A/HRC/17/43 highly innovative priority new medical entities.7 Medicines were thus insensibly modified, and thereafter patented, needlessly making them more costly. In this respect, the patent system needed to change, to prevent the overpricing of drugs that were only slightly different from already existing ones. 41. During the discussion, some State representatives expressed concern that too much responsibility was placed on Governments, and too little on international organizations and pharmaceutical companies. It was especially difficult for developing countries to reconcile human rights with trade concerns, while developed countries pressure them not to use the flexibilities provided for in trade agreements. On the other hand, it remained unclear whether pharmaceutical companies had a true incentive to fulfil human rights, and this, according to some countries, was an overarching issue. Other State representatives still emphasized the important role of generic medicines in setting the price and opening the floor to competition, and wondered whether the time frame for patents could not be reviewed in the interest of public health. In addition, some State representatives underlined the importance of traditional medicine. Drug supply chains, insufficient and inequitable pricing, inappropriate prescriptions, poor medicine selection and information on access to medicines, weak accountability and low public participation were all sources of considerable concern. Several countries noted that price differentiation should also take into account that some countries that were not considered least developed should nevertheless enjoy price differentiation, owing to the high prevalence of a disease tied to their climate or other unique factors. 42. In response to these observations, Dr. Marks reiterated the potential role and function of regional organizations, some of which had already noted and discussed all the issues considered during the expert consultation. He agreed with the fact that, while 90 per cent of the poor lived in low-income countries, they were dispersed, and three quarters actually lived in middle-income countries and Europe. Thus, the differentiation not only between poorest countries on the international level but also between rich and poor on the country level needed to be taken into account. 43. In his concluding remarks, Mr. Dasgupta raised the issue of the impact of climate change on health and the fact that some countries in North America could be facing malaria, dengue fever and other diseases commonly thought of as “third world” diseases or diseases prevalent in least developed and developing countries. This “migration” of diseases could change the world’s perspective on the importance of access to medicines, their price and patent-related context. IV. Conclusions and recommendations 44. The right of everyone to the enjoyment of the highest attainable standard of health encompasses access to medical services and the underlying determinants of health, such as water, sanitation, non-discrimination and equality. As access to medicines is an integral and fundamental part of the right to health, Governments and the international community as a whole have a responsibility to provide access to medicines for all. Yet massive inequalities remain in access to medicines around the world, as up to 2 billion people (or one third of the world’s population) lack access to essential medicines. Most of them live in low- and middle-income countries, where the needs of persons living in poverty, women, children and undocumented migrants, as 7 12 National Institute for Health Care Management Research and Educational Foundation, Washington, D.C. “Changing patterns of pharmaceutical innovation”, May 2002, p. 3. Available at nihcm.org/pdf/innovations.pdf. GE.11-11842