A/HRC/17/43 2 billion people2 (or one third of the world’s population) lack such access. Furthermore, more than 100 million people fall into poverty annually because of high health-care costs. In low- and middle-income countries, 50 to 90 per cent of the cost of medicines is paid by the patient, even though medicines account for 20 to 60 per cent of the health-care budget. The median coverage of health insurance is 35 per cent in Latin America, 10 per cent in Asia, and less than 8 per cent in Africa.3 Furthermore, only 5.2 of the 15 million persons living with HIV receive antiretroviral treatment. 6. The Special Rapporteur pointed out the positive examples of domestic courts in Latin America, South Asia and South Africa, which have abolished the distinction between civil and political rights, on the one hand, and economic, social and cultural rights, on the other, by recognizing the individual’s right to have access to medicines. He recalled the importance of the availability, accessibility, acceptability and quality of medicines, as well as equality and non-discriminative approach, indicating that special attention needed to be paid to women, children and marginalized groups. 7. The Special Rapporteur recalled that some issues relating to intellectual property laws threatened access to medicines. Current health inequalities demonstrated that States had to respect their obligations under international law, including laws and practices relating to intellectual property, and take into consideration the need to ensure access to affordable medicines for all. In this respect, the Special Rapporteur warned that the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), or at least its application by certain States, remained an impediment to greater access to medicines. In this respect, he noted the pressure of developed countries on least developed and developing countries to refrain from using the flexibilities that TRIPS provides for. He cautioned against new standards in the area of patent law in free-trade agreements such as TRIPS-plus, which threatened to compound this problem even further. He concluded that developing and least developed countries should be allowed to use TRIPS flexibilities. 8. Other issues brought up by the Special Rapporteur as crucial to facilitating access to medicines were calls to resist the establishment of anti-counterfeiting laws, rules and measures, and the setting-up of border controls. He noted the need to ensure that medicinerelated health priorities were not weakened in exchange for investment, and ensuring adequate drug regulations. In addition, he warned against the reduction of funding for medicines at the international and national levels, and lamented the lack of technology transfer, which is crucial for the long-term development of least developed countries. 9. Following the Special Rapporteur’s opening remarks, Stephen Marks of the Harvard School of Public Health recalled Commission on Human Rights resolution 1999/49 on the protection of human rights in the context of HIV/AIDS, in which the Commission reaffirmed that international agreements should not prevent Governments from taking measures to protect public health but rather encourage them to do so. Dr. Marks, who also chaired the High-level Task Force on the Implementation on the Right to Development, had been in charge of informing the Task Force on the attainment of Millennium Development Goal 8 on the development of global partnership development. He noted that the Task Force had devoted particular attention to target E on access to essential medicines, and had positive interaction with all stakeholders involved in this issue, including pharmaceutical 2 3 4 World Health Organization (WHO), The world medicines situation, World Health Organization, 2004, (WHO/EDM/PAR/2004.5), pp. 61–63. See also WHO, WHO Medicines strategy countries at the core 2004–2007, p. 2. World Health Organization, “Equitable access to essential medicines: a framework for collective action”, leaflet No. 8, WHO Policy Perspective on Medicines, Geneva, March 2004. Available from http://apps.who.int/medicinedocs/pdf/s4962e/s4962e.pdf. GE.11-11842