Hostname: page-component-8448b6f56d-c47g7 Total loading time: 0 Render date: 2024-04-18T16:38:29.773Z Has data issue: false hasContentIssue false
  • English
  • Français

Pharmaceutical Companies and Global Lack of Access to Medicines: Strengthening Accountability under the Right to Health

Published online by Cambridge University Press:  01 January 2021

Anand Grover ,
Brian Citro ,
Mihir Mankad  and
Fiona Lander
Get access Rights & Permissions [Opens in a new window]

Extract

Approximately two billion people lack access to medicines globally. People living with HIV, cancer patients, those suffering from tuberculosis or malaria, and other populations in desperate need of life-saving medicines are increasingly unable to access existing preventative, curative, and life-prolonging treatments. In many cases, treatment may be unavailable or inaccessible for even some of the most common and readily treatable health concerns, such as hypertension. In the developing world, many of the factors that contribute to making the world’s most vulnerable and marginalized populations particularly susceptible to illness also operate to restrict their access to medicines. As a result of dramatic economic inequities and widespread poverty, it is not profitable for most originator pharmaceutical companies to develop new medicines for sale in developing markets or to lower the cost of existing drugs so that they are affordable for the majority of these populations.

Type
Symposium
Information
Journal of Law, Medicine & Ethics , Volume 40 , Issue 2 , Summer 2012 , pp. 234 - 250
Copyright
Copyright © American Society of Law, Medicine and Ethics 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

World Health Organization, “WHO Medicines Strategy 2004–2007: Countries at the Core,” Geneva, 2004, available at <http://whqlibdoc.who.int/hq/2004/WHO_EDM_2004.5.pdf> (last visited May 10, 2012).+(last+visited+May+10,+2012).>Google Scholar
International Covenant on Economic, Social, and Cultural Rights, Committee on Covenant on Economic, Social, and Cultural Rights, General Comment no. 14 on the right of everyone to the highest attainable standard of mental and physical health, UN doc. E/C.12/2000/4, August 11, 2000.Google Scholar
Committee on Economic, Social and Cultural Rights, General Comment No. 17 on the right of everyone to benefit from the protection of the moral and material interests resulting from any scientific, literary or artistic production of which he or she is the author, UN doc. E/C.12/GC/17, January 12, 2006, at para. 35.Google Scholar
World Health Organization, “Medicines Expenditures,” in the World Medicines Situation, Geneva, 2011. The cost of medicines as a percentage of health expenditures is, as could be expected, higher amongst developing countries than developed countries.Google Scholar
World Health Organization, “Global Trends in Medicines Spending and Financing,” in the World Medicines Situation, Geneva, 2004.Google Scholar
These three broad categories are taken from Pogge, T. Rimmer, M. Rubenstein, K., “Introduction: Access to Essential Medicines: Public Health and International Law,” in Pogge, T. Rimmer, M. Rubenstein, K., eds., Incentives for Global Public Health: Patent Law and Access to Essential Medicines (Cambridge: Cambridge University Press, 2010): At 3–8.CrossRefGoogle Scholar
Drugs for Neglected Diseases Working Group, Fatal Imbalance: The Crisis in Research and Development for Drugs for Neglected Diseases, 2001, at 10.Google Scholar
Id.Google Scholar
Flynn, S. Hollis, A. Palmedo, M., “An Economic Justification for Open Access to Essential Medicine Patents in Developing Countries,” Journal of Law, Medicine & Ethics 37, no. 1 (2009): 184–208.CrossRefGoogle Scholar
Marrakesh Agreement Establishing the World Trade Organization, opened for signature April 15, 1994, 1867 UNTS 3, annex 1C (Agreement on Trade-Related Aspects of Intellectual Property Rights) (entered into force January 1, 1995); see also UNCTAD-ICTSD, Resource Book on TRIPS and Development: An Authoritative and Practical Guide to the TRIPS Agreement, May 2005, at 3, available at <http://www.iprsonline.org/unctadictsd/ResourceBookIndex.htm> (last visited May 10, 2012).+(last+visited+May+10,+2012).>Google Scholar
