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extracted text
Intellectual Property Rights Series

Imports by and Exports to
Countries with Insufficient or
No Manufacturing Capacities in
the Pharmaceutical Sector
Measures Required by the WTO Decision of
30 August 2003 in Relation to the
TRIPS Agreement and Public Health

TWN
Third World Network

8

Imports by and Exports to Countries with
Insufficient or No Manufacturing Capacities
in the Pharmaceutical Sector
Measures Required by the WTO Decision of 30 August 2003
in Relation to the TRIPS Agreement and Public Health

TWN
Third World Network

Imports by and Exports to Countries with
Insufficient or No Manufacturing Capacities
in the Pharmaceutical Sector
Measures Required by the WTO Decision of 30 August 2003 in Relation
to the TRIPS Agreement and Public Health
is published by
Third World Network
121-S, Jalan Utama
10450 Penang, Malaysia.

© Third World Network 2005

Printed by Jutaprint
2 Solok Sungei Pinang 3, Sg. Pinang
11600 Penang, Malaysia.

ISBN: 983-2729-52-1

CONTENTS
1

(a)

Overcoming the TRIPS Restriction on
Pharmaceutical Imports by and Exports to
Countries with Insufficient Manufacturing Capacity
Background to the “Paragraph 6” issue in the Doha Declaration

on the TRIPS Agreement and Public Health

b)

1
1

Problem of countries with insufficient or no manufacturing
capacities

1

(c)

In search of a solution

2

(d)

The Decision and Statement

4

2

Conditions and Measures for Implementing the
Waiver to the TRIPS Restriction

5

(a)

Countries and situations where the waiver is not required

5

(b)

General situation where the waiver is required

6

(c)

Measures required by the importing country

7

3

Measures Required by the Exporting Country

(a)

Notify the WTO

10

(b)

Conditions of the compulsory licence

11

(c)

Payment of compensation

12

(d)

Regional arrangements

12

4

Additional Requirements under the WTO
General Council Chairperson’s Statement

13

Comment on the ‘Dampening Effect’ of the
Conditions and Procedures in the Decision and
Chairperson’s Statement

15

5

6

Limited Area of Applicability of the Decision

17

7

Conclusions

19

References

22

Annex 1

23

Annex 2

29

Annex 3

30

Annex 4

33

NOTE
This report is on the measures required by countries lacking drug manufactur­

ing capacity and wishing to import generic drugs and measures required by
countries able and willing to export generic drugs and wishing to overcome the

constraints imposed by TRIPS Article 31(f) that production under compulsory

licence has to be supplied predominantly for the domestic market. It is based on
the Decision of 30 August 2003 adopted by the WTO General Council.
This report is a supplement updating the Manual on Good Practices in Public-

Health-Sensitive Policy Measures and Patent Laws, published by the Third
World Network.

1
(a)

Overcoming the TRIPS
Restriction on Pharmaceutical
Imports by and Exports to
Countries with Insufficient
Manufacturing Capacity

Background to the “Paragraph 6” issue in the Doha Declaration on
the TRIPS Agreement and Public Health

THE Doha Declaration on the TRIPS Agreement and Public Health adopted in

November 2001 states that the TRIPS Agreement “does not and should not”
prevent Members from taking measures to protect public health, and affirmed

that the Agreement can and should be interpreted and implemented in a manner

supportive of the WTO Members’ right to protect public health and promote

access to medicines for all.

The Declaration confirmed the right of developing countries to use compulsory
licences (CLs) to override patents on medicines, in order to allow generic drug

manufacturers to produce cheaper versions of patented medicines.

(b) Problem of countries with insufficient or no manufacturing
capacities
However, at the Doha Ministerial meeting, there was also a recognition of a
particular problem. Countries that want access to cheaper generic drugs but do

not have the capacity to produce their own drugs will have to rely on imports of
the generic drugs. An option for these countries is to grant a CL or a “govern­
ment use” order for the import of such drugs. However these countries may

find it difficult to obtain the drugs because the TRIPS Agreement limits the
amount of generic versions of patented drugs that a country (that has the capac­

ity to produce them) may export. This is because the TRIPS Agreement (Ar-

tide 31(f)) requires that the production of generic drugs under a CL is “pre­

dominantly for the supply of the domestic market".

This restriction means that only a limited amount of the generic drugs produced
under CL in a country can be exported, since a “predominant" portion of the
output must be supplied to the domestic market. The portions that are allowed

to be exported by the countries that can produce may not be sufficient to meet
the needs of the countries wishing to import. Thus countries lacking production

capacity and that would like to use compulsory licensing to import could find it
difficult or impossible to obtain the required amounts of affordable medicines.
Whilst the Ministers recognized the problem, they were unable to agree to a
solution, and they therefore delegated the task of finding “an expeditious solu­

tion” to the WTO’s TRIPS Council.

