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Mr. Simon Thomas (Ceredigion): Not only did I anticipate what the hon. Member for City of York (Hugh Bayley) would say with reference to the 0.7 per cent. target; he anticipated what I would say with regard to TRIPS and the health needs of developing countries.
On behalf of Plaid Cymru and the Scottish national party, I put on record our welcome for the debate, which we hope will become an annual event. We are pleased to have the opportunity to take part in it, but I have one small suggestion to make. The Order Paper should refer to the annual report as the relevant document for the debate. It would be useful for other hon. Members to realise that this was an opportunity to hear what the Government have been doing during the past year.
The debate has been well attended, considering that local government elections are taking place somewhere or other, though not in Wales. Those participating, however, tend to be the usual suspects. Although the standard of debate has been very high, I am sure that if we had an opportunity to widen the forum, other Members might be called to speak.
The debate is also worth while because this is the Global Campaign for Education's week of action, which reminds us about the central goal of ensuring that its action plan on free primary education for all should be decided by the end of this year. I hope that the Minister will say in his winding-up speech whether he thinks that that action plan is on track to be agreed by the end of this year. However, I want to confine my remarks to the TRIPS regime and GATS and to some of the difficulties that we need to address to deliver health care to developing countries.
There is obviously a disproportionate burden of death and illness in developing countries, especially because of HIV/AIDS, tuberculosis and malaria. Some 2.4 million people have died of HIV/AIDS in sub-Saharan Africa. A further 25.3 million people in the region are HIV positive, of whom only 25,000 receive the drugs that could revolutionise their treatment. Many of those drugs are still under patent.
Under the TRIPS agreement, many countries that presently produce generic drugs, such as India, will need to abandon that production under a new system of patent protection by 2005. We have to review how the new system progresses. It is clear that generic drugs are much cheaper because there is a competitive market and no research and development costs. A triple combination treatment for HIV/AIDS costs $930 per person per year, whereas a generic version of that treatment is available for $250 per person per year. Nevertheless, we have to take into account the fact that per capita spending on health in Africa is about $10 per person per year, so there is still a huge gap to overcome.
I had an opportunity to see the health interaction between this developed country and developing countries this week, when the Nigerian Minister of Health, Professor Nwosu, visited a company in my constituency. The company, Micropharm, produces snake venom antidotes using sheep. We have a few sheep in Wales, but not so many snakes.
The sheep are not threatened and I am not talking about animal experimentation; they are simply used to produce the antibodies to the snake venom. Those antibodies are exported to developing countries, especially those in Africa. In Nigeria, 1,000 deaths a year are caused by the carpet viper. Micropharm produces the antidote to that snake's venom in my constituency.
Incidentally, Micropharm has a wonderful stock line. A bit like the Trotters' van, it says, "New York, London, Ffostrasol." That is a wonderful way to bring home to us all the international aspects of things that happen in our constituencies. I want to put on record my thanks to Professor John Landon, who was responsible for establishing that company and who works in those three towns, which are, of course, in three countries.
One of the difficulties is how to get our best technology and medical understanding into developing countries to help them. TRIPS is obviously designed to help by protecting patent rights to encourage companies to undertake research and development and to supply the
There are some difficulties with TRIPS however and some exemptions to the way that it works. I understand that an exemption can be made in national emergencies. I think that the United States Government used that exemption after the events of 11 September to increase the production of anthrax vaccine for its domestic market. One of the key issues that we need to consider is how we can ensure the domestic availability of medicines under the new TRIPS regime.
After 2005, developing countries that do not have a domestic capability for developing generic medicines will no longer be able to buy those generic drugs. That is my central concern. Countries that produce them now, such as India, will have to come under the TRIPS agreement by 2005. That leaves other developing countries to develop generic medicines for their own domestic markets, but I am not convinced that they will have developed the necessary capacity to do so by 2005 or even by 2016, which is the latest possible date for the least developed countries.
