Asia
1.End the Death Penalty for Drug-Related Offenses
22/06/09 by Transform Drug Policy Foundation
Joint Statement by The Anti Death Penalty Asia Network (ADPAN), of which Amnesty International is a member, Human Rights Watch and the International Harm Reduction Association
2.[India] HIV/AIDS spreading in 3 hill dists'
20/06/09 by Hueiyen News Service
Even though the spreading of HIV/AIDS in the valley area has been able to control, the same is continuing in the three hill districts bordering with Myanamar, Churachnadpur, Chandel and Ukhrul, said project director of Manipur AIDS Control Society, Dr Kh Promodkumar today.
3. [Thailand] Thailand in denial over HIV spread
26/06/09 by The Nation
Minister Witthaya Kaewparadai claims that Thailand has "highly successful programmes that have slashed the spread of HIV among injecting drug users" and deserves more funding from UNAIDS, and also claims that Thailand's methadone programmes "helped reduce the number of injecting drug users with HIV from 59 per cent to 6 percent." These are gross inaccuracies.
4.[Thailand] Two new Aids virus strains
11/06/09 by The Nation
The public and people living with Aids should not panic over the discovery of two new Aids strains here, but should remain cautious about contracting them, a government microbiologist said yesterday.
5.[Vietnam] Vietnam cuts list of death penalty crimes: official
19/06/09 by AFP
Vietnam on Friday removed rape and several other offences from the list of crimes punishable by death, an official said, but deputies maintained capital punishment for drug trafficking.
Global
6.General Assembly review on HIV/AIDS
16/06/09 by UNAIDS
As the HIV response represents one of the soundest of all possible global investments, it is critical that commitment to HIV efforts be maintained and strengthened in the midst of these economic challenges Report of the Secretary General to the 63rd General Assembly.
7.TRIPS and FTAs have adverse impact on access to drugs
04/06/09 by SUNS #6712
Developing countries and LDCs should not introduce TRIPS-plus standards in their national laws. Developed countries should not encourage developing countries and LDCs to enter into TRIPS-plus FTAs and should be mindful of actions which may infringe upon the right to health.
Outside Asia
8. [Egypt] Needle sharing rife among drug users
21/06/09 by IRIN
The prevalence of HIV among intravenous drug users (IDUs) in Egypt is relatively low, but needle sharing is rife among this group, putting them at risk of contracting the virus, experts say.
9. [USA] Senate Confirms Goosby As U.S. Global AIDS Coordinator
22/06/09 by KFF
The Senate on Friday confirmed President Obama's U.S. Global AIDS Coordinator nominee Eric Goosby, the San Francisco Chronicle reports.