Paragraph 6 of the Doha Declaration states: “We recognize that WTO Members
with insufficient or no manufacturing capacities in the pharmaceutical sector

could face difficulties in making effective use of compulsory licensing under
the TRIPS Agreement. We instruct the Council for TRIPS to find an expedi­
tious solution to this problem and to report to the General Council before the

end of 2002.”

(c)

In search of a solution

After the Doha meeting, the WTO members spent many months trying to find

common ground for a solution. A few major countries suggested that they could
agree to a temporary waiver to the Article 31 (f) restriction for developing coun­
tries, provided the scope of diseases was limited, and that the waiver be only for

national emergencies or in circumstances of extreme urgency. These conditions
were unacceptable to the developing countries, which argued that they would

detract from what had been achieved in the Declaration, which did not restrict

the scope of diseases in its coverage, and did not restrict its application only to
national emergencies.

2

On 16 December 2002, the Chair of the TRIPS Council produced a text con­
taining a proposed solution, which was accepted as a compromise by almost all

Members except the United States. The deadline was thus missed. Negotiations
then stalled on the proposed solution, known as the December 16 text.

On 30 August 2003, the WTO General Council finally adopted the original 16
December text, together with an accompanying Statement by the Chair of the

WTO General Council. The 30 August documents are known as “Implementa­
tion of Paragraph 6 of the Doha Declaration on the TRIPS Agreement and Pub­

lic Health: Decision of 30 August 2003”, and “The General Council

Chairperson’s Statement”.
The 30 August Decision is in the nature of a “temporary solution” as it also

mandates that work be carried out to amend the TRIPS Agreement, to be initi­
ated by the end of 2003 with a view to its adoption within six months, i.e. by the

end of June 2004. This deadline has been missed, and a new deadline was fixed
for March 2005.

The 30 August “temporary solution” is in the form of an interim waiver to the

Article 31(f) restriction, such that countries producing generic versions of pat­
ented products under CLs would be allowed to export the products to eligible
importing countries, without having to limit the exported amount, as the condi­

tion that the output must be “predominantly for the domestic market” is waived.
However, the Decision also obliges importing and exporting countries that wish

to make use of the waiver to undertake several measures and fulfill several

conditions. It has been pointed out by some experts and NGOs that these mea­
sures and conditions are difficult for the relevant companies and governments
to comply with. As a result, the Decision is hardly an “expeditious solution”, as
called for by paragraph 6 of the Doha Declaration.

Below is a brief explanation of the Decision and Chairperson’s statement, and
an outline of the measures that countries are required to follow, should they
wish to import or export under the waiver. Whether the set of measures can be
3

implemented easily, or proves too complicated and difficult to implement re­
mains to be seen.

(d) The Decision and Statement
The Decision of 30 August 2003 covers pharmaceutical products, active ingre­
dients necessary for their manufacture, and diagnostic kits.
The “solution" is an interim waiver of the Article 31 (f) limitation on exports. It

revokes the requirement that pharmaceutical products produced under a CL

shall be “predominantly for the supply of the domestic market”. The waiver

allows a predominant portion or even the entire quantity of output produced
under a CL to be exported to countries that are “eligible” to import under the
scheme.
The Decision was accompanied by a statement by the General Council Chair,

which had been drawn up after intense consultations among a few members in
the weeks before the end of August. The Chair’s statement elaborates on some

“key shared understandings” of how the Decision would be interpreted and

implemented. The statement, which places more conditions in addition to those
in the Decision, was an attempt to provide some language that would be accept­
able to the United States, whose big pharmaceutical companies were concerned

that the Decision would give be advantageous to the producers of generic drugs,

which are their rivals.
The Statement states that Members recognize that the system established by the

Decision “should be used in good faith to protect public health” and “not be an

instrument to pursue industrial or commercial policy objectives.” It also states
that “all reasonable measures” should be taken to prevent diversion of medi­
cines from the markets for which they are intended, and elaborates on the trade

diversion prevention measures that are required to be taken by countries using
the Decision.

4

Conditions and Measures for
Implementing the Waiver to
the TRIPS Restriction

2
(a)

Countries and situations where the waiver is not required

THE special measures required to obtain a waiver to Article 31(f) of the TRIPS

Agreement need not be applied in countries and situations where such a waiver

is not needed. Examples of these are as follows:
(i)

Countries wishing to produce and export a generic pharmaceutical prod­
uct can do so without a CL if there is no patent in force on the product. In
this case, there is no limit to the export.

