A/HRC/29/44
low-cost generic pharmaceuticals as crimes against humanity. Others called on the Human
Rights Council and special procedures mandate holders to focus on access to medicines.
They supported a holistic, people-centred and community-driven approach to health. That
would include innovative efforts to address neglected diseases, like multiple drug-resistant
tuberculosis, that disproportionately impacted on the poorest and most vulnerable, and to
promote improved governance mechanisms, particularly for regulatory oversight and
accountability of multinational corporations. The question was raised as to whether or not
efforts to promote access had gone far enough to seek alternatives to market-based
approaches.
49.
In their concluding remarks, the panellists supported further integration of human
rights considerations in access to medicines. Ms. Lim stressed the need to integrate human
rights principles throughout procurement processes. She noted that the concept of middleincome countries was an artificial one and that access to medicines should not be dictated
by the economic status of a country but by the needs of people, and that the Global Fund to
Fight AIDS, Tuberculosis and Malaria was supporting the strengthening of health systems
in a number of countries. Citing the work of the Committee on Economic, Social and
Cultural Rights, Ms. Kähler asserted that the right to health required access to all medicines
not only essential medicines. Mr. Adlide clarified that Gavi only supplied vaccinations
through governments; responded to requests from governments; worked to reduce prices
and emphasized transparency in its operations. Mr. Malpani decried continued mispricing
of vaccines, called for rendering access to medicines sustainable and reiterated that middleincome countries faced substantial challenges in improving access.
J.
Good practices in promoting access to medicines (round table)
50.
Mr. de Felice described the Access to Medicine Index, a ranking of the world’s
20 largest research-based pharmaceutical companies on the basis of what they did to
facilitate access to medicine in developing countries. He noted that there was hope, that
there were good practices, and that the Index, by drawing attention to corporate behaviour,
could influence businesses to exercise greater responsibility. The Index compared
corporations on the basis of their performance over time with regard to multiple factors,
including but not confined to governance, pricing, patents, local stakeholder engagement,
capacity-building and donations. Although progress was uneven, the Index indicated that
the pharmaceutical industry had stepped up its efforts to improve access to medicine in
developing countries. A competitive environment that not only held pharmaceutical
companies accountable when required, but also recognized their efforts and
accomplishments, would help advance access to medicines.
51.
Sathyanarayanan Doraiswamy, Senior Reproductive Health/HIV Coordinator,
Office of the United Nations High Commissioner for Refugees (UNHCR), described
UNHCR work to ensure access for refugees and other persons of concern. When people
were forcibly displaced across national borders, they became refugees, often with limited
access to health care in countries of asylum. UNHCR efforts to promote health care for
refugees were guided by its global strategy for public health and its guidelines on essential
medicines and medical supplies. Those addressed the needs of persons in differing phases
and contexts including acute emergencies, protracted displacement and in their pursuit for
durable solutions. The two main models for providing health care were direct integration in
national systems of host States and integration to the maximum extent possible combined
with support from UNHCR and non-governmental organizations. UNHCR pursued various
methods to promote access, including: provision of emergency health kits, collaboration
with national AIDS programmes to support antiretroviral treatment, research programmes
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