Open Letter from Richard Rockefeller, MD to US Trade Representative Richard Zoellick
December 13, 2002 Ambassador Robert B. Zoellick
United States Trade Representative
600 17th Street, N.W.
Washington, DC 20508

Sent Via E-mail, Facsimile Transmission, and U.S. Mail

Dear Ambassador Zoellick,

I am writing as a medical doctor to share my views with you on the status of negotiations at the World Trade Organization (WTO) on public health, access to medicines, and intellectual property rights. At the 4th Ministerial Conference of the WTO in Doha last year, the imperative of public health was affirmed by all WTO member states through the adoption of the Ministerial Declaration on the TRIPS Agreement and Public Health. Just one year after this historic agreement was reached, this advance is at risk of being compromised, to the detriment of millions of people suffering from diseases throughout the world.

The WTO was charged with producing a solution to the problem expressed in paragraph 6 of the Doha Declaration, which states that:

"6. We recognize that WTO Members with insufficient or no manufacturing capacities in the pharmaceutical sector could face difficulties in making effective use of compulsory licensing under the TRIPS Agreement. We instruct the Council for TRIPS to find an expeditious solution to this problem and to report to the General Council before the end of 2002."

Negotiations on the solution to this problem should be guided by the needs and interests of poor people who are suffering without access to medicines, and by the Doha Declaration itself, which states that the TRIPS Agreement "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* [my emphasis]." I urge you to consider the following:

1. The solution must not be restricted to medicines and medical technologies for the treatment of HIV/AIDS, tuberculosis and malaria. While there is no doubt that these epidemics are ravaging developing countries, they cannot be considered the sole public health threats in poor regions--either now or in the future. Furthermore, the WTO is not the appropriate forum for determining sovereign countries' national public health priorities and needs.
2. The solution must not be limited to medicines only. Vaccines, diagnostics, and monitoring tests, for example, are important medical technologies for developing countries. They should not be excluded from any solution.
3. The solution should not limit which countries may benefit from it. Arbitrary restrictions based on economic criteria are unnecessary and will only serve to undermine efforts to protect public health. While least developed countries such as those in sub-Saharan Africa are in particularly acute need of increased access to medicines, they should not be the only countries to benefit from a solution.
4. The solution must be workable and must not include overly burdensome procedural requirements. Complex, restrictive conditions for making use of the solution will only serve to undermine the overall objective of protecting public health.

Increasing the pace of innovation in pharmaceuticals is necessary if the medical community is to have any hope of success in battling major public health problems. But rewarding innovation must not come at the expense of equitable and sustainable access to these essential inventions.

As a health professional and concerned citizen, I urge you to reject any solution that includes any of these restrictions.

Sincerely,

Richard Rockefeller, MD
Chair, Board of Advisors, Doctors Without Borders/Médecins Sans Frontières
Associate Professor, Maine Medical Center, Portland, ME

cc: Sen. Olympia Snowe
Sen. Susan Collins
Rep. Tom Allen
Joe Papovich, Assistant USTR for Services, Investment, and Intellectual Property Rights
Claude Burcky, Deputy Assistant USTR for Intellectual Property Rights