Asia
1.End the Death Penalty for Drug-Related Offenses
22/06/09 by Transform Drug Policy Foundation
As the International Day Against Drug Abuse and Illicit Trafficking approaches on 26 June, the Anti Death Penalty Asia Network (ADPAN), of which Amnesty International is a member, Human Rights Watch (HRW) and the International Harm Reduction Association (IHRA) call upon governments in Asia to cease applying the death penalty for drug-related offences.
There is a clear, longstanding and worldwide move toward restriction or abolition of the death penalty. Only a small minority of countries continue to implement the death penalty: in 2008, 25 countries carried out executions. ADPAN, Human Rights Watch and the International Harm Reduction Association oppose the death penalty in all cases as a violation of fundamental rights- the right to life and the right not to be subjected to cruel, inhuman and degrading punishment.
Sixteen countries in Asia apply the death penalty for drug-related offences. As many countries in the region do not make information on the death penalty available, it is impossible to calculate exactly how many drug-related death sentences are imposed. However, in Indonesia, Malaysia, Singapore and Thailand, reports indicate that a high proportion of death sentences are imposed upon those convicted of drug offences. ADPAN, HRW, and IHRA express particular concern that China, Indonesia, and Vietnam continue to execute individuals for drug offences – and that some countries, such as China since the early 1990s, and Indonesia in 2008, have marked the occasion of June 26 with such executions.
Despite the executions in Asia there is no clear evidence of a decline in drug-trafficking that could be attributed to the threat or use of the death penalty. There is no credible evidence that the death penalty deters serious crime in general more effectively than other punishments. The most recent survey of research findings on the relation between the death penalty and homicide rates, conducted for the United Nations (UN) in 1988 and updated in 1996 and 2002, concluded: "...research has failed to provide scientific proof that executions have a greater deterrent effect than life imprisonment. Such proof is unlikely to be forthcoming. The evidence as a whole gives no positive support to the deterrent hypothesis."
UN human rights mechanisms – including the UN Special Rapporteur on extrajudicial, summary, or arbitrary executions, and the UN Human Rights Committee -- have concluded that the death penalty for drug offences fails to meet the condition of “most serious crime”, under which the death penalty is allowed only as an “exceptional measure” where “there was an intention to kill which resulted in the loss of life” (UN Doc, A/HRC/4/20, 29 January 2007, para 53). The UN High Commissioner for Human Rights and the director of the UN Office on Drugs and Crime have likewise expressed grave concerns about the application of the death penalty for drug offences.
Death sentences are often handed down after unfair legal processes, a problem made worse by laws, policies or practices regulating drug offences in some Asian countries. Mandatory death sentences are applied for certain drug offences in Brunei, India, Laos, Singapore and Malaysia, leaving a judge with no discretion over the sentence for defendants found guilty. Mandatory death sentences violate international standards on fair trials. Individualised sentencing is required to prevent cruel, inhuman or degrading punishment and the arbitrary deprivation of life. Singapore, which has one of the highest per capita execution rates in the world, as well as Malaysia, continue to hand down death sentences to individuals alleged to be drug traffickers after trials that presume guilt, and in which death sentences are mandatory.
Confessions that have been coerced sometimes form the basis of guilty verdicts, death sentences and executions. Competent legal assistance is unavailable to many defendants, including defendants facing drugs-related charges, leaving many with little capacity to mount a defence at any stage of the proceedings.
Draconian penalties for drug offences, including the death penalty, hinder public health programmes that reduce the harm drugs may cause to individual drug users, their loved ones, communities and states. China, Malaysia and Viet Nam have recently stepped up their harm reduction programmes to reduce HIV, hepatitis C and other drug-related health and social harms. However, excessive punishments and overly repressive drug law enforcement have been shown time and again to drive target groups away from such services. The death penalty therefore not only violates the right to life of those condemned, but is actually counterproductive to efforts to reduce the harm caused by drugs.

On the occasion of UN Anti-Drugs Day 2009 ADPAN, Amnesty International, Human Rights Watch and the International Harm Reduction Association appeal to Asian governments to:
* Introduce an immediate moratorium on executions with a view to the abolition of the death penalty in line with UN General Assembly resolution 62/149 and 63/168 on “moratorium on the use of the death penalty”;
* Commute all death sentences including for drug offences;
* Remove provisions within their domestic legislation that allow for the death penalty for drugs offences;
* Abolish the use of mandatory sentencing in capital cases;
* Publicize statistics on the death penalty and facts around the administration of justice in death penalty cases;
* Use the occasion of Anti-Drugs Day 2009 to highlight public health policies that have proven effective in reducing drug-related harms.
http://transform-drugs.blogspot.com/2009/06/end-death-penalty-for-drug-related.html

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2.[India] HIV/AIDS spreading in 3 hill dists'
20/06/09 by Hueiyen News Service
The project director observed this while speaking as guest of honour at the concluding function of the two-month entrepreneurship development programme for people living with HIV/AIDS organized by the Institute of Co-operative Management (ICM) under the sponsorship of the MACS and United Nations Development Programme (UNDP).
Co-operative commissioner, P Vaiphei attended the function as chief guest in the function which was presided by ICM chairman Kh Borkishore.
Promodkumar said, the spreading of the dreaded disease in the three districts of Manipur, Churachandpur, Chandel and Ukhrul located along the 358 km long porous international border with Myanmar is on the raise citing the main spreading agent as women sex workers.
Myanmar women entering to the Manipur side could earn money easily from the flesh trade as Rs 100 in Indian Currency they get from having relation with a man when converted into Myanmar Currently, they could get 1000 kyat.
Out of the total population of the country 0.3 percent is infected by HIV/AIDS while in Myanmar it is 1.3 percent.
The main reason for high prevalence of the disease in the districts inter marriage between Myanmarese and Indian and having unsafe sex relation with the HIV/AIDS positive women, he said.
He revealed that in the valley area, the spreading of the disease to the uninfected persons can successfully control.
If steps for controlling the spreading in these hill areas be taken up, the state will continue getting impact of the disease.
http://www.e-pao.net/GP.asp?src=27..210609.jun09