Report of the U.N. Special Rapporteur on right of everyone to the highest attainable standard of physical and mental health, U.N. Doc.A/HRC/11/12, March 31, 2009, at paras. 17–22.Google Scholar
World Health Organization, “Access to Affordable Essential Medicines,” in Millennium Development Goal 8: Strengthening the Global Partnership for Development in a Time of Crisis, Millennium Development Goal Gap Task Force Report (2009).Google Scholar
Doctors Without Borders, Untangling the Web of Price Reductions, June 2005, at 10, available at <www.accessmed-msf.org> (last visited May 10, 2012).+(last+visited+May+10,+2012).>Google Scholar
Id.Google Scholar
Id., at para 3.Google Scholar
For example, many countries may lack the necessary infrastructure, such drug manufacturing facilities, to make use of voluntary or compulsory licenses or the technical capacity to take advantage of opposition or revocation procedures.Google Scholar
Montevideo Convention on the rights and duties of States, 1933, Article 1.Google Scholar
Although there are some notable exceptions to this, such as recognition of the Holy See, various insurgents, and so on: Shaw, M., International Law, 5th ed. (Cambridge: Cambridge University Press, 2003): At 177.CrossRefGoogle Scholar
Alston, P., “The ‘Not-a-Cat’ Syndrome: Can the International Human Rights Regime Accommodate Non-State Actors?” in Alston, P., ed., Non-State Actors and Human Rights (Oxford: Oxford University Press, 2005): At 14.Google Scholar
Danzig Railway Officials, PCIJ, Series B, No. 15 (1928); 4 AD, at 287.Google Scholar
UN Doc. CCPR/C/21/Rev.1/Add. 13. A.Google Scholar
UN Doc. E/C.12/2000/4, para. 42 (emphasis added).Google Scholar
“Maastricht Guidelines on Violations of Economic, Social and Cultural Rights,” HRQ 20, no. 3 (1998): 691–704.CrossRefGoogle Scholar
Clapham, A., Human Rights Obligations of Non-State Actors (Oxford, U.K.: Oxford University Press, 2006): At 25.CrossRefGoogle Scholar
See Tórrez, B., “Honduras: Analysis of the Impact of the Collective of Honduran Women (CODEMUH) on Workers' Rights and Occupational Health, 2002 to 2005,” Oxfam International, 2008; McLeay, F., “Corporate Codes of Conduct and the Human Rights Accountability of Transnational Corporations – A Small Piece of a Large Puzzle,” NYU School of Law, Global Law Working Paper Series 01/05, Symposium: Transnational Corporations and Human Rights (2005), at 5–6, available at <http://www.law.nyu.edu/global/workingpapers/2005/ECM_DLV_015787> (last visited May 10, 2012).Google Scholar
See UN Doc. A/HRC/11/12.Google Scholar
International Federation of Pharmaceutical Manufacturers and Associations, “The Pharmaceutical Industry and Global Health: Facts and Figures,” Issue 2011, at 53.Google Scholar
Id., at 49.Google Scholar
Global Policy Forum, Comparison of the World's 25 Largest Corporations with the GDP of Selected Countries, 2010, available at <http://www.globalpolicy.org/images/pdfs/Comparison_of_Corporations_with_GDP_of_Countries_table.pdf> (last visited May 10, 2012). (last visited May 10, 2012).' href=https://scholar.google.com/scholar?q=29+Global+Policy+Forum,+Comparison+of+the+World's+25+Largest+Corporations+with+the+GDP+of+Selected+Countries,+2010,+available+at++(last+visited+May+10,+2012).>Google Scholar
See Fortune 500's 2011 annual ranking of America's largest corporations, available at <http://money.cnn.com/magazines/fortune/fortune500/2011/industries/21/index.html> (last visited May 10, 2012); and International Monetary Fund, “Nominal GDP List of Countries for the Year 2010,” World Economic Outlook Database, September 2011, available at <http://www.imf.org/external/pubs/ft/weo/2011/02/weodata/index.aspx> (last visited May 10, 2012). (last visited May 10, 2012); and International Monetary Fund, “Nominal GDP List of Countries for the Year 2010,” World Economic Outlook Database, September 2011, available at (last visited May 10, 2012).' href=https://scholar.google.com/scholar?q=30+See+Fortune+500's+2011+annual+ranking+of+America's+largest+corporations,+available+at++(last+visited+May+10,+2012);+and+International+Monetary+Fund,+“Nominal+GDP+List+of+Countries+for+the+Year+2010,”+World+Economic+Outlook+Database,+September+2011,+available+at++(last+visited+May+10,+2012).>Google Scholar
