Words into Action: What the Doha Declaration means for public health

In November 2001 at the World Trade Organisation Ministerial Conference in Doha, Qatar, WTO Members passed the groundbreaking "Declaration on the TRIPS (Trade-related aspects of intellectual property rights) Agreement and Public Health." For the first time, the Declaration sent a clear political message that TRIPS "can and should be interpreted and implemented in a manner supportive of WTO Members' right to protect public health and, in particular to promote access to medicines for all." Among other measures, the Declaration affirmed the right of countries to use compulsory licenses and to determine the grounds on which to grant them. It also gave least-developed nations a ten-year extension from 2006 until at least 2016 to institute patents on pharmaceuticals. Both of these provisions can help countries to secure more affordable essential medicines through generic competition. Since the Doha meeting, MSF and other concerned actors have been working to translate this political message into action, and ultimately, into better access to medicines for patients on the ground. An important step will be to ensure that countries take advantage of the Declaration as they develop national legislation regarding patents and medicines. Recognizing the vital role that international technical assistance plays in this process, MSF and other NGOs convened a conference in March 2002 to examine the best ways to implement Doha, and specifically, to consider how the World Intellectual Property Organization (WIPO) has and has not promoted health concerns through its technical assistance programs. As the United Nations body charged with developing intellectual property systems worldwide, WIPO is in a critical position to determine whether the Doha Declaration benefits developing countries, or whether it becomes a useless piece of paper. MSF's experiences in West Africa and Cambodia have raised concerns that WIPO is not helping countries to maximize their options to protect access to medicines; rather, some countries receiving WIPO advice have instituted more stringent protections on intellectual property than is required or advisable in light of pressing health needs. Many legal and political hurdles remain before the world's poorest patients see any benefits from Doha; thus, public pressure exerted by MSF and others will be necessary to hold responsible actors, including WIPO, the WTO, and Member governments, accountable. Such sustained scrutiny will be required to translate the political victories won at Doha into tangible improvements in people's lives.