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3. [Thailand] Thailand in denial over HIV spread
26/06/09 by The Nation
In fact, Thailand is one of the only countries in the region that has failed to implement evidence-based, comprehensive harm reduction programs that provide a range of risk-reduction options to people who use drugs, including opiate substitution therapy such as methadone, and clean injecting equipment. China, Burma, and Vietnam have all sanctioned the harm reduction approach.
In fact, Thailand has publicly admitted its failure to address an explosive HIV epidemic among injectors, who have suffered 50 per cent HIV prevalence rates since 1988 and continue to do so today. Many experts including UN officials attribute this to the lack of a national harm reduction policy and programmes across the country. Injecting drug users (IDU) continue to suffer from extremely high HIV transmission and prevalence rates, as do other highly stigmatised and criminalised groups including migrants and men who have sex with men.
As the article demonstrates, another major barrier to Thailand effectively addressing the HIV/Aids epidemic is denial at the highest levels. Until public officials who have the power to effect change acknowledge the problem and invite a multi-sectoral and evidence-based response, Thailand will continue to lose the fight against HIV/Aids by ignoring the most highly vulnerable groups.
http://www.nationmultimedia.com/search/read.php?newsid=30103580&keyword=drug+in+Thailand

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4.[Thailand] Two new Aids virus strains
11/06/09 by The Nation
Those who are HIV positive or living with Aids are at greater risk of catching the hybrid Aids than normal people, said Professor Ruangpheng Suttharane of Mahidol University.
However, there had been no documented cases of the hybrid Aids becoming resistant to Aids drugs.
Two Thai women were found with the two Aids strains from Africa.
One contracted a mix of types A, G and D - or AG/D - and the other, while pregnant, types A, E and G (AE/G).
The baby was Aidsfree at birth because the mother was given medication during gestation.
Ruangpheng said she and her research team were working on a study of the two African Aids strains and would know next month how detrimental they could be, or how much faster or slower they could destroy good cells compared with mainstream Aids.
http://www.nationmultimedia.com/search/read.php?newsid=30104851&keyword=HIv

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5.[Vietnam] Vietnam cuts list of death penalty crimes: official
19/06/09 by AFP
"This morning, the national assembly approved some amendments to the criminal code," an official from the National Assembly office told AFP.
He said that, in addition to rape, deputies voted to remove six other offences from the list: awarding of bribes, counterfeiting of money and bonds, hijacking ships and planes, destruction of weapons and military equipment, and appropriation of property through swindling.
Seventy-five percent of deputies in the communist-dominated National Assembly endorsed the amendments to the penal code, which take effect January 1 next year, state media reported.
The amendments were controversial, with lively debate particularly about rape and drug trafficking, according to local media reports of the proceedings, which were closed to foreign reporters.
A draft amendment presented to the deputies had proposed removing eight crimes from the list, including drug trafficking, but as their month-long sitting closed on Friday deputies rejected the move.
Global human rights group Amnesty International said it "very much" welcomed the reduction in the number of capital offences.
"And we hope that this is the first concrete step in a move towards abolition, which the highest levels of the Vietnam government have indicated support for," and which is a worldwide trend, Amnesty's Janice Beanland said from London.
She said Amnesty was disappointed that drug offences were excluded from the changes, despite a recommendation from Vietnam's Ministry of Justice, but was encouraged by the National Assembly's debate of the issue.
More than 90 percent of National Assembly deputies are Communist Party members but the parliament has in recent years become more vocal over the country's major problems.
"I think the National Assembly is doing a good job in not being seen as a rubber stamp... It's a start," an Asian diplomat said before the voting.
Vietnam last reduced the number of death penalty crimes in 1999, but even with the latest amendments the country still has 22 crimes on its statutes that are punishable by death.
Dozens of people each year in Vietnam are sentenced to die by firing squad, mostly for murder and drug trafficking.
http://news.yahoo.com/s/afp/20090619/wl_asia_afp/vietnamjusticesentencedeathpolitics

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Global
6.General Assembly review on HIV/AIDS
16/06/09 by UNAIDS
At the 63rd session of the General Assembly held in New York on 16 June 2009, the United Nations Secretary-General Ban Ki-moon presented a report on the progress made in the implementation of the Declaration of Commitment on HIV/AIDS and the Political Declaration on HIV/AIDS. The first address by UN member states was delivered by Dr Aaron Motsoaledi, the new Minister of Health of South Africa. Speaking on behalf of the Southern African Development Community (SADC), Motsoaledi noted recent progress made in South Africa and in the SADC region in confronting AIDS.

