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Trade-related aspects of intellectual property rights remain a problem
POLICY AND PEOPLE
WHO programme gives hope to blind and partially sighted people in Africa WHO’s regional director for Africa, Ebrahim Malick Samba, highlighted the plight of blind people in the region, and warned that “begging becomes the only way for those affected to survive” because of a lack of social support services.
Panos Pictures
HO and various international donor agencies launched Vision 2020: the right to sight—a global initiative to eliminate avoidable blindness by the year 2020—in 20 Englishspeaking African countries at a meeting in Johannesburg, South Africa, on April 19. The region is home to 3–4 million blind people and 10–12 million visually impaired people. “Vision 2020 aims to increase the number of trained eye-care professionals, improve accessibility to eye-care services, procure appropriate technologies, and develop and implement cost-effective strategies for the prevention of blindness”, said Dr Pararajasegaram, former president of International Agency for the Prevention of Blindness. The English-speaking African countries include: Botswana, Eritrea, Ethiopia, The Gambia, Ghana, Kenya, Lesotho, Liberia, Malawi, Mauritius, Namibia, Nigeria, Seychelles, Sierra Leone, South Africa, Swaziland, Uganda, Tanzania, Zambia, and Zimbabwe.
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Most cases of blindness are preventable
WHO says that 80% of blindness and visual impairment in the region is avoidable. About 2·4 million people are blind from cataracts, with 600 000 new cases of blindness caused by cataracts occurring each year. Despite these frightening figures “less than 10% of cataract-blind people receive surgical treatment, and
most of them live and die blind”, warned Serge Resnikoff, from WHO’s Blindness and Deafness Prevention Programme. Also the “backlog of unoperated cataracts is on the rise”. To deal with this, the group is planning to increase the rate of cataract operations to 2500 per million in the next 5 years. The English-speaking African countries also have about 200 000 children that are blind because of vitamin-A deficiency, ophthalmia neonatorum, harmful traditional eye practices, congenital cataract, and hereditary disorders. Another leading problem is onchocerciasis which is endemic in Ethiopia, Liberia, Sierra Leone, Malawi, Tanzania, and Uganda—and Nigeria—which is the worst hit country. Ghana excluded, the disease constitutes a serious obstacle to socioeconomic development, warned the group, which is aiming to control river blindness by 2010. Khabir Ahmad
African leaders discuss ways to “roll back malaria”
A
frican leaders called on the world to cancel the debt of poor and heavily indebted countries to enable them to fight poverty caused by malaria, at a summit on malaria, on April 25, in Abuja, Nigeria. The heads of state met under the aegis of Roll Back Malaria, an international collaboration including WHO, that aims to halve the number of malaria deaths in Africa
by the end of the decade. To achieve this aim, participants signed a declaration calling for at least US$1 billion in aid. By the end of the 2-day conference donors including the World Bank, USA, UK, and others, had promised $750 million. WHO estimates that about 1 million people die from malaria each year. Deaths linked to malaria in Africa are increasing due to changes in climate, movement of
populations arising from political instability and civil strife, and resistance of malaria to common and inexpensive medicines. The disease is also keeping Africa poor. Jeffrey Sachs from Harvard University, USA, noted in a report that over 15 years a country could lose 20% of its national income because of the disease. Haroon Ashraf
Trade-related aspects of intellectual property rights remain a problem nternational health organisations and European Commission officials from trade, development, and health departments discussed the impact of World Trade Organisation agreements on health policy at a meeting in Brussels, Belgium, on April 18. The meeting, convened by non-governmental health organisations including Médecins Sans Frontières (MSF), covered topics including access to essential medicines, health-systems development, and consumer protection. MSF highlighted the issue of the effect that trade-related aspects of intellectual property rights (TRIPS) can have on patients in developing
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countries. For example, treatment for tuberculosis with ciprofloxacin, which is patent-protected until 2003, costs US$325 per month in the USA. A generic version costs $32·31 per month in India. Once India has fully implemented TRIPS, it is supposed to abandon local production of patentprotected drugs, which could have a serious impact on national health care. Recently, Pfizer offered to donate fluconazole to treat HIV-related cryptococcal meningitis in South Africa (see Lancet 2000; 355: 1342). Pfizer has exclusive marketing rights for the drug there. The drug costs $10 per capsule, but in countries where fluconazole is pro-
duced generically, the price is $0·6. Marc Biot of MSF welcomed an opportunity to save lives in South Africa, but said donations were not a sustainable policy. He called for segmentation of markets, with lower drug prices in developing countries; stimulation of generic competition; and compulsory licensing to enable countries to produce patented products. However, participants heard that pharmaceutical companies are unlikely to develop new products for diseases that affect less-affluent populations. Treating diseases that affect western society is more lucrative. Ellen ‘t Hoen
THE LANCET • Vol 355 • April 29, 2000
WHO programme gives hope to blind and partially sighted people in Africa WHO’s regional director for Africa, Ebrahim Malick Samba, highlighted the plight of blind people in the region, and warned that “begging becomes the only way for those affected to survive” because of a lack of social support services.
