Anand Grover Senior advocate, Supreme court of
Description: Anand Grover Senior advocate, Supreme court of india Director, Lawyers Collective Former U.N. Special Rapporteur on the Right to Health (2008-2014) Member global commission on drug policy Member unaids reference group on Hiv Adjunct
Related Topics
Download Presentation
"Anand Grover Senior advocate, Supreme court of" is the property of its rightful owner. Permission is granted to download and print the materials on this website for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Presentation Transcript
slide1. Anand Grover
Senior advocate, Supreme court of india
Director, Lawyers Collective
Former U.N. Special Rapporteur on the Right to Health (2008-2014)
Member global commission on drug policy
Member unaids reference group on Hiv
Adjunct professor, Georgetown law center
Expert workshop on new developments in ensuring access to medicines, vaccines and other health products
OHCHR
Geneva
21 january 2025 Access to medicines and Vaccines The International Health Crisis<br>
slide2. The Crisis in Health Internationally We have had two major health crisis at the international level in the last 4 decades or so
The HIV and the Covid Pandemics
The Responses in both cases have been very different
There are diverse parameters on which basis we can analyse the responses in the two pandemics. They include:-
Who the communities which were affected; the actors in the response, their respective roles,
How did the treatment come about and how accessible it was to those affected<br>
slide3. The initial response to HIV In 1981 when HIV hit the world, HIV, it was an unknown disease, wreaking havoc to the lives of those affected, first in the US and then all over the world
It was a “disease of the wretched of earth” affecting gay men, sex workers, and drug users, all stigmatized and marginalized communities
Because of that, the initial response was very negative towards the the affected communities,
Until the advent of the triple combination therapy being HIV+ meant a certain death
It was only in the mid-1990s that treatment came in the form of triple combination ARV therapy<br>
slide4. Gay men’s movement in the US forced Pharms to fast track drugs The treatment came about because the gay men’s movement in the US launched a valiant struggle to fight for the very survival of their members; not because Big pharma wanted to do something about HIV
With their tactics of targeting Big pharma and the FDA, they were able to force the FDA to release experimental drugs for treatment earlier than they would have otherwise been approved in the market
From being without any treatment or cure in the early 1980s, HIV became a became a treatable ailment in the mid 1990s
Today we have an international target of getting rid of HIV/AIDS by 2030<br>
slide5. Rights based approach with the involvement of community actors key Marginalized communities of sex workers, drugs users, gay men got fully involved. They became the front-line soldiers for the fight against the HIV pandemic.
The advocacy, promotion, and the actual use condom amongst gay men, sex workers was critical for preventing transmission.
Similarly, the advocacy, promotion and the use of the needle syringe programmes amongst injecting drug users to arrest the transmission of HIV became the norm
It was the rights-based response of the marginalized communities, vulnerable to HIV coupled with treatment which was the key to overcome the spread of HIV
HIV also opened spaces for the marginalized communities, especially the gay men’s communities which was the vista for LGBTQI rights later: decriminalization of same sex relations; and same sex marriages<br>
slide6. Role of Indian generic pharma companies The role of innovator Big pharma was epitomised by the legal action taken by them in the South African court
This was responded to by the affected communities who take direct action around the world, forcing the SA Government also to take action resulting in the Big Pharma withdrawing the suit
In this context role of the Indian generic companies was crucial.
Their entry reduced the prices of the triple combination ART from USD 10,000 per person per year to about USD 500
Because of the patent landscape, Indian generic industry was able to supply affordable generic ARTs initially to the developing world, and later also to the developed world
US PEPFAR and international community Global Fund, Unitaid provided funds with to get medicines to the PLHVs all over the world
As a result, m0st of the PLHIV could be delivered the triple combination therapy and lives be saved
Today we are on the way to eliminating HIV/AIDS by the next decade<br>
slide7. Covid: Response dictated by profits Covid was also an unknown disease at the beginning
Because it appeared to affect the mainstream population and huge numbers were involved the response was not dictated by prejudice
The Big pharma response was dictated by the lure of huge profits that could be made
The Big pharma claim that they spend a USD 1 billion for inventing a block buster drug which fetches them a USD 1 billion in return in the 1st year of marketing
The actual figure is not more than USD 100 million
In the Covid the innovative pharma industry did not spend any money upfront
Money was put up front by western Governments.
The Big pharma only made profits, more profits and even super profits<br>
slide8. Covid: Crude nationalism prevailed over the Rights based approach Innovation itself was not undertaken by the Big Pharma
It was the small companies who had already been working on m-RNA technology that were key to developing the vaccine
Big pharma bought over that technologies from the smaller companies and developed it up to industrial scale
There was no involvement of the communities affected by Covid in the response
The decision line was Key Philanthropic Foundations, Big Pharma, Developed Country governments (pharma coterie).