(ii)

Where a generic version of a patented pharmaceutical product is being

produced under CL in a country, the generic product can be exported in

amounts up to the level where the output would no longer be “predomi­
nantly supplied for the domestic market.” Up to this level, the special
measures required under the 30 August Decision need not apply. For

amounts to be exported above this level, the special measures will have to
be applied. It should be noted that the TRIPS Agreement does not define

the meaning of the term “predominantly”.

(iii)

If a country wishes to import a generic version of the product, the import­

ing country can do so without having to resort to the special measures

required for the waiver (such as notification to the TRIPS Council) if it is
able to find a foreign supplier of the generic product where:

-

the product is not patented in the supplying country; or

-

the product is under patent in the supplying country, and the

country has issued a CL enabling production of the generic product,

and the output is predominantly supplied to the domestic market (even

after taking into account the new amount to be exported).

NOTE: A country wishing to import a generic product need not issue a CL to
import if there is no patent in force on the product in the country.

In this

context, it is important to note that LDCs need not allow for drug patents until
2016. However, if a patent is in force on the product in the country, then the

country is required to issue a CL in order to import. Whether the importing
country requires a CL to import is a separate issue from whether the exporting
country requires a waiver in order to export.

(b) General situation where the waiver is required
The objective of the Decision is to allow for countries wishing to import ge­

neric medicines to do so from a foreign generic producer, without the latter
being constrained by having to produce under CL “predominantly for the do­
mestic market.”
Where a patent is in force in the importing country on the drug in question, the

importing country government will have to issue a CL to enable the import of

the generic version of the patented drug. In the exporting country, if a patent is

in force, then the generic manufacturer would have to obtain a CL to produce
the drug and export it.

Therefore, in many cases, two CLs will have to be issued. Under the TRIPS
Agreement and confirmed by the Doha Declaration, WTO Members have the
right to determine the grounds for the grant of CLs. The standard procedural

conditions for the grant of CL are set out in the TRIPS Agreement (Article 31),

which includes the condition that an application for a CL should be preceded by
a failed attempt to obtain a voluntary licence from the patent holder, and the
condition that the person or agency obtaining the CL payment should pay com­
pensation to the patent holder.
6

The Decision modifies some of these requirements and sets out another set of
procedures to be complied with, when the waiver of Article 31(f) is required to

allow for generic medicines made in one country to be exported to another.

(c)

Measures required by the importing country

When a developing country wishes to import a generic product, and a waiver is

required by the exporting country (because it would no longer be producing
predominantly for the domestic market), the importing country will have to do
the following:

(i)

Notify the WTO

The country has to notify the WTO’s TRIPS Council of its intention to use the

solution as an importer. The notification must:



Specify the names and expected quantities of product(s) needed;



Confirm that it has established that it has insufficient or no manufac­

turing capacities in the pharmaceutical sector for the product in ques­

tion. However, LDCs need not make such a confirmation. (See Para
2 below for ways to establish this lack of capacities);


Confirm, where the product is patented in the country, that it has
granted or intends to grant a CL in accordance to TRIPS article 31

and this Decision (Decision, Para 2 (a)).
An important footnote in the Decision states that: “It is understood that this

notification does not need to be approved by a WTO body in order to use the

system set out in this Decision.” Thus, whilst importing countries have to no­
tify, the notification will not be subjected to the need for approval.

(ii) Establish insufficient or no manufacturing capacities.
As part of the notification, the importing country has to establish it has insuffi­
cient or no manufacturing capacities. LDCs are automatically deemed to qualify

and thus need not establish their lack of capacity. Other developing countries
7

have to establish either that:


they have no manufacturing capacity in the pharmaceutical sector;
or



the capacity is currently insufficient for the purpose of meeting its

needs. (Annex to the Decision).
The assessment that the country has no or insufficient manufacturing capacity

is for the particular pharmaceutical product required, and not for pharmaceuti­
cal products in general. The importing country can either establish that it has

no manufacturing capacity, or that it has some pharmaceutical manufacturing
capacity but has found that (excluding the capacity owned or controlled by the

patent holder) it is presently insufficient to meet its needs.
Under the Decision, countries are to make this determination themselves. There

are no criteria or methods to establish the lack of capacity of insufficient capac­
ity. The Chair’s statement says that notification by the importing country would

include information on how it has established that it has insufficient or no manu­

facturing capacities in the pharmaceutical sector. However the outcome of the
self-assessment cannot be challenged by other Members or be subject to review

or rejected by the TRIPS Council (Correa 2004, pl7).

(iii) Take measures against trade diversion
Importing countries shall take “reasonable measures within their means” to

prevent re-exportation of the products that have actually been imported under
the system, as “proportionate to their administrative capacities and to the risk
of trade diversion”. Developed countries shall provide, on request, technical

and financial cooperation to countries having difficulty implementing this pro­
vision (Decision, para 4).

(iv) Grant a CL to import
Where the product is patented in the country, and there is an intention to import

a generic version