This year’s report provides an update on developments in the AIDS response, looks forward to the agreed 2010 milestones, recommends key actions to accelerate progress and urges renewed commitment to the goal of universal access to HIV prevention, treatment, care and support.

In June 2008, the General Assembly held a High-level Meeting on HIV/AIDS that assessed progress in the response to the global HIV epidemic. Reports from 147 countries showed that important progress had been made, including in the areas of access to antiretroviral therapy and the prevention of mother-to-child transmission.

However, the report shows that, despite such encouraging developments, considerable challenges remain, including significant access gaps for key HIV-related services. The pace of new infections continues to outstrip the expansion of treatment programmes, and commitment to HIV prevention remains inadequate. While funds available for HIV in low- and middle-income countries increased from $11.3 billion in 2007 to $13.7 billion in 2008, there has been a global economic downturn since the 2008 High-level Meeting.

As the HIV response represents one of the soundest of all possible global investments, it is critical that commitment to HIV efforts be maintained and strengthened in the midst of these economic challenges, report of the Secretary-General.

The Secretary-General’s report also highlights that despite the many commitments made by Member States to protect the rights of people living with HIV and people vulnerable to HIV infection, many countries have laws and policies that are inconsistent with the commitments and result in reduced access to essential HIV services and commodities.

In 2007, one third of countries reported that they still lacked laws to prohibit HIV-related discrimination, and many countries with anti-discrimination legislation have problems with adequate enforcement. A total of 84 countries reported that they have laws and regulations that present obstacles to effective HIV prevention, treatment, care and support for vulnerable subpopulations. Furthermore, some 60 countries have laws that restrict the entry, stay and residence of people living with HIV based on HIV-positive status only. Finally, an increasing number of countries have enacted overly broad laws that criminalize transmission or exposure to HIV, as well as non-disclosure of HIV status. Such measures are likely to lead people to avoid HIV testing, thereby undermining efforts to achieve universal access. Therefore, the report recommends that laws and law enforcement should be improved and programmes to support access to justice should be taken to scale to prevent discrimination against people living with HIV. HIV-related travel restrictions should be eliminated; the criminalization of HIV transmission should be limited to intentional transmission; and laws that burden or impede service access among sex workers, men who have sex with men and injecting drug users should be repealed.

Improved analytic methods have enabled countries to better characterize the magnitude and dynamics of their epidemics, to select appropriate interventions and tailor evidence-informed strategies to address their specific national context. The strategic tailoring of national responses magnifies the results of HIV programmes and reduces waste and inefficiency. Improved monitoring and evaluation systems also permit countries to revise national strategies as their epidemics evolve over time. In their efforts to closely align national strategies with actual national circumstances, countries should work to understand and address the social and structural determinants of HIV risk and vulnerability, such as gender inequalities, social marginalization and stigma and discrimination.

The HIV epidemic presents a long-term global challenge and requires a sustained commitment for an effective long-term response. As the coverage and quality of HIV programmes increase, the report calls to intensify efforts to strengthen the health, education, social welfare and other key sectors, and to integrate HIV with tuberculosis, sexual and reproductive health and other health services.

The long-term AIDS response will be sustainable only if substantially greater success is achieved in slowing the rate of new HIV infections, while providing optimal services for people living with HIV, the report underlines. Bringing to scale the appropriate mix of behavioural, biomedical and structural HIV-prevention strategies would more than halve the number of all new HIV infections between now and 2015. Access to such a combination of prevention strategies, however, remains sharply limited in most countries according to the Secretary-General’s report.