UN Doc. E/CN.4/Sub.2/1995/11.Google Scholar
United Nations Conference on Trade and Development, “World Investment Report: Transnational Corporations, Agricultural Production and Development,” UNCTAD, New York and Geneva, 2009, at 17.Google Scholar
United Nations Conference on Trade and Development, “World Investment Report: Transnational Corporations, Agricultural Production and Development,” UNCTAD, New York and Geneva, 2009, at 17.Google Scholar
International Federation of Pharmaceutical Manufacturers and Associations, “The Pharmaceutical Industry and Global Health: Facts and Figures,” Issue 2011, at 47; and International Monetary Fund, “Nominal GDP List of Countries for the Year 2010,” World Economic Outlook Database, September 2011, available at <http://www.imf.org/external/pubs/ft/weo/2011/02/weodata/index.aspx> (last visited May 10, 2012).+(last+visited+May+10,+2012).>Google Scholar
Senyonjo, M., “The Applicability of International Human Rights Law to Non-State Actors: What Relevance to Economic, Social and Cultural Rights?” International Journal of Human Rights 12, no. 5 (December 2008): At 726.CrossRefGoogle Scholar
See Pentikäinen, M., “Changing International ‘Subjectivity’ and Rights and Obligations under International Law – Status of Corporations,” Utrecht Law Review 8, no. 1 (January 2012), available at <http://www.utrechtlawreview.org/index.php/ulr/article/viewFile/184/183> (last visited May 10, 2012).CrossRefGoogle Scholar
Id., at 152.Google Scholar
International Convention on Civil Liability for Oil Pollution Damage, November 29, 1969, Art.1(2) (entered into force June 19, 1975), available at <www.admiraltylawguide.com/conven/civilpol1969.html> (last visited May 10, 2012).+(last+visited+May+10,+2012).>Google Scholar
Convention for Civil Liability for Damages Resulting from Activities Dangerous to the Environment, June 21, 1993, Art.2(6), Europ, T.S. No. 150, available at <www.conventions.coe.int/treaty/en/Treaties/Word/150.doc> (last visited May 10, 2012).+(last+visited+May+10,+2012).>Google Scholar
Convention on the Settlement of Investment Disputes between States and Nationals of Other States, Art. 25(2)(b) defines “National of another Contracting State” to include “any juridical person which had the nationality of a Contracting State,” available at <http://icsid.worldbank.org/ICSID/StaticFiles/basicdoc/partA.htm> (last visited May 10, 2012).+(last+visited+May+10,+2012).>Google Scholar
Kirton, J., “NAFTA Dispute Settlement Mechanisms: An Overview,” NAFTA and Its Implications for ASEAN's Free Trade Area, Experts Workshop, Asian Institute, Munk Centre for International Studies, Toronto, May 27, 2004, at 5.Google Scholar
Clapham, A., Human Rights Obligations of Non-State Actors (Oxford: Oxford University Press, 2006): At 349.CrossRefGoogle Scholar
Clapham, A. Garcia Rubio, M., “The Obligations of States with Regard to Non-State Actors in the Context of the Right to Health,” Health and Human Rights Working Paper Series No. 3, 2006.Google Scholar
See Santa Clara County v. Southern Pacific Railroad, 118 U.S. 394 (1886).Google Scholar
See Citizens United v. Federal Elections Commission, 130 S.Ct. 876 (2010).Google Scholar
Brief for the United States as Amicus Curiae Supporting Petitioners, No. 10–149, Kiobel v. Royal Dutch Petroleum, in the Supreme Court of the United States, available at <http://www.earthrights.org/sites/default/files/documents/USG-Kiobel-amicus.pdf> (last visited May 10, 2012).+(last+visited+May+10,+2012).>Google Scholar
Id., at 21.Google Scholar
Id., at 18.Google Scholar