The affected people were only objects in the exercise and not the subjects who were deciding
There was no talk of rights of the populations to access vaccines.
Crude nationalism prevailed to get the vaccine for the populations of western nations
Covid vaccines were hoarded by the US and Western Governments<br>
slide9. Covid: vast majority of the global population were left out in the cold Though it was possible to deliver vaccines to vast majority of people in the developing world, they did not get the vaccines because of the pure greed of the Big pharma aided by the western governments
There was no generic industry to compete with the pharma MNCs
Serum Institute of India (SII) was the world’s largest distributor of vaccine before Covid
On account of the pharma coterie, SII it had to buy the Oxford vaccine not directly but via Astra Zeneca
Moreover, the Indian government compelled SII to sell its product to it for the Indian public to access the vaccines
This meant that contracts that SII had with the developing countries had to be reneged
The Indian generic industry played a second fiddle to Big Pharma<br>
slide10. Covid : TRIPS waiver a non-starter Some in international community (South Africa and India) interested in reaching Covid vaccines to the population of world, proposed the TRIPS waiver regime internationally during the period of Covid and a pandemic treaty later
The idea was that the generic companies would be able to manufacture vaccines using patented technology of the Big Pharma patent holders without fear of injunctions and damages infringement suits: compulsory licensing route
The proposal was mooted South Africa and India in the TRIPS Council
The Council controlled by the pharma coterie was bound to fail
One cannot go the lions den and ask for concessions. Not surprising that it was on it way to failure
Now with the US withdrawing from the WHO it is bound to fail<br>
slide11. Covid :Alternative to get vaccines There is a fundamental contradiction between IP/TRIPS Agreement with Human Rights
It has to be appreciated that the TRIPS agreement was forced down the throats of the the Developing Countries and LDC
It is the TRIPS Agreement which needs an overhaul
But the Pharma coterie is pushing TRIPS plus provisions through the “Free” Trade Agreements
We have to resist TRIPS plus provisions
We have to use Compulsory Licensing (CL) in particularly in countries with generic industry e.g. India, Brazil etc
However, with the Voluntary Licensing strategy being pursued by pharmaceutical companies, the international NGOs and Medicine Patent Pool has meant that the CL strategy has been lying disused in the cupboard and has become rusted
A rusted tool is always easy to discard<br>
slide12. Covid :Alternative to get vaccines Unless we overhaul that we will not realize the goal of access to medicines for all
There is no international solidarity on these issues
Like there is none on the violation of rights in Gaza by Israel
Despite the ICJ holding against Israel no one has paid heed
Today more than ever the Pharma coterie in control of the Health response
This is the crisis in health all over the world
It will be exacerbated by the US actions in the future<br>
slide13. THANK YOU!!!<br>
Senior advocate, Supreme court of india
Director, Lawyers Collective
Former U.N. Special Rapporteur on the Right to Health (2008-2014)
Member global commission on drug policy
Member unaids reference group on Hiv
Adjunct professor, Georgetown law center
Expert workshop on new developments in ensuring access to medicines, vaccines and other health products
OHCHR
Geneva
21 january 2025 Access to medicines and Vaccines The International Health Crisis<br>
slide2. The Crisis in Health Internationally We have had two major health crisis at the international level in the last 4 decades or so
The HIV and the Covid Pandemics
The Responses in both cases have been very different
There are diverse parameters on which basis we can analyse the responses in the two pandemics. They include:-
Who the communities which were affected; the actors in the response, their respective roles,
How did the treatment come about and how accessible it was to those affected<br>
slide3. The initial response to HIV In 1981 when HIV hit the world, HIV, it was an unknown disease, wreaking havoc to the lives of those affected, first in the US and then all over the world
It was a “disease of the wretched of earth” affecting gay men, sex workers, and drug users, all stigmatized and marginalized communities
Because of that, the initial response was very negative towards the the affected communities,
Until the advent of the triple combination therapy being HIV+ meant a certain death
It was only in the mid-1990s that treatment came in the form of triple combination ARV therapy<br>
slide4. Gay men’s movement in the US forced Pharms to fast track drugs The treatment came about because the gay men’s movement in the US launched a valiant struggle to fight for the very survival of their members; not because Big pharma wanted to do something about HIV
With their tactics of targeting Big pharma and the FDA, they were able to force the FDA to release experimental drugs for treatment earlier than they would have otherwise been approved in the market
From being without any treatment or cure in the early 1980s, HIV became a became a treatable ailment in the mid 1990s
Today we have an international target of getting rid of HIV/AIDS by 2030<br>
slide5. Rights based approach with the involvement of community actors key Marginalized communities of sex workers, drugs users, gay men got fully involved. They became the front-line soldiers for the fight against the HIV pandemic.
The advocacy, promotion, and the actual use condom amongst gay men, sex workers was critical for preventing transmission.