Finally, the report emphasizes that achieving national universal access targets by 2010 will require an estimated annual outlay of $25 billion within two years, necessitating renewed commitment from all providers of HIV-related funding. Sustaining an effective AIDS response will require unprecedented leadership at all levels, including from Governments, civil society and affected communities.
http://www.unaids.org/en/KnowledgeCentre/Resources/FeatureStories/archive/2009/20090612_UN_SG_AIDS_progress.asp

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7.TRIPS and FTAs have adverse impact on access to drugs
04/06/09 by SUNS #6712
The WTO TRIPS Agreement and the TRIPS-plus provisions in Free Trade Agreements (FTAs) have had an adverse impact on prices and availability of medicines, making it difficult for countries to comply with their obligations to respect, protect and fulfil the right to health, the UN Special Rapporteur on the right to health, Mr Anand Grover, said on Tuesday.
Similarly, lack of capacity coupled with external pressures from developed countries has made it difficult for developing countries and least developed countries (LDCs) to use TRIPS flexibilities to promote access to medicines. States need to take steps to facilitate the use of TRIPS flexibilities.
Furthermore, developing countries and LDCs should not introduce TRIPS-plus standards in their national laws. Developed countries should not encourage developing countries and LDCs to enter into TRIPS-plus FTAs and should be mindful of actions which may infringe upon the right to health.
These were some of the key recommendations made by the rights expert in his report (A/HRC/11/12) to the UN Human Rights Council, which began its regular eleventh session on Tuesday.
The Special Rapporteur recommended that developing countries and LDCs should review their laws and policies and consider whether they have made full use of TRIPS flexibilities or included TRIPS-plus measures, and if necessary consider amending their laws and policies to make full use of the flexibilities.
Developing countries and LDCs should also establish high patentability standards and provide for exclusions from patentability of medicines - such as new forms and new or second uses, and combinations - in order to address evergreening and facilitate entry of generic medicines. They should adopt the principle of international exhaustion and provide for parallel importation with simplified procedures in their national laws.
In addition, developing countries and LDCs need to incorporate in their national patent laws all possible grounds upon which compulsory licences, including government use, may be issued. Such laws provide straightforward, transparent procedures for rapid issue of compulsory licences. There is also a need to revisit the 30 August decision (of the WTO General Council) and provide for a simpler mechanism.
In presenting his report to the Council, the Special Rapporteur noted that nearly two billion people lack access to essential medicines, and massive inequalities still remain regarding access to health services and medicines around the world, which is partly due to high costs. Improving access to medicines could save 10 million lives a year, 4 million in Africa and South East Asia.
"It is clear that intellectual property (IP) rights have an impact on the enjoyment of the right to health as it directly affects affordability of medicines," said Grover.
The report by the Special Rapporteur explores the impact of the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and "TRIPS plus" standards on access to medicines within the broader framework of the right to health.
Referring to the work done by former Special Rapporteur on the right to health, Mr Paul Hunt, and the Office of the UN High Commissioner for Human Rights (OHCHR) on trade and intellectual property issues relevant to the right to health, the rights expert found that these reports highlighted the need for TRIPS flexibilities to be implemented and noted the adverse impacts of FTAs on access to medicines.
The full use of TRIPS flexibilities can help countries meet their obligations to protect, promote and fulfil the right to health by improving access to affordable medicines. However, that use of TRIPS flexibilities has been variable and that there are growing instances of developing countries and LDCs adopting TRIPS-plus standards that may have an adverse effect on the right to health.
The rights expert stressed the need to revisit trade-related agreements in light of their impact on the right to health and in particular, on access to medicines.
He further noted that the right to health, enshrined in numerous international and regional human rights treaties and in many national constitutions, is an inclusive right, extending not only to timely and appropriate health care, but also to the underlying determinants of health, such as access to clean water and sanitation, adequate housing and nutrition as well as social determinants such as gender, racial and ethnic discrimination and disparities.
He emphasized that, if integrated into national and international health policy-making, the right to health can help establish laws, policies and practices that are sustainable, equitable, meaningful and responsive to the needs of those living in poverty.
According to the report, health trends indicate that despite progress made in the last 30 years, massive inequalities remain in access to health services and medicines around the world. "Diseases of poverty" (i. e. communicable, maternal, perinatal, and nutritional diseases) still account for 50% of the burden of disease in developing countries, nearly ten times higher than in developed countries.
There has been a resurgence of tuberculosis and malaria in the last decade: 58% of malaria cases occur in the poorest 20% of the world population and each year there are nearly 529,000 maternal deaths.
