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Global Bully Goes to Guatemala
By Russell Mokhiber and Robert Weissman

There's something profoundly disturbing -- sickening, really -- about
watching a bully at work.

You feel either complicit, or powerless, or both.

The global bully, the United States, has just coerced Guatemala, its
latest victim, into repealing an important law to lower the price of
pharmaceuticals and promote generic competition. The U.S. ambassador to
Guatemala acknowledged that the Guatemalan law was intended to advance
public health objectives. But, no matter, he said -- U.S. commercial
interests in the form of Big Pharma demanded that the law go.

Here's how this went down, what it will mean, and what can be done:

The United States has negotiated a trade deal with the Central American
countries. It goes by the acronym of CAFTA (US-Central America Free Trade
Agreement).

CAFTA is a complex agreement, but in shorthand you can consider it an
extension of NAFTA to Central America.

CAFTA includes a chapter on patents, copyright and other forms of monopoly
protections for knowledge. All of the CAFTA countries are already members
of the World Trade Organization, which requires countries to adopt
U.S.-style patent systems, featuring 20-year patent protection of all
products, including pharmaceuticals.

Although it imposed on countries the requirement to adopt 20-year patents
for drugs, the WTO also contains certain safeguards. Most important among
them is the right to undertake compulsory licensing -- enabling
governments to authorize generic competition for on-patent products.

These safeguards are vital, especially in the developing world. Patent
monopolies drive up prices, and are the main reason drug prices are so
high. The best remedy to these high prices is generic competition.
Evidence: The price of a triple-drug AIDS therapies in developing
countries has fallen by 98 percent over the last six years, thanks to
generic competition, as well as an international campaign for access to
medicines.

But in CAFTA, the United States proposes to eviscerate countries' right to
speed up generic competition and undertake compulsory licensing for
pharmaceuticals, most importantly by requiring CAFTA members to establish
special monopoly protections for pharmaceutical regulatory data (known as
"data exclusivity").

To gain regulatory approval to sell generic versions of drugs already
approved for market, generic companies generally do not repeat safety and
efficacy studies, which are very time consuming and relatively costly.
Instead, they typically show their product is chemically equivalent to,
and works the same in the body as, the brand-name drug. Then they rely the
drug regulatory agency�s approval of the patented product to earn approval
for the generic version of the product.

But the U.S.-imposed provision would prevent this, and establish a 5-10
year period during which generic firms could not rely on the brand-name
companies' tests. As a result, brand-name companies would get protected
monopolies even if a product is not on patent, or even if a compulsory
license was issued.

Under pressure from the United States, Guatemala has adopted exclusivity
on two separate occasions in recent years.

But each time, after health advocates pointed out the dangers, the
provisions have been eliminated.

Making Big Pharma very unhappy.

So John Hamilton, the U.S. ambassador to Guatemala, issued what amounted
to an ultimatum: Guatemala had to change its law to provide data
exclusivity, as is required by CAFTA, or the U.S. Congress wouldn't
approve the deal.

And so Guatemala did.

Despite intense street protests, including by people with HIV/AIDS, the
Guatemalan Congress last week imposed a data exclusivity regime, and then
approved CAFTA.

Get this: the United States demanded the change on data exclusivity even
as it acknowledged that Guatemala had rid itself of such rules in order to
advance public health objectives.

In an op-ed in the Guatemalan press demanding a change in the country's
data protection rules, Ambassador Hamilton wrote, "there is no doubt" that
Guatemala had rescinded data exclusivity rules "out of its concern to
protect public health."

But no matter.

Protecting public health isn't a good enough reason to offend Pfizer.

Unfortunately, this is not just an esoteric matter. It will have
life-and-death consequences.

"In Guatemala today, 78,000 people are infected with HIV/AIDS," says Berta
Chete, who works with the Association Gente Positiva, an organization of
people living with HIV/AIDS in Guatemala. "Nearly 13,500 of us are in
urgent clinical need of ARV treatment. But only an estimated 3,600 people
receive it. Most of them get it from the Social Security system and
non-governmental organizations. The Ministry of Health only provides
treatment to 350 patients."

The government has the duty to provide treatment, she points out.

But, "we doubt that the Government has the capacity to respond to this
situation, because, if there is not competition between generic medicines
and brand-name drugs to reduce prices, the national budget will never be
able to cover the needs of the country in terms of treating AIDS
patients."

The group Doctors Without Borders (known by the French acronym, MSF)
offers an example of the harm to come from the U.S.-imposed data
exclusivity rules, based on the period April 2003-November 2004, when
Guatemala had data exclusivity rules in place.

During that time, according to MSF, 25 medicines received data exclusivity.

One of them was the AIDS drug atazanavir, a key part of second-line
therapy for people with HIV/AIDS once they experience treatment failure on
their first-line regimen. It is used widely in the United States, Europe
and Brazil.

There is presently no generic competition for atazanavir, a relatively new
drug, and today's price is more than $10,000 per person, per year.

"If a more affordable generic version of atazanavir is developed,
however," MSF notes -- and such a version would be expected if competition
is permitted -- "it will not be able to enter the Guatemalan market until
2009," thanks to the data exclusivity rules.

"This means," explains MSF, "that Bristol-Myers Squibb will have a
monopoly during the entire period of exclusivity and, free from
competition, will be able to charge whatever the market will bear --- far
more than what the average Guatemalan will be able to afford. It is
therefore unlikely that the vast majority of Guatemalans who will need
this medicine will be able to access it."

These issues don't only involve HIV/AIDS, but the severity of the AIDS
epidemic, and the importance of recently developed medicines in providing
treatment, highlights the issue.

There is one piece of good news in this disgusting bully-boy saga: CAFTA
is not yet enacted.

The odds are reasonably good that CAFTA will be defeated in the U.S.
Congress.

And so this is unlike most occasions when you witness a bully at work. 
This time, at least if you live in the United States, you can undo the
bully's violence -- by demanding your Member of Congress vote against the
trade pact.

For a quick and easy first step, go to:
http://action.citizen.org/pc/mail/oneclick_compose/?alertid=6064681


Russell Mokhiber is editor of the Washington, D.C.-based Corporate Crime
Reporter, <http://www.corporatecrimereporter.com>. Robert Weissman is
editor of the Washington, D.C.-based Multinational Monitor,
http://www.multinationalmonitor.org, and co-director of Essential Action,
a corporate accountability group that works on access to medicines issues.
Mokhiber and Weissman are co-authors of On the Rampage: Corporate
Predators and the Destruction of Democracy (Monroe, Maine: Common Courage
Press).

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