2008-09 AMSA Legislative Agenda

6. Congress must invest in global health and set policies that guarantee access to health care and affordable essential medicines.  

Essential Medicines Background

U.S. policy should protect doctors’ abilities to prescribe affordable medications to patients in need of treatment both domestically and abroad. We are concerned that some existing U.S. trade policies instead protect the ability of pharmaceutical companies to maximize profit, without regard to the negative role that expensive drug prices play in patient access to essential medicines.

The TRIPS Agreement (trade related aspect of intellectual property rights) established a worldwide, uniform baseline for patent, copyright, and trademark protection between countries.

TRIPS-Plus agreements are agreements between two or a few countries that create restrictions on access to essential medicines and over-ride agreements in the original TRIPS Agreement. This type of agreement restricts access to WHO guideline standard-of-care treatments for AIDS and other diseases.

AMSA Essential Medicines Position

As leaders of our world’s future physician workforce, we call upon Congress to reauthorize the TRADE Act [S.3083, H.R.6180] to:

1. Honor the commitments that our country made in the 2001 WTO Doha Declaration and TRIPS Agreement. Refrain from promoting or enforcing TRIPS-Plus measures:
   1. Renegotiate existing free trade agreements to conform to TRIPS minimum requirements, and set aside existing TRIPS-Plus restrictions that limit access to essential medicines;
   2. Refrain from seeking intellectual property provisions in new trade agreements that decrease access to essential medicines, including data exclusivity, patent term extensions, and limits on compulsory licenses;
   3. Refrain from pressuring, threatening or punishing countries that adopt or use TRIPS flexibilities by means of the Special 301 Watch List, the granting or withholding of benefits under the Generalized System of Preferences, or diplomatic pressure to unilaterally adopt TRIPS-Plus provisions in national law.

Honoring our commitments will further reduce the price of medications purchased by U.S. government programs like PEPFAR, especially in the case of expensive improved and second-line treatments for HIV/AIDS, tuberculosis, and malaria.

1. Encourage innovation and affordable access to new drugs through mechanisms other than granting of patents, e.g.
   1. Implementing or joining a model like the UNITAID Patent Pool
   2. Creating prize funds to reward pharmaceutical companies that develop new medications, especially for neglected diseases
   3. Ensuring that medical innovations produced with government support are accessible to developing countries and to researchers

Global AIDS Initiative Background

As of 2008 the estimated number of people living with HIV globally is 33 million 33.

• Only 11% of people in developing countries have ever been tested for HIV
• 7 in 10 people in need of ARVs do not have access to this life-saving treatment
• In Eastern Europe and Central Asia where the AIDS epidemic is fueled by injection drug use only 10% of users have access to prevention programs
• 2/3 of pregnant women do not receive treatment to prevent passing HIV to their children

As the next generation of physicians, we must advocate for increased access to treatment and evidence-based prevention in order to continue these promising gains against the global AIDS pandemic.

AMSA Global AIDS Initiative Position

Congress must appropriate $48 Billion USD over 5 years to meet America’s commitment to fighting global AIDS through the President’s Emergency Plan for AIDS Relief (PEPFAR, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, S. 2731, H.R. 5501)) for the prevention, care, and treatment of HIV/AIDS. This amount will allow the US to fulfill its commitment to treat 1/3 of the people in immediate clinical need of antiretroviral treatment by 2013 and provide our fair share contribution to The Global Fund.

Sensible Pharmaceutical Policy and Research: Congress must support access to affordable medications in the developing world by recognizing the WHO prequalification process as comparable to FDA drug approval. 

Global Gag Rule (formerly HR 619 and S1744)
Congress and the next President must end the United State’s global gag rule (or Mexico City policy) that forbids any family planning organization from receiving U.S. funding if they provide or lobby for abortion.  This forces clinics on the frontlines of the fight against HIV/AIDS and death from childbirth to choose between jeopardizing patient health or loosing funding.

33 Kaiser Family Foundation “The Global HIV/AIDS Epidemic” July 2008.