The inability of populations to access medicines is partly due to high costs, said the report. In the context of HIV, as of 2007, only 31% of people living with HIV who needed treatment received it. In addition, it is estimated that people living with HIV will become resistant to their first-line medicine regimens and will need second-line treatment which can currently cost between 9 and 19 times as much as first-line medicines.
IP law has an impact on the right to health, as it protects pharmaceutical products. Patents create monopolies, limit competition and allow patentees to establish high prices. In regard to medicines, a product patent enables a patentee to set high prices.
Generic competition in the field of pharmaceuticals has the potential to significantly lower prices and increase access, said the report, pointing out that in 2001, when the HIV crisis was at its peak and the need for antiretrovirals (ARVs) was the most acute, it was the availability of cheaper generic ARVs from developing countries that led to a reduction in prices from over $10,000 per patient per year to less than $350 per patient per year for a first-line combination therapy. Today, generic competition has helped reduce prices of first generation ARVs by more than 99%.
The importance of generic medicines continues to be underscored today by their prominence in international medicine supply programmes. However, the continued supply of generic medicines is now in doubt, said the report.
For developing countries including those that manufacture and supply generic medicines, the deadline for TRIPS compliance and the introduction of product patents came in 2005. With this deadline, there is concern that the ability of companies to patent new pharmaceutical products on a near-global scale could inhibit further competition and prevent the price reductions needed to make antiretroviral therapy more widely available.
Developing countries and LDCs should be enabled to take steps to modulate the implementation of TRIPS on access to medicines including by encouraging competition and being able to access affordable generic versions of patented medicines, the rights expert recommended.
The rights expert also noted that the WTO TRIPS Agreement was one of the most controversial agreements, as developed countries pushed for extensive IP protection and the harmonization of IP norms. Developing countries argued that extensive IP standards would hinder their development prospects as they were not well-equipped to reap the benefits of such standards. Developing countries eventually gave way, under the pressure of developed countries as they were ultimately dependent on them for trade.
From a right-to-health perspective, said the rights expert, developing countries and LDCs should be enabled to use TRIPS flexibilities. Their national laws should incorporate the flexibility to: make full use of the transition periods; define the criteria of patentability; issue compulsory licences and provide for government use; adopt the international exhaustion principle, to facilitate parallel importation; create limited exceptions to patent rights; and allow for opposition and revocation procedures.
In addition, countries need to have strong pro-competitive measures to limit abuse of the patent system.
The importance of the transition period is underscored by the fact that the absence of product patents on medicines can help establish local manufacturing capacity, promote generic manufacturing and facilitate the import of affordable medicines from other countries, said the report, adding that developing countries that have been successful in the use of the transition period in any of these respects may present good examples for LDCs to consider in adapting to their own needs and circumstances.
With regards to patentability criteria, the report said that from a right-to-health perspective, the "evergreening" of patents by pharmaceutical companies is of particular concern.
Evergreening refers to the practice of obtaining new patents on a patented medicine by making minor changes to it. For example, patents are obtained on new uses, forms, combinations and formulations of known medicines in a bid to extend the period of the patentee's monopoly. Such evergreening delays the entry of competitive generic medicines into the market.
The freedom to set high patentability criteria and exclude certain inventions is an important tool that countries can use to address evergreening and ensure that patents are granted only to genuine inventions in the pharmaceutical field. Thus, countries can deny patents on new uses, forms, formulations or combinations of known medicines, said the rights expert.
He noted, for example, that India and the Philippines exclude from patentability new forms of known substances unless they are significantly more efficacious and new (or second) uses and combinations of known substances. Reducing the number of patents granted on medicines can limit the impact of patents on access to medicines and facilitate the early entry of generic competition.
Countries with little or no manufacturing capacity face difficulties in utilizing compulsory licences to import generic medicines. The report noted that this difficulty was recognized by the Doha Declaration, pursuant to which the WTO General Council provided a framework to address this issue through the decision of 30 August 2003.
However, countries have faced difficulties in implementing the 30 August decision as it entails complex administrative procedures. Even though a number of potential exporting countries amended their national laws to incorporate the 30 August decision, their regulations have added further administrative requirements that make it difficult to implement.