Two former UN High Commissioners for Human Rights, Mary Robinson and Sergio Vieira de Mello, have written that the term “organs of society” in the Declaration includes corporations. Robinson, M., “The Business Case for Human Rights,” in Visions of Ethical Business, Financial Times Management (London: Financial Times Professional, 1998): 14–17, at 14; Vieira de Mello, S., “Human Rights: What Role for Business?” New Academy Review 2, no. 1 (2003): 19–22, at 19.Google Scholar
United States Diplomatic and Consular Staff in Tehran (United States v. Iran), ICJ Reports (1980): At 3, 42; Humphrey, J., “The International Bill of Rights and Implementation: Scope and Implementation,” William and Mary Law Review 17 (1976): 527–541, at 259, cited in Schachter, O., “International Law in Theory and Practice,” Hague Academy International Law, Recueil des Cours, 178, no. 9 (1982): At 340.Google Scholar
For example, the right to life, a paradigmatic first-generation, negative right, imposes a positive duty upon the state to establish and maintain law enforcement and judicial mechanisms. At the same time, the right to health, a second-generation, positive right, imposes negative duties upon the state, including the right to be free from interference by the state in matters concerning one's health, for example through non-consensual medical treatment and experimentation, and the right to be free from discrimination in access to health goods and services.Google Scholar
Reinisch, A., “The Changing International Legal Framework for Dealing with Non-State Actors,” in Alston, P., ed., Non-State Actors and Human Rights (Oxford: Oxford University Press, 2005): At 42.Google Scholar
See Clapham, , supra note 42, at 195.Google Scholar
Schilling, D. M., “Making Codes of Conduct Credible: The Role of Independent Monitoring,” in Williams, O., ed., Global Codes of Conduct: An Idea Whose Time Has Come (Notre Dame, Indiana: University of Notre Dame Press, 2000): At 221; Frenkel, S. J. Scott, D., “Compliance, Collaboration, and Codes of Labor Practice: The Adidas Connection,” California Management Review 45, no. 1 (2004): 29.Google Scholar
Sullivan Principles, available at <http://muweb.marshall.edu/revleonsullivan/indexf.htm> (last visited May 10, 2012).+(last+visited+May+10,+2012).>Google Scholar
MacBride Principles, available at <http://www1.umn.edu/humanrts/links/macbride.html> (last visited May 10, 2012).+(last+visited+May+10,+2012).>Google Scholar
GlaxoSmithKline's 2010 Corporate Responsibility Report has a section titled “Access to Medicines,” in which there is a sub-section titled “Engaging on the human right to health.” This sub-section references the company's response to the former Special Rapporteur's mission to the company in 2008. It states: “Pharmaceutical companies, including GSK, must make their medicines as affordable as possible to people in the world's poorest communities, in a sustainable manner. We must invest in research into diseases of the developing world because new prevention tools and treatments are urgently needed. We must work with others to find innovative solutions to delivering our medicines and vaccines to the people who need them most.” It was available at <http://www.gsk.com/responsibility/down-loads/GSK-CR-2010-Access.pdf>..' href=https://scholar.google.com/scholar?q=57+GlaxoSmithKline's+2010+Corporate+Responsibility+Report+has+a+section+titled+“Access+to+Medicines,”+in+which+there+is+a+sub-section+titled+“Engaging+on+the+human+right+to+health.”+This+sub-section+references+the+company's+response+to+the+former+Special+Rapporteur's+mission+to+the+company+in+2008.+It+states:+“Pharmaceutical+companies,+including+GSK,+must+make+their+medicines+as+affordable+as+possible+to+people+in+the+world's+poorest+communities,+in+a+sustainable+manner.+We+must+invest+in+research+into+diseases+of+the+developing+world+because+new+prevention+tools+and+treatments+are+urgently+needed.+We+must+work+with+others+to+find+innovative+solutions+to+delivering+our+medicines+and+vaccines+to+the+people+who+need+them+most.”+It+was+available+at+.>Google Scholar
Global, U.N. Compact, available at <http://www.unglobalcompact.org/AboutTheGC/index.html> (last visited May 10, 2012).+(last+visited+May+10,+2012).>Google Scholar
