A/HRC/37/74 50. During the interactive dialogue, the moderator and representatives of Ecuador, Nigeria, UNAIDS and the World Social Forum took the floor. They raised points related to examples of local good practices on key populations’ access to health, taking into account local expertise and experience to provide inputs when planning global policies, and questions on how to bring big business to the table and negotiate in a context of power asymmetries at the global level. Some participants mentioned legal issues such as law as a determinant of health, and the importance of imposing the duty to grant access to basic medicines. 51. Mr. Zellweger described the transition of drug policies to harm reduction, a practice promoted by Switzerland in its foreign cooperation. Laws that were based on human rights and the promotion of gender equality were determinants of health. Evidence-based policies should be applied, even when they ran contrary to certain cultural behaviours. Mr. Thomas reflected on plurilateral and bilateral dialogue by emphasizing the work of Partners in Population and Development to facilitate the sharing of information to solve issues related to health, access to medicines and ageing populations. Mr. Yu considered that law could shape society, making it a determinant of health, for good or for bad. In developing countries, any changes in laws required in order to qualify for aid should be implemented in full respect of rights, local officials and the role of the State. He called for the implementation of the right to development. Panellists welcomed the Sustainable Development Goals and related recent agreements as major achievements on international cooperation, and called for further cooperation to implement them. I. Access to medicines, diagnosis, vaccines and treatment in the context of the right to health 52. The Chief Executive Officer of the World Hepatitis Alliance, Raquel Peck, argued that the development of lifesaving medicines for hepatitis C had created hope for those affected by that condition. However, extremely high medicine costs had left many behind; indeed, only 1.5 million out of the 75 million who were infected had received treatment. She gave some specific examples of advocacy by communities that had expanded the right to access to medicines. NOhep was a global movement that aimed at the elimination of hepatitis by empowering communities. Eliminating hepatitis went beyond the right to health; it required steps to be taken to reduce inequalities, address poverty and tackle stigma and discrimination. As technical solutions existed, no one should be dying from that epidemic. 53. The Intellectual Property and Access to Medicines Lead at the International Treatment Preparedness Coalition, Othoman Mellouk, praised the decision of the Government of Malaysia to issue the first compulsory licence under trade-related intellectual property rights (TRIPS) flexibilities for sofosbuvir, an expensive drug for treating hepatitis C. That had been the result of actions by local civil society organizations. Many middle-income countries were excluded from licences and prices arrangements and had lower treatment coverage rates than lower-income countries. Civil society organizations and communities had challenged big pharmaceutical companies despite the power asymmetries. Developed countries were, on behalf of big pharmaceutical companies, pushing for restrictive intellectual property demands in bilateral and plurilateral trade treaties, with potentially adverse effects for the world’s poor. He called for stronger international and national rights frameworks for a paradigm shift on the right to access medicines. 54. Senior Researcher for the Global Health Unit of the University Medical Centre Groningen, Ellen ´t Hoen, said that the distinction between communicable and noncommunicable diseases was artificial, as one group often caused diseases under the other group. The right to health implied that States had the duty to ensure the availability, accessibility, acceptability and good quality of medicines. Intellectual property norms should be interpreted in a manner supportive of States’ human rights obligations. States had a duty to use TRIPS flexibilities when it was necessary to ensure the right to access to medicines. Echoing the United Nations High-level Panel on Access to Medicines, she called for a coalition of like-minded countries to exert pressure for a global agreement on 14