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The WTO ministerial meeting in Doha, Qatar provides an ideal occasion for the United States to make a new commitment to multilateral and bilateral trade policy consistent with concern for the global crisis of HIV/AIDS. We are writing to urge your leadership toward a commitment from the U.S. government to allowing all countries suffering from HIV/AIDS' devastation to make full use of TRIPS exceptions in their pursuit of access to affordable anti-AIDS drugs for their populations.

The vast majority of the more than 22 millions deaths from AIDS thus far have occurred in countries where treatment for AIDS is largely unaffordable. The overwhelming majority of the more than 36 million persons infected today live in countries where they can have no reasonable hope of affordable treatment. HIV/AIDS is an unprecedented social, economic and human rights crisis in sub-Saharan Africa. It has killed 18 million Africans in the prime of their productive lives and left a generation of desperate and impoverished orphans.

Your recent proposal to extend the transition period for TRIPS compliance for least developed countries in Africa to the year 2016 and to place a moratorium on initiation of disputes against these countries is a step in the right direction. This proposal, however, does not go far enough. Firstly, Kenya, South Africa, Namibia, Botswana and Zimbabwe would not be covered by these measures since they are not currently classified as "least developed." For all of these countries, HIV/AIDS is a national emergency. In at least two of these countries, government officials have spoken publicly about pressures on them from the WTO or from trade representatives in wealthy countries to refrain from discussions of compulsory licensing or parallel importation of generic versions of antiretroviral drugs. In addition, this proposal does nothing for countries such as Thailand, Haiti, the Dominican Republic, and others that are either not "least developed" or not in Africa but have HIV/AIDS problems that constitute national emergencies.

Secondly, we are especially concerned that the United States' history of bilateral actions belies the spirit of your recent proposal and shows a consistent pattern of putting patent protections above the emergency needs of countries heavily affected by HIV/AIDS. U.S. pressures on Thailand in response to the January 2001 resolution of the Thai Food and Drug Administration on the waiting period for generic drug production are just one recent example of these actions. The U.S.' continued support for "TRIPS-Plus" measures in new trade agreements for the Americas and in the recent U.S.-Jordan Free Trade Agreement also fly in the face of the U.S.' stated concern for countries affected by HIV/AIDS. The conditionalities in the Africa Growth and Opportunity Act (H.R. 2489 of 1999), which predate your appointment as Trade Representative, include reviewing a country's record on intellectual property before granting trade preferences. It is hypocritical for the U.S. as a member state of WTO to appear to be pushing the WTO to allow greater capacity for AIDS-affected countries to use the emergency provisions of TRIPS and at the same time to be pursuing bilateral trade policies that undercut that capacity.

Thirdly, unless the U.S. and other wealthy countries provide more leadership to increase the support of the international community for greater investment in the HIV/AIDS problem in Africa, Asia and Latin America, there is no reason to think that things will be much different in 2016 than they would be in 2006 or than they are now. The Global Fund established by the United Nations Secretary-General as one mechanism for mobilizing resources of the international community to address the HIV/AIDS crisis has attracted only a fraction of the estimated $7 to $10 billion needed annually. The U.S. government's own contribution to that effort, which will apparently be $190 million rather than the $200 million earlier announced, is grossly incommensurate to the crisis.

We urge you to use the Doha summit to make a clear and unambiguous pledge that the United States will use neither multilateral nor bilateral pressures to prevent AIDS-affected countries that have judged HIV/AIDS to constitute a national emergency from using the full range of TRIPS provisions to increase anti-AIDS drug access for their people.

Sincerely yours,

Joanne Csete
Director, HIV/AIDS and
Human Rights Program

Arvind Ganesan
Director, Business and
Human Rights Program

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