A/HRC/29/44 and partnerships with the private sector. While those provided short-term solutions, the only long-term sustainable solution was total integration into national health systems. 52. Soraya Ramoul, Director, Access to Health, Novo Nordisk, described the company’s efforts to promote access to medicines for the treatment of diabetes. Many people with diabetes resided in low and middle-income countries. Novo Nordisk provided half of the insulin worldwide. It employed differential pricing policies so that patients in developing countries paid one quarter of the price paid in developed countries. However, access was not simply a matter of affordability. It also required strong health delivery systems including sufficient and adequately trained medical personnel. Local prices might differ from initial purchasing prices because of supply chain problems, price mark-ups, import duties and taxes. Further efforts were needed to ensure that prices offered to patients were affordable and also sustainable from a business perspective. Better implementation of the right to health in the private sector context required translation of technical human rights language into business language. 53. James Love, Director, Knowledge Ecology International, recommended drastic changes to existing models of research and development and intellectual property rights. The prevailing system had failed to promote access and was fundamentally unfair. It created patent monopolies, vesting power and profits in private hands. Corporate lobbying to protect those interests contributed to regulatory arbitrage and perpetuation of the status quo. That system valued profits over human well-being and failed to achieve its stated objective of promoting innovation, particularly in research and development for treatment of diseases that disproportionately impacted the poor and the vulnerable. He argued for changes to the intellectual property regime, improved incentives for underfunded areas of research and development, mobilization of innovative sources of finance, increased scrutiny by the Human Rights Council, particularly in applying the right to development in relation to intellectual property rights, and innovative approaches to research and development. Mr. Love advocated deep, radical and transformative reforms that would delink research and development costs from product prices along with the elimination of product monopolies, in favour of other financing mechanisms, including combination of research grants, contracts and other subsidies and delinked financial incentives, including robust funding of large innovation inducement prizes for HIV/AIDS and cancer as well. 54. Esteban Burrone, Head of Policy, Medicines Patent Pool, described the evolution and work of that initiative. WHO first proposed the idea of a patent pool in 2008 as part of its global strategy on public health and innovation. After a feasibility study by the International Drug Purchase Facility (UNITAID) (“Innovative financing to shape markets for HIV/AIDS, malaria and tuberculosis”), which was welcomed by the Human Rights Council at its fifteenth session, the Medicines Patent Pool was set up to promote access to medicines for HIV treatment through resource pooling and voluntary licensing. Since 2010, that entity had negotiated licences for 11 antiretrovirals with five patent-holders. It worked with 10 generic manufacturers through 53 sublicensing agreements to improve access to antiretrovirals in low and middle-income countries where up to 94 per cent of people living with HIV resided. Patent pool licences had been recognized for their public health orientation, transparency and flexibility. Within four and a half years, the Pool had contributed to opening up the market for first and second line antiretrovirals. It was exploring expansion to cover tuberculosis and hepatitis C. 55. Smiljka de Lussigny, HIV Programme Manager, UNITAID, discussed that initiative’s focus on innovative access to medicines. UNITAID used innovative financing, a major portion of which came from a levy on air tickets, for greater access to treatments and diagnostics for HIV, malaria and tuberculosis in low-income countries. It focused on maximizing available resources for the promotion of access by mobilizing resources and promoting their effective use. Affordability posed a substantial barrier to access, 16

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