A/HRC/36/19 faced problems, with many medicines being unaffordable even in rich countries, threatening the sustainability of universal health systems. 31. Following the focus by many of the panellists on the Panel report, most representatives of States highlighted problems with the intellectual property regime and the current innovation model. Several representatives of States acknowledged that while the current model had led to progress, including extended life expectancy, there were a number of challenges, such as: high prices; market failures in addressing specific public health needs, particularly in developing countries; and the need for coherence among human rights law, intellectual property rights and trade and investment regimes. Many blamed policy incoherence for the disparities in access to medicines. As several delegations underscored, that was heightened by the limited production capacity of many developing countries and their subsequent dependence on foreign pharmaceutical companies. 32. Echoing some of the views of the panellists, several representatives highlighted the unaffordable prices of many medicines, particularly those used in the treatment of cancer and hepatitis C, which, as well as impeding individual access, threatened the sustainability of many health-care systems. Governments needed to continue to work with the industry and regulators to ensure that the development and use of new health technologies was accompanied by the delivery of more affordable treatments. They asked the panellists how they could pursue more transparency with regard to costs and pricing. 33. A number of representatives of States expressed strong support for TRIPS flexibilities, as had been affirmed in the Doha Declaration, which included the right to grant compulsory licences on a number of different grounds, such as public interest, and provided special treatment for least developed countries. Participants heard for instance how the Parliament of Fiji had just approved the ratification of an amendment to the Protocol amending the TRIPS Agreement. However, several representatives, including one from an NGO, drew attention to ongoing cases in which States were being pressurized because they were taking advantage of the flexibilities provided for in the Doha Declaration. The representative of the NGO specifically highlighted the impact of “evergreening” patents on reducing the enjoyment of human rights. The representative observed that the Panel report contained essential recommendations to address that and that countries should set vigorous standards to protect public health concerns regarding inventions and patents. Many representatives of States also asked the panellists to describe how the developing world could utilize TRIPS flexibilities to ensure the affordability of medicines and how their recommendations could be used to support ongoing cases in which the use of flexibilities by some States was under attack. 34. Representatives of several States also raised the issue of the difficulty of raising funding for certain medicines, particularly since the market-driven system failed to deliver treatments and diagnostics for “unprofitable” diseases that affected only a small section of the population or least developed countries. They spoke of the decline of global access to adequate sustainable and equitable financing of medicines, particularly in Africa. They asked the panellists for examples of possible actions or schemes that could finance medicines through public partnerships, improve the transfer of key technologies and investment to developing countries, and increase the demand for medicines through economies of scale to strengthen the global market and reduce prices. 35. In general, most representatives of States supported the Panel report, and they explicitly encouraged countries to implement its recommendations. According to one representative, the European Parliament had welcomed the Panel report and called on the European Union institutions and member States to take steps to implement its recommendations. Representatives of several States requested the Human Rights Council to call for the implementation of the Panel’s recommendations through enhanced cooperation among all United Nations funds and programmes, as well as specialized agencies, in order to support Governments to apply public-health-service criteria in ensuring access to medicines. Several representatives expressed appreciation for the recommendation for Governments to review, at regular intervals, the situation of access to health technologies in their countries in the light of human rights principles and State obligations, and the important role of the Council and OHCHR in following up on this. Many also reiterated the Panel’s recommendation that the Secretary-General initiate a process for Governments to 7

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