The problem was recognised at the WTO meeting in Doha in November where there was a declaration on TRIPS and public health. That declaration agreed that the primacy of public health over intellectual property rights should be protected and agreed the rights of Governments to use public health safeguards within TRIPS. The Doha declaration said:
I have received a suggestion from Oxfam as a possible solution to the problem. It is the removal of TRIPS restrictions on exports of public health-related products. Under article 30, the TRIPS agreement could be amended or interpreted in such a way as to allow countries to export generic versions to countries that cannot manufacture them themselves. That would be a simple way of overcoming the possibly temporary, but nevertheless real, difficulty that TRIPS in its present form may present for some developing countries. I understand that the European Commission in its own paper has more or less gone along those lines. The African Group has also called for a similar approach.
Hugh Bayley: I agree with the hon. Gentleman's approach. It will be necessary also to build in some mechanism that stops what the pharmaceutical industry would call parallel tradethe selling back of drugs from poor countries where they are available at low prices to rich countries. If that happened, pharmaceutical companies would not make the profits to pay for the research and development of drugs that we all want. Does the hon. Gentleman agree that that is an important nut to crack as well?
TRIPS does not just affect health; it affects access to knowledge, software and so on. It is important to emphasise, as all hon. Members have done, that if we are to achieve health improvements in developing countries, particularly in sub-Saharan Africa, it comes down to money. With TRIPS or any other agreement, it comes down to how much money we can release into development in those sub-Saharan countries. That, in turn, comes down to getting our 0.7 per cent. target and a timetable to achieve it on the Government's agenda. It may be on the agenda, but it has not yet been agreed.
Related to TRIPS is the General Agreement on Trade in Services. One side of the health coin is the provision of medicines and the other is the provision of public services, such as clean water and sanitation. There are some concerns with the current GATS negotiations, and I shall touch on them briefly. We have perhaps not yet had the opportunity in Parliament fully to scrutinise GATS. I am not aware of a debate having taken place in Westminster Hall or on the Floor of the House, yet there seems to be increasing pressure within the GATS regime. In theory, liberalisation does not necessarily lead to privatisation, so GATS should be at the heart of the way in which developing countries improve their economies. We have as much obligation to lower our trade barriers as those countries do to operate in an open and liberalised market, but that could lead to increasing emphasis on the privatisation of public services and we could exclude developing countries from the virtuous circle that we have achieved in this country.
I am slightly concerned that the United Kingdom has missed a trick in GATS. Given our increasing use of private health companies and the private finance initiative to meet our needs, it could be argued that GATS will start to affect our own public services. Whether or not one accepts that argumentthe Government obviously do notwe need a debate in the House on GATS. It is also clear from the report of the International Development Committee and an early-day motion signed by 262 MPs that we need an independent assessment of the way in which GATS affects services in this country and, more importantly, services in developing countries.
Finally, we must complete the circle. In a recent inspiring speech to the London School of Economics, Kofi Annan, the United Nations Secretary-General, talked about the road to sustainable development from Doha via Monterrey to Johannesburg which is bringing together trade, development and environmental issues in a unified package to support sustainable development and maximise our contribution to it. I want to draw the attention of the House to three key recommendations in the report of the Select Committee on Environmental Audit on which I serve. First, the world summit on sustainable development provides the best opportunity to establish a framework for integrating trade and sustainable development agendas. Although the Environmental Audit Committee does not agree, corporate social responsibility should be on the Johannesburg agenda, and we should work towards an international agreement on it. The Johannesburg summit should be the key reference point for future negotiations on TRIPS, GATS and so on.
Secondly, we need a better evaluation of the UN's commitment to the summit, as some countries are not pulling their weight. In particular, are we doing enough in the European Union to allow all countries fully to participate in the summit and have their voices heard? Finally, we must ensure that agreements on financing development, particularly those made in Monterrey, are linked to action plans agreed in Johannesburg. If we do not do so, Johannesburg will be just another talking shop. Whatever Rio's faults, our understanding of the environment is much clearer thanks to that summit than it was 10 years ago. In 10 years' time, this country's understanding of development issues and the alleviation of poverty should be as clear as our understanding of the environment post-Rio. We have an opportunity to begin that process in Johannesburg, but our understanding must be linked to serious action plans.