Panos Pictures
HO and various international donor agencies launched Vision 2020: the right to sight—a global initiative to eliminate avoidable blindness by the year 2020—in 20 Englishspeaking African countries at a meeting in Johannesburg, South Africa, on April 19. The region is home to 3–4 million blind people and 10–12 million visually impaired people. “Vision 2020 aims to increase the number of trained eye-care professionals, improve accessibility to eye-care services, procure appropriate technologies, and develop and implement cost-effective strategies for the prevention of blindness”, said Dr Pararajasegaram, former president of International Agency for the Prevention of Blindness. The English-speaking African countries include: Botswana, Eritrea, Ethiopia, The Gambia, Ghana, Kenya, Lesotho, Liberia, Malawi, Mauritius, Namibia, Nigeria, Seychelles, Sierra Leone, South Africa, Swaziland, Uganda, Tanzania, Zambia, and Zimbabwe.
W
Most cases of blindness are preventable
WHO says that 80% of blindness and visual impairment in the region is avoidable. About 2·4 million people are blind from cataracts, with 600 000 new cases of blindness caused by cataracts occurring each year. Despite these frightening figures “less than 10% of cataract-blind people receive surgical treatment, and
most of them live and die blind”, warned Serge Resnikoff, from WHO’s Blindness and Deafness Prevention Programme. Also the “backlog of unoperated cataracts is on the rise”. To deal with this, the group is planning to increase the rate of cataract operations to 2500 per million in the next 5 years. The English-speaking African countries also have about 200 000 children that are blind because of vitamin-A deficiency, ophthalmia neonatorum, harmful traditional eye practices, congenital cataract, and hereditary disorders. Another leading problem is onchocerciasis which is endemic in Ethiopia, Liberia, Sierra Leone, Malawi, Tanzania, and Uganda—and Nigeria—which is the worst hit country. Ghana excluded, the disease constitutes a serious obstacle to socioeconomic development, warned the group, which is aiming to control river blindness by 2010. Khabir Ahmad
African leaders discuss ways to “roll back malaria”
A
frican leaders called on the world to cancel the debt of poor and heavily indebted countries to enable them to fight poverty caused by malaria, at a summit on malaria, on April 25, in Abuja, Nigeria. The heads of state met under the aegis of Roll Back Malaria, an international collaboration including WHO, that aims to halve the number of malaria deaths in Africa
by the end of the decade. To achieve this aim, participants signed a declaration calling for at least US$1 billion in aid. By the end of the 2-day conference donors including the World Bank, USA, UK, and others, had promised $750 million. WHO estimates that about 1 million people die from malaria each year. Deaths linked to malaria in Africa are increasing due to changes in climate, movement of
populations arising from political instability and civil strife, and resistance of malaria to common and inexpensive medicines. The disease is also keeping Africa poor. Jeffrey Sachs from Harvard University, USA, noted in a report that over 15 years a country could lose 20% of its national income because of the disease. Haroon Ashraf
Trade-related aspects of intellectual property rights remain a problem nternational health organisations and European Commission officials from trade, development, and health departments discussed the impact of World Trade Organisation agreements on health policy at a meeting in Brussels, Belgium, on April 18. The meeting, convened by non-governmental health organisations including Médecins Sans Frontières (MSF), covered topics including access to essential medicines, health-systems development, and consumer protection. MSF highlighted the issue of the effect that trade-related aspects of intellectual property rights (TRIPS) can have on patients in developing
I
1528
countries. For example, treatment for tuberculosis with ciprofloxacin, which is patent-protected until 2003, costs US$325 per month in the USA. A generic version costs $32·31 per month in India. Once India has fully implemented TRIPS, it is supposed to abandon local production of patentprotected drugs, which could have a serious impact on national health care. Recently, Pfizer offered to donate fluconazole to treat HIV-related cryptococcal meningitis in South Africa (see Lancet 2000; 355: 1342). Pfizer has exclusive marketing rights for the drug there. The drug costs $10 per capsule, but in countries where fluconazole is pro-
duced generically, the price is $0·6. Marc Biot of MSF welcomed an opportunity to save lives in South Africa, but said donations were not a sustainable policy. He called for segmentation of markets, with lower drug prices in developing countries; stimulation of generic competition; and compulsory licensing to enable countries to produce patented products. However, participants heard that pharmaceutical companies are unlikely to develop new products for diseases that affect less-affluent populations. Treating diseases that affect western society is more lucrative. Ellen ‘t Hoen
THE LANCET • Vol 355 • April 29, 2000