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The price of Cambodia's WTO
entry
By Marwaan Macan-Markar
BANGKOK - After an eight-and-a-half year quest,
Cambodia has finally gained admission into the World
Trade Organization (WTO) - sparking a debate over
whether membership will be a panacea or bitter pill for
this poor Southeast Asian nation.
The decision
on Thursday by ministers attending the 146-nation WTO
meeting in Cancun, Mexico, to approve both Cambodia's
and Nepal's applications marks the first time the
organization has opened its doors to least developed
countries (LDCs) since it was established in 1995.
By gaining membership in the Geneva-based WTO
starting next year, Phnom Penh hopes to give a boost to
the mainstay of its export sector - garments.
Officials from the garment trade, which
contributed some 85 percent of the country's US$1.5
billion in export revenues in 2002, have said that WTO
membership will help Cambodia to attract more investment
to an industry that employs more than 200,000 people.
However, international humanitarian agencies
such as Oxfam and Medecins Sans Frontieres (MSF) are
worried by the impact that being bound by WTO rules will
have on 170,000 Cambodians living with the human
immunodeficiency virus (HIV) that can cause AIDS.
At the heart of their concern are the new trade
rules on access to essential medicines that will come
into force almost immediately after Cambodia becomes a
member. Critics have said this will strangle the
lifeline - generic anti-retroviral (ARV) drugs - that
those with AIDS need.
"It is going to be hard
for Cambodia to get medicines at affordable prices, and
that is the price Cambodia will pay immediately for the
dubious benefits of joining this club of trading
nations," said Alex Renton, spokesperson for Oxfam's
Southeast Asia office.
The reasons are varied,
according to background papers by Oxfam and MSF prepared
on the eve of the WTO ministerial meeting. For one,
these analyses say, Cambodia will not be entitled to the
benefits given to the 30 LDCs that have been with the
WTO since its inception.
"Cambodia has been
forced into immediately halting the use of affordable
generic versions of new medicines, even though the Doha
declaration allows LDCs to wait until at least 2016 to
implement this complicated and far-reaching agreement,"
says Oxfam's report, "Cambodia's Accession to the WTO:
How the Law of the Jungle is Applied to One of the
World's Poorest Nations".
At the last WTO
ministerial meeting, held in Doha, Qatar, in 2001,
member governments agreed in the wake of growing
pressure from poor countries hit by HIV/AIDS,
humanitarian agencies and activists to reconsider its
rules on Trade Related Aspects of Intellectual Property
Rights (TRIPS).
The outcome was the Declaration
on the TRIPS Agreement and Public Health, which
underscored the need to place people over profits when
it came to dispensing medicines to patients afflicted by
killer diseases such as AIDS in the developing world.
It meant that countries could in the event of
medical emergencies work around costly patent-protected
ARVs produced by the giant pharmaceutical multinationals
by either importing or producing cheaper, generic
versions of the anti-AIDS drugs.
A cheap-drug
deal was reached among WTO members ahead of the Cancun
meeting, supposedly aimed at easing stringent patent
rules in order to allow poor countries access to drugs
for public health needs.
But Oxfam says it is of
little use because of the complex conditions poor
countries are expected to follow if they want to benefit
from generic drugs.
"The case of Cambodia's
accession not only demonstrates how some [WTO] members
are completely disregarding their Doha commitments, but
also sets a dangerous precedent for other developing
countries wishing to join the WTO," MSF argues in its
background paper.
Compounding these concerns is
another factor: Cambodia's main supplier of generic
anti-AIDS drugs, India, is due to become TRIPS-compliant
by 2005 - and this will cut off the country's current
supply line of more affordable drugs.
Little
wonder, then, that the prospect of cheap anti-AIDS drugs
drying up has begun to unnerve some of the country's
public health officials. "This is a big concern in
Cambodia, gaining access to generic drugs and to
distribute it to the patients," said Dr Tia Phalla,
secretary general of the National AIDS Authority.
The magnitude of these concerns can be
understood in light of Cambodia's HIV-prevalence rate of
more than 2 percent, the highest of any country in Asia,
according to a report by the United Nations Economic and
Social Commission for Asia and the Pacific (ESCAP).
There are more than 170,000 people living with
HIV in Cambodia. But the National AIDS Authority says
only 700 patients have access to the generic anti-AIDS
drugs distributed by humanitarian agencies and
non-governmental organizations.
The limited
number of those with HIV who are on ARVs is in keeping
with the average across the Asian continent, where only
4 percent, or about 43,000, of the 1 million who need
the medication have access to it, states the ESCAP
study.
"Worldwide, less than 10 percent of
HIV/AIDS patients have access to ARVs," said Paul Toh,
an adviser at the Southeast Asia office of the Joint
United Nations Program on HIV/AIDS (UNAIDS). "Countries
like Cambodia are very reliant on imported generic drugs
for their HIV/AIDS patients. To produce ARVs for all its
patients would cripple the public health budget."
Yet, critics say, pharmaceutical companies in
industrialized countries rake in huge profits when
governments enforce trade rules to protect the patents
of the brand-name drugs the multinationals produce.
According to a US-based website that lobbies for
affordable health care, the pharmaceutical industry is
one of the most profitable industries in the United
States. "Sales of ARVs alone roughly total $3 billion a
year," it reveals.
"High prices have been the
single biggest obstacle to providing ARV drugs to people
living with HIV/AIDS," states the ESCAP report. "The
main patent-holding manufacturers resisted calls for
lower prices and were reluctant to license production to
other manufacturers."
(Inter Press
Service)
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