Similarly, the advocacy, promotion and the use of the needle syringe programmes amongst injecting drug users to arrest the transmission of HIV became the norm
It was the rights-based response of the marginalized communities, vulnerable to HIV coupled with treatment which was the key to overcome the spread of HIV
HIV also opened spaces for the marginalized communities, especially the gay men’s communities which was the vista for LGBTQI rights later: decriminalization of same sex relations; and same sex marriages<br>
slide6. Role of Indian generic pharma companies The role of innovator Big pharma was epitomised by the legal action taken by them in the South African court
This was responded to by the affected communities who take direct action around the world, forcing the SA Government also to take action resulting in the Big Pharma withdrawing the suit
In this context role of the Indian generic companies was crucial.
Their entry reduced the prices of the triple combination ART from USD 10,000 per person per year to about USD 500
Because of the patent landscape, Indian generic industry was able to supply affordable generic ARTs initially to the developing world, and later also to the developed world
US PEPFAR and international community Global Fund, Unitaid provided funds with to get medicines to the PLHVs all over the world
As a result, m0st of the PLHIV could be delivered the triple combination therapy and lives be saved
Today we are on the way to eliminating HIV/AIDS by the next decade<br>
slide7. Covid: Response dictated by profits Covid was also an unknown disease at the beginning
Because it appeared to affect the mainstream population and huge numbers were involved the response was not dictated by prejudice
The Big pharma response was dictated by the lure of huge profits that could be made
The Big pharma claim that they spend a USD 1 billion for inventing a block buster drug which fetches them a USD 1 billion in return in the 1st year of marketing
The actual figure is not more than USD 100 million
In the Covid the innovative pharma industry did not spend any money upfront
Money was put up front by western Governments.
The Big pharma only made profits, more profits and even super profits<br>
slide8. Covid: Crude nationalism prevailed over the Rights based approach Innovation itself was not undertaken by the Big Pharma
It was the small companies who had already been working on m-RNA technology that were key to developing the vaccine
Big pharma bought over that technologies from the smaller companies and developed it up to industrial scale
There was no involvement of the communities affected by Covid in the response
The decision line was Key Philanthropic Foundations, Big Pharma, Developed Country governments (pharma coterie).
The affected people were only objects in the exercise and not the subjects who were deciding
There was no talk of rights of the populations to access vaccines.
Crude nationalism prevailed to get the vaccine for the populations of western nations
Covid vaccines were hoarded by the US and Western Governments<br>
slide9. Covid: vast majority of the global population were left out in the cold Though it was possible to deliver vaccines to vast majority of people in the developing world, they did not get the vaccines because of the pure greed of the Big pharma aided by the western governments
There was no generic industry to compete with the pharma MNCs
Serum Institute of India (SII) was the world’s largest distributor of vaccine before Covid
On account of the pharma coterie, SII it had to buy the Oxford vaccine not directly but via Astra Zeneca
Moreover, the Indian government compelled SII to sell its product to it for the Indian public to access the vaccines
This meant that contracts that SII had with the developing countries had to be reneged
The Indian generic industry played a second fiddle to Big Pharma<br>
slide10. Covid : TRIPS waiver a non-starter Some in international community (South Africa and India) interested in reaching Covid vaccines to the population of world, proposed the TRIPS waiver regime internationally during the period of Covid and a pandemic treaty later
The idea was that the generic companies would be able to manufacture vaccines using patented technology of the Big Pharma patent holders without fear of injunctions and damages infringement suits: compulsory licensing route
The proposal was mooted South Africa and India in the TRIPS Council
The Council controlled by the pharma coterie was bound to fail
One cannot go the lions den and ask for concessions. Not surprising that it was on it way to failure
Now with the US withdrawing from the WHO it is bound to fail<br>
slide11. Covid :Alternative to get vaccines There is a fundamental contradiction between IP/TRIPS Agreement with Human Rights
It has to be appreciated that the TRIPS agreement was forced down the throats of the the Developing Countries and LDC
It is the TRIPS Agreement which needs an overhaul
But the Pharma coterie is pushing TRIPS plus provisions through the “Free” Trade Agreements
We have to resist TRIPS plus provisions
We have to use Compulsory Licensing (CL) in particularly in countries with generic industry e.g. India, Brazil etc
However, with the Voluntary Licensing strategy being pursued by pharmaceutical companies, the international NGOs and Medicine Patent Pool has meant that the CL strategy has been lying disused in the cupboard and has become rusted
A rusted tool is always easy to discard<br>
slide12. Covid :Alternative to get vaccines Unless we overhaul that we will not realize the goal of access to medicines for all
There is no international solidarity on these issues
Like there is none on the violation of rights in Gaza by Israel
Despite the ICJ holding against Israel no one has paid heed
Today more than ever the Pharma coterie in control of the Health response
This is the crisis in health all over the world
It will be exacerbated by the US actions in the future<br>
slide13. THANK YOU!!!<br>