Intellectual property, trade, human rights and access to medicines in Africa: A Reader
by Atangcho N Akonumbo
ISBN: 978-1-991213-17-4
Pages: 523
Print version: Available
Electronic version: Free PDF available

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About the publication

Blurb:Intellectual property, trade, human rights and access to medicines in Africa: A reader by Atangcho N Akonumbo explores the current debates and conflicts pertaining to intellectual property (IP), trade and access to medicines in Africa as a public health issue, in a public health context. The Reader has a broad focus running across fourteen chapters. It examines the complex web of access to medicines, while introducing major concepts pertaining to access to medicines such as IP, trade, medicine and human rights, and provides a historical overview of the nexus between IP and human rights. It establishes the link between human rights, IP and access to medicines within the context of developing countries broadly and Africa in particular. The Reader discusses key flexibilities within the international IP framework championed by the TRIPS Agreement to enhance access to medicines, including compulsory licensing and parallel importation, while addressing impediments therein which provoked the Doha Declaration and arrangements thereafter. Also, it examines issues such as the implications of data exclusivity and linkage techniques; the role of anti-counterfeiting and competition laws in checking the effect of IP regimes; current threats to access to medicines at the international, regional and national levels such as the influence of regional or bilateral trade agreements; and research and development in respect of medicines for neglected and (re)emerging infectious diseases. It discusses the contributions of naturopathic and traditional medicines as parallel and complementary systems to modern medicine in the access to medicines landscape in the African context. The Reader further addresses the implications of the difficulty of access to medicines for women, children and other social minorities such as disabled persons and Lesbian, Gay, Bisexual, and Transgender (LGBT) persons.

This  Reader comes at a critical time, and potentially, a turning point in the history of public health crisis in Africa – when concerns about access to medicines have been heightened in the face of (re)emerging diseases and today the Covid-19 pandemic – a situation which has revealed gross lapses in public health governance. It is written in a simple language, making its content accessible to a wide audience. It contains informative and useful graphs, text boxes and illustrative excerpts from various primary and secondary sources. The  Reader is likely to become an invaluable tool for a wide range of persons and institutions, including academics, students, legal practitioners, health professionals, drug procurement agencies, civil society organisations and the public at large, involved or interested in the access to medicines discourse.

Table of Contents

About the author
Acronyms and abbreviations

Chapter 1
The problem of access to medicines in Africa: Setting the context and conceptual clarifications
1 Situating the discourse on access to medicines
2 Parameters and problems of access to medicines
3 ‘Medicines’; not just ‘essential medicines’
4 Definition of key terms
Chapter bibliography

Chapter 2
Introducing and situating intellectual property and
human rights in access to medicines
1 Introduction
2 Intellectual property and human rights
2.1 Intellectual property
2.2 Human rights
3 Linking IP and human rights
4 IP/access to medicines nexus and effect of IP on access
5 Economics of patents, monopoly, prices and access to medicines
6 Brief overview of the human rights framework for access to medicines
7 A human rights-based approach to access to medicines?
Review questions
Chapter bibliography

Chapter 3
TRIPS Flexiblties in the context of access to medicines: Compulsory licensing and parallel importation
1 Introduction
2 Compulsory licence (non-voluntary licence)
2.1 Rationale for issuing a compulsory licence
2.2 What is required?
3 Parallel importation
3.1 Embodiment of parallel importation under TRIPS
3.2 Effectiveness of parallel importations: lingering concerns
4 Lingering concerns on the effectiveness of compulsory licensing and parallel importation on access to medicines?
Review questions:
Chapter bibliography

Chapter 4
Article 31 of TRIPS and implications on access to medicines
1 Introduction
2 Understanding article 31 TRIPS: Scope
2.1 Preliminary observations
2.2 Forerunners of the article 31 solution: Articles 7, 8 and 30 TRIPS
2.3 Analyses of article 31 TRIPS
3 The initial difficulty under article 31
4 Way forward
Chapter bibliography

Chapter 5
Contributions of the Doha Declaration and key post Doha developments
1 Introduction
2 Reasons for the Doha Declaration
3 Status and scope of the Declaration
4 Key achievements of Doha Declaration
5 Post Doha developments
5.1 The ‘Paragraph 6 system’ – article 31bis TRIPS
5.2 Other post-Doha developments
6 Submission
Review question
Chapter bibliography

Chapter 6
Effect of data exclusivity and linkage
1 Introduction
2 Purport and uncertain scope of data protection
3 Scope of unfair commercial use under article 39(3) TRIPS
4 Duration of protection
5 Understanding data exclusivity and linkage
6 Why do drug companies want data exclusivity?
7 Opting out of data exclusivity
Chapter bibliography