The first and only case of export of a patented medicine under the 30 August decision occurred in 2008 to Rwanda, five years after the adoption of the decision. "The case of Rwanda highlights the need to revisit the decision."
The report found that the use of anti-competition law can be an important tool to promote access to medicines. TRIPS Article 31, for example, allows a relaxation of certain restrictions, such as prior negotiation with patentees and predominantly domestic use, relating to compulsory licences which may be useful to remedy anti-competitive practices.
There is a need for countries to adopt and effectively apply pro-competitive measures allowed under TRIPS to prevent or remedy anti-competitive practices having a bearing on the use of patented medicines.
The rights expert also found that developing countries, while attempting to implement TRIPS flexibilities in order to address public health concerns, have experienced pressures from developed countries and multinational pharmaceutical corporations.
The report illustrates the cases of South Africa, Thailand and India experiencing pressures in this regard. In 1996, South Africa adopted a new National Drugs Policy with the goal of "ensuring an adequate and reliable supply of safe, cost-effective drugs of acceptable quality to all citizens of South Africa".
Following the principles of the Policy, the South African Government amended its existing Medicines Act to improve access to medicines. In response, South Africa was placed on the United States Special 301 Watch List and 39 pharmaceutical companies filed a suit, challenging the amendments, contending that they would destroy patent protections by giving the Health Minister overly broad powers to produce or import cheaper versions of drugs still under patent. Worldwide public outrage eventually led to a change in the US position and to the withdrawal of the lawsuit by the pharmaceutical companies in 2001.
Thailand also faced pressure following its attempts to lower prices of medicines through compulsory licensing. Between 2006 and 2007, Thailand issued compulsory licences for HIV and heart disease medicines in order to meet its obligations to provide universal access to medicines. In 2007, Thailand was placed on the Special 301 Priority Watch List.
The report also highlighted India facing pressure for its attempt to use safeguards. In 2005, India included strict patentability criteria in its patent law to address the evergreening of patents. This provision was challenged by a pharmaceutical company in the Madras High court alleging it was a violation of TRIPS and of the constitutional equality provision. The amendment was upheld, among other grounds as a fulfilment of the right to health obligations of the Government.
The experiences of South Africa, Thailand and India provide examples of difficulties countries have had to overcome to implement TRIPS flexibilities. Although they were successful in their attempts, there is fear that pressure from developed countries and pharmaceutical companies will thwart future actions, said Grover.
The report underscored that few LDCs have local manufacturing capacities or any technological base to fully take advantage of TRIPS or TRIPS flexibilities. In this regard, concrete steps towards the specific obligation under Article 66, paragraph 2, of TRIPS of developed countries to provide incentives to promote and encourage technology transfer to LDCs in order to enable them to create a sound and viable technological base should be encouraged.
Turning to the issue of FTAs and their imposition of TRIPS-plus standards, the report said that many countries have signed or are currently engaged in negotiations on extensive trade agreements, including bilateral investment treaties (BITs), FTAs, economic partnership agreements (EPAs) etc. Such agreements have extensive implications for pharmaceutical patent protection, which can directly impact access to medicines. Some developed countries, for example, have negotiated FTAs which reflect their standard of IP protection.
These agreements are usually negotiated with little transparency or participation from the public, and often establish TRIPS-plus provisions. These provisions undermine the safeguards and flexibilities that developing countries sought to preserve under TRIPS. Studies indicate that TRIPS-plus standards increase medicine prices as they delay or restrict the introduction of generic competition, said the report.
"As FTAs can directly affect access to medicines, there is a need for countries to assess multilateral and bilateral trade agreements for potential health violations and that all stages of negotiation remain open and transparent."
The report noted that TRIPS-plus provisions in FTAs differ from agreement to agreement, but their purposes are by and large to: extend the patent term; introduce data exclusivity; introduce patent linkage with drug registration and approval; and create new enforcement mechanisms for IPRs.
With respect to TRIPS-plus IP enforcement, the Special Rapporteur expressed concern over reports of IP enforcement measures that have resulted in multiple seizures at some ports of shipments of generic medicines heading to developing countries and LDCs. Such regulations impose a far higher standard of IPR enforcement than that required by TRIPS, which requires that IP enforcement measures should not create barriers to legitimate trade.
"In effect, such actions can bring to naught TRIPS flexibilities exercised by developing countries and LDCs, and de facto impose IP protection on LDCs that are not yet required to comply with TRIPS as generic medicines they need do not reach them. In particular, the use of compulsory licensing or the 30 August decision to export and import medicines is effectively negated," the rights expert said.
http://health.groups.yahoo.com/group/mtaagplus/message/2423

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Outside Asia
8. [Egypt] Needle sharing rife among drug users
21/06/09 by IRIN
“Sharing needles and syringes is very high in Egypt. This is very alarming because although only 1 percent of IDUs are HIV-positive, the high percentage of needle sharing may mean that we are sitting on a ticking bomb,” Ehab Kharrat, a senior programme adviser for the UNDP HIV/AIDS Regional Programme in the Arab States (HARPAS), told IRIN.
Different studies of sample groups show that 45-50 percent of drug users in Egypt share needles, he said.
“When the IDUs get the drugs, many of them do not wait to get a clean needle or syringe, so they grab the next available one they find,” Midhat Al-Arabi, head of a programme dealing with drug users at the Freedom Drug Rehabilitation Centre, a local NGO, told IRIN.
“They [addicts] believe that securing the tool [the syringe] first is a bad omen,” said 29-year-old Mohammed (he preferred to give his first name only), who stopped injecting himself eight months ago, told IRIN by phone from Cairo. “I used to buy the narcotic first then inject myself with the first syringe I found.”
“This belief increases the risk of needle sharing and hence the transmission of HIV and other [blood transmittable] diseases,” Midhat Al-Arabi told IRIN.
Mohammed said he knew he contracted HIV five months ago, a few months after he gave up drugs. “I am quite sure I got it from needle sharing. I did not engage in any sexual relationship or undergo a blood transfusion”.
Study
A 2007 study on drug addiction in Egypt by the National Centre for Social and Criminal Research showed that 600,000-800,000 people suffer from “substance dependency disorder” - about 0.8 percent of the country’s 76 million population, Kharrat, said.
“But the promising thing is that right now we have four or five outreach projects for IDUs in Egypt and these projects are effective. There are also drug rehabilitation centres which have started to have an impact and hopefully will prevent an HIV epidemic from spreading among IDUs,” Kharrat said, adding that their success rate in getting people off drugs was 40-60 percent.
Al-Arabi from the Freedom Drug Rehabilitation Centre said that harm reduction programmes have started to become acceptable in Egypt. “We have a programme where we go to the addicts and make them aware of dangerous practices. We also provide them with clean syringes which they collect from the centre,” he said.
Prisons and slums
The main obstacle is reaching drug users in prisons and detention centres, Kharrat said. “There is evidence that syringes and drugs are being smuggled into prisons and detention centres and effective prevention programmes are not in place”.
IRIN tried to contact the prisons department in Egypt but no one was available to comment.
Poor addicts and those living in slums are not easily reached, according to Kharrat. “Outreach programmes for drug users depend heavily on peer education. Because many of the current former drug addicts come from the middle class, it is easier for them to reach people of the same class,” he said.
http://www.irinnews.org/Report.aspx?ReportId=84927

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9. [USA] Senate Confirms Goosby As U.S. Global AIDS Coordinator
22/06/09 by KFF
Goosby – who "served previously in the Clinton administration as director of HIV/AIDS policy in the Department of Health and Human Services and as chief adviser to the president on HIV-related issues" – will now "head the U.S. strategy for addressing HIV around the world, and oversee the implementation of the President's Emergency Plan for AIDS Relief" (PEPFAR), the newspaper writes. Goosby "has more than 25 years of experience treating HIV/AIDS," and most recently served as chief executive officer and chief medical officer of the Pangaea Global AIDS Foundation, which is affiliated with the San Francisco AIDS Foundation, according to the San Francisco Chronicle (Doyle, San Francisco Chronicle, 6/20).
Mark Cloutier, CEO of the San Francisco AIDS Foundation, said in a written statement, "The world’s most vulnerable populations will benefit from Dr. Goosby’s guidance through greater access to HIV treatment and prevention programs based on sound science" (San Francisco AIDS Foundation release, 6/19). "What's unusual about Eric is that he already comes into the arena with a lot of global experience," Cloutier added (San Francisco Chronicle, 6/20).
http://globalhealth.kff.org/Daily-Reports/2009/June/22/GH-062209-Goosby-Confirmed.aspx

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