United Nations Global Compact, “UN Global Compact Has Expelled Over 3,000 Companies,” New York, February 9, 2012, available at <http://www.unglobalcompact.org/news/188-02-09-2012> (last visited May 10, 2012).+(last+visited+May+10,+2012).>Google Scholar
Organisation for Economic Co-operation and Development, OECD Guidelines for Multinational Enterprises, 2008, available at <http://www.oecd.org/dataoecd/56/36/1922428.pdf> (last visited May 10, 2012).+(last+visited+May+10,+2012).>Google Scholar
Id., at 9; id., at 14.Google Scholar
International Labour Organisation, The ILO Tripartite Declaration of Principles Concerning Multinational Enterprises and Social Policy, International Labour Office, Geneva, 2001, at para. 2, available at <http://www.ilo.org/wcmsp5/groups/public/@ed_emp/@emp_ent/documents/publication/wcms_101234.pdf > (last visited May 10, 2012).+(last+visited+May+10,+2012).>Google Scholar
Id., at para. 8.Google Scholar
United Nations, “Norms on the Responsibilities of Transnational Corporations and Other Business Enterprises with Regard to Human Rights,” E/CN.4/Sub.2/2003/12/Rev.2 (2003), at para. 1.Google Scholar
UN Doc. E/CN.4/RES/2005/69, (April 20, 2005) para.1(a).CrossRefGoogle Scholar
UN Doc. A/HRC/RES/8/7, (June 18, 2008), available at <http://ap.ohchr.org/documents/E/HRC/resolutions/A_HRC_RES_8_7.pdf> (last visited May 10, 2012).+(last+visited+May+10,+2012).>Google Scholar
UN Doc. A/HRC/17/31, March 21, 2011, available at <http://www.ohchr.org/Documents/Issues/Business/A-HRC-17-31_AEV.pdf> (last visited May 10, 2012).+(last+visited+May+10,+2012).>Google Scholar
UN Doc. A/63/263, (11 August 2008) Annex, available at <http://daccess-dds-ny.un.org/doc/UNDOC/GEN/N08/456/47/PDF/N0845647.pdf?OpenElement>..>Google Scholar
UN Doc. A/63/263, August 11, 2008, at para. 46.CrossRefGoogle Scholar
Steinhardt, R. G., “The New Lex Mercatoria,” in Non-State Actors and Human Rights, Alston, P., ed. (Oxford: Oxford University Press, 2005): 181–182.Google Scholar
See Frenkel, S. J. Scott, D., “Compliance, Collaboration, and Codes of Labor Practice: The Adidas Connection,” California Management Review 45, no. 1 (2004): At 29.Google Scholar
Ratner, S., “Corporations and Human Rights: A Theory of Legal Responsibility,” Yale Law Journal 111, no. 443 (November 2001): 536–537.CrossRefGoogle Scholar
Id., at 532.Google Scholar
Kasky v Nike, 27 Cal. 4th 939, 45 P.3d 243 (2002); Nike Inc. v Kasky 123 S.Ct 2554, U.S. 2003, Jun 26 2004.Google Scholar
UN Doc. A/63/263, (August 11, 2008), Annex, Preamble (h).Google Scholar
Id., at Preamble (i).Google Scholar
Id., at Annex, para. 1 (emphasis added).Google Scholar
Id., at Annex, para. 2 (emphasis added).Google Scholar
Id., at para. 46.Google Scholar
Id., at Annex, para. 8.Google Scholar
Id., at Annex, para. 14.Google Scholar
Id., at Annex, Neglected diseases, Commentary.Google Scholar
UN Doc. E/C.12/2000/4, August11, 2000, at para. 59.CrossRefGoogle Scholar
UN Doc. E/C.12/2000/4, August 11, 2000, at para. 59.CrossRefGoogle Scholar
UN Doc. A/63/263, August 11, 2008, at Annex, para. 9.Google Scholar
Id., at Annex, Preamble (j).Google Scholar
A/HRC/11/12/Add.2, at para. 105.Google Scholar
GlaxoSmithKline, “Statement in Response to Paul Hunt's Report on GSK,” June 2009, available at <http://198.170.85.29/GSK-response-to-Paul-Hunt-report-June-2009.pdf> (last visited May 10, 2012). (last visited May 10, 2012).' href=https://scholar.google.com/scholar?q=88+GlaxoSmithKline,+“Statement+in+Response+to+Paul+Hunt's+Report+on+GSK,”+June+2009,+available+at++(last+visited+May+10,+2012).>Google Scholar
Foreign Corrupt Practices Act of 1977 (FCPA) (15 U.S.C. §§ 78dd-1, et seq.) 91 Stat. 1495, available at <http://www.justice.gov/usao/eousa/foia_reading_room/usam/title9/47mcrm.htm> (last visited May 10, 2012).+(last+visited+May+10,+2012).>Google Scholar
See UN Doc. A/RES/60/25, April 3, 2006, available at <http://daccess-dds-ny.un.org/doc/UNDOC/GEN/N05/502/66/PDF/N0550266.pdf?OpenElement>..>Google Scholar