PHA-Exchange> Internal Memo Suggests Shift In WHO Handling Of US Criticism

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By Tove Iren S. Gerhardsen
A World Health Organization (WHO) director has taken the unusual step
of writing a memorandum directly to the head of the WHO, seeking
clarity on the organisation’s handling of a United States complaint
involving WHO staff, according to anonymous sources.

The memo was prompted by concern that the organisation is handling new
US criticism in a less transparent way than it has in the past. In a
previous case, the office of the WHO director general consulted and
informed relevant officers within the organisation, but has not done so
this time, sources said.

The WHO would not comment on the issue, and has said in the past that
the organisation normally does not discuss letters from member
countries (IPW, Public Health, 28 September 2006).

Separately, two key Democratic members of Congress have begun
investigation of the US government’s behaviour in trade and public
health, including questioning the US complaint from this case.
Democrats this week regained control of congressional committees (which
conduct investigations), and one source said the two members plan to
step up their oversight.

The internal memo was sent to the WHO director general on 4 September
by Germán Velásquez, the assistant director general of the Department
of Technical Cooperation for Essential Drugs and Traditional Medicine,
a source said. This department oversees intellectual property issues at
the WHO.

At the time of the memorandum, the director general role was filled by
Anders Nordström, who since the death of Director General Lee Jong-wook
in May has acted as assistant director general. He will be succeeded by
Margaret Chan, who was elected in early November.

The memo, according to the source, says Velásquez accidentally learned
about an August letter to Nordström written by William Steiger, a
senior US health official, taking issue with the WHO co-sponsored
publication, “The use of flexibilities in TRIPS by developing
countries: Can they promote access to medicines?”

This publication was written by Sisule Musungu of the intergovernmental
organisation, South Centre, and a WHO staff person, Cecilia Oh, who
left the WHO in October. Oh said that she had made the decision to
leave before this complaint was filed. But a source close to the issue
told Intellectual Property Watch that afterward, a WHO official
indicated that Oh should discontinue working on intellectual property
issues, despite it being her field of specialty.

Nongovernmental sources said it appears to be unusual timing for the
WHO to let its IP experts go at a time when it should be stepping up
such efforts in relation to its role on the intergovernmental working
group on public health, innovation and intellectual property, created
in May. This group will have its first meeting in Geneva on 4-8
December (IPW, Public Health, 2 October 2006).

In his letter, Steiger said that the US government asserts the
publication “spuriously characterises the trade policy of the United
States as a threat to public health, and it makes unnecessarily
inflammatory and prejudicial recommendations as to how the United
States can improve its trade policies.” Steiger asked Nordström to
review the WHO publication policy and withdraw the publication in
question, the letter said.

The memo asserted that relevant officers would typically be informed
but that those in the department in which Oh was working, including
Velásquez and Director Precious Matsoso, were not informed about the
letter from Steiger (which was not marked confidential), nor about a
potential reply from Nordström, the source said.

When asked about the memo, Velásquez told Intellectual Property Watch
that Nordström neither officially informed nor consulted him about the
letter from Steiger. He is still not aware of any reply letter from the
WHO, nor whether Steiger has sent a follow-up letter to Nordström.

1998 Case Was Handled Differently

In contrast, in July 1998, key officers were informed within hours by
former WHO Director General Gro Harlem Brundtland when she received a
similar letter from the US government as well as one from the
pharmaceutical industry complaining about a publication that also
criticised US trade policy.

The 1998 publication in question was entitled, “Globalization and
access to drugs: Implications of the WTO/TRIPS [World Trade
Organization Agreement on Trade-Related Aspects of Intellectual
Property Rights] agreement,” and was written by Velásquez and Pascal
Boulet, who worked for WHO. It was nicknamed “the red book.”

The red book was ordered by a World Health Assembly resolution adopted
in 1996, which mandated the WHO “to report on the impact of the work of
the WTO with respect to national drug policies and essential drugs and
make recommendations for collaboration between WTO and WHO, as
appropriate,” according to a 2004 book on the history of TRIPS and
public health, edited by Jorge Bermudez and Maria Auxiliadora Oliveira.

The US government “prepared a 17-page paper ‘pointing out the
inaccuracies and false implications with which the document is
riddled’,” the book said. Separately, a letter from the Pharmaceutical
Research and Manufacturers of America (PhRMA), dated 30 June 1998,
stated that this is: “ 
 a deeply flawed document that misleads its
readers and creates a false impression of how the WTO TRIPS agreement
will affect pharmaceuticals.”

Brundtland immediately briefed the WHO officials involved and set up an
independent expert committee, according to the 2004 book. “WHO revised
a revision of the monograph [the red book] with independent external
reviewers and input from the WTO,” it said, adding that this was after
publication in January 1999 of the revision, which was referred to as
the “blue book.”

The WHO’s intentions remain unclear. In his letter, Steiger said he
expects a “full review” of the WHO’s publication policy at the
Executive Board meeting scheduled for January 2007. Steiger also
indicated that he would follow with a letter providing the specifics of
his complaint. It is not clear whether the WHO has received such a
letter.

US Democrats Plan Pressure On Administration

Separately, there also has been US congressional pressure regarding the
Steiger letter. Senator Edward Kennedy (Massachusetts) and
Representative Henry Waxman (California), both Democrats, “have
requested that the Government Accountability Office investigate the
administration’s trade negotiations and their negative effects on
developing countries’ access to medicines,” according to a joint press
release.

In a 13 October letter to US Secretary of Heath and Human Services
Michael Leavitt, Kennedy and Waxman decry the behaviour of the Bush
administration through the Steiger letter.

“Attempting to suppress a report because it is critical of US trade
policy is unacceptable,” they wrote. “Instead, the United States should
seriously assess the impact of our trade politicise on access to
medicines and public health,” they write.

The senators also requested copies of past correspondence between the
United States and the WHO mentioned in Steiger’s letter, as well as
subsequent communication made by Steiger. Intellectual Property Watch
was unable to confirm with the senators by press time whether this
request had been met.

Separately, Switzerland sent a letter to the WHO to clarify a reference
made in the Musungu-Oh publication. Switzerland has adopted a TRIPS
amendment on public health.

US government officials were not reached for this story.

Tove Gerhardsen may be reached at tgerhardsen at ip-watch.ch.


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