 2001:http://www.wto.org/english/thewto_e/minist_e/min01_e/mi...(accessed Feb 14, 2007)..
5. Letter from Ambassador Susan Schwab. United States Trade Representative, to Congressman Allen. Jan 17, 2007:http://www.cptech.org/ip/health/c/thailand/letter.pdf(accessed Feb 14, 2007)..
6. Bristol-Myers Squibb. Bristol-Myers Squibb company reports financial results for the fourth quarter and twelve months of 2006 and announces EPS guidance for 2007http://newsroom.bms.com/index.php?s=press_releases&item...(accessed Feb 14, 2007)..
7. Abbott. Abbott reports strong fourth-quarter results and record operating cash flow in 2006. 2006:http://www.abbott.com/global/url/pressRelease/en_US/60....(accessed Feb 14, 2007)..
8. Wilson D, Cawthorne P, Ford N, Aongsonwang S. Global trade and access to medicines: AIDS treatments in Thailand. Lancet 1999; 354: 1893-1895. Full Text Full-Text PDF (58 KB) MEDLINE CrossRef
9. World Health Organization. External review of the health sector response to HIV/AIDS in Thailand. August, 2005:http://searo.who.int/LinkFiles/News_and_Events_Thailand...(accessed Feb 14, 2007)..
10. Revenga A, Over M, Masaki E, et al. The economics of effective AIDS treatment: evaluating policy options for Thailand. Jan1, 2006:http://www-wds.worldbank.org/external/default/main?page...(accessed Feb 14, 2007)..
11. Treerutkuarkul A. Ministry pushes ahead with patent breaking. BangkokPost. Feb 13, 2007:http://www.bangkokpost.com/130207_News/13Feb2007_news16... (accessed Feb 14, 2007)..
12. Zamiska N. Abbott escalates Thai patent rift: firm pulls plans to offer new drugs in spat with regime. Wall Street J March 142007;.
13. Letter from Dr Margaret Chan to Dr Mongkoi NaSongkhla. . Feb12, 2007:http://www.cptech.org/blogs/ipdisputesinmedicine/index....(accessed Feb 14, 2007).
Affiliations
a. Médecins Sans Frontières, Bangkok 10240, Thailand
b. Faculty of Pharmaceutical Sciences, ChulalongkornUniversity,Bangkok,Thailand
c. AIDS Access Foundation, Bangkok, Thailandd. Thai Network of People Living with HIV/AIDS,Bangkok, Thailand
quinta-feira, fevereiro 08, 2007