Chapter 7
Addressing intellectual property barriers: Anti-counterfeiting and competition laws
1 Introduction
2 Anti-counterfeiting legislation and access to medicines – the Kenyan example
3 Competition law and access to medicines in South Africa
Chapter bibliography

Chapter 8
Impact of bilateral trade agreements on access to medicines: TRIPS plus provisions in FTAs
1 Introduction
2 State of the problem of trade and access to medicines
3 Justification for stiffer IP regimes in trade agreements?
4 Analysis of health-related provisions in FTAs and their impact
4.1 TRIPS-plus in the area of patent law
4.2 TRIPS-plus in the area of data protection
Chapter bibliography

Chapter 9
Options outside TRIPS to enhance access to medicines
1 Introduction
2 Alternative access to medicines measures
2.1 Aid
2.2 Donations and pharmaceutical company programmes
2.3 Pricing schemes
2.4 Support by civil society and NGO actions
2.5 Introducing low tariff schemes on medicines
2.6 Cost-containment mechanisms
2.7 Public, private partnerships in R&D: Developing Africa’s pharmaceutical industry
2.8 International cooperation and Assistance
Review question
Chapter bibliography

Chapter 10
Human rights duties to promote access to medicines in trade policies
1 Introduction
2 Centrality of the State in the enforcement of human rights
3 Basis of State’s duties to promote access to medicines
3.1. Duties arising under human rights law
3.2 Duties arising under IP law
4 Scope of states’ duty to ensure access to medicines
5 Bartering: Medicines for trade or trade for medicines?
6 Possible solutions
Chapter bibliography

Chapter 11
Gender, social minorities and access to medicines
1 Introduction
2 Explaining the non-discrimination and equality standard
3 The gender dimension in the access to medicines paradigm
3.1 The Human rights framework for gender-based access
to medicines for women
3.2 Barriers to women’s access to medicines
3.3 Overcoming the barriers to women’s access to medicines
4 Children in need of paediatric care
4.1 The peculiarity of children’s health situation
4.2 Brief over view of the general human rights framework for children’s access to medicines
4.3 Key challenges to access to medicines by children under paediatric care
4.4 Overcoming challenges: towards increased access
5 Persons with Disabilities (PWD) and access to medicines
5.1 Scope of, and approaches to disability
5.2 Disabilities health human rights framework
5.3 Challenges to access to medicines by PWD
5.4 Overcoming challenges
6 LGBT people and access to medicines
6.1 Legal framework for access to medicine for LGBT
6.2 Barriers to access to medicine by LGBT people
6.3 Overcoming barriers to LGBT people’s access to medicines
7 Perspectives for access to medicines for women and other social minorities
Review questions
Chapter bibliography

Chapter 12
Ensuring access to medicines in the context of the COVID-19 pandemic
1 Introduction
2 The COVID-19 dynamics
3 COVID-19 scare and the stockpiling syndrome
4 The hydroxychloroquine/chloroquine magic wand?
5 Some COVID-19 concerns
6 COVID-19 developing trends: contribution from the pharmaceutical industry
6.1 Modern medicine and challenges of a COVID-19 vaccine
6.2 Contribution of naturopathy and traditional medicine
7 Need for achieving global access
8 Options to enhance access to medicines in the context of COVID-19
8.1 Creation of a COVID-19 Technology Pool
8.2 Effective use of compulsory licences for export
8.3 Options for regional economic communities
9 Concluding remarks
Chapter bibliography

Chapter 13
Research and development for neglected and (re-)emerging infectious diseases
1 Introduction
2 ‘Neglected diseases’ and the problem of access to medicines
3 Typology of NDs
4 Socio-economic impact of NDs
5 Problems related to drug innovation for NDs in Africa
5.1 Some reasons for lack of new medicines for NDs
5.2 The problem of ‘new’ medicines for NDs
6 Human rights approach to R&D for NDs and EIDs
7 What prospects for R&D for NDs and EIDs?
7.1 Filling the funding gap
7.2 Lessons from India’s experience and India’s contribution to global efforts
7.3 Other gateways
7.4 Recent developments on R&D for NDs: the South African experience
7.5 What next?
Chapter bibliography

Chapter 14
Human rights institutions and strategies for access to medicines
1 Introduction
2 Relevant institutions and strategies
3 Thematic investigation of the role of NHRIs in the accessto medicines strategy
Chapter bibliography
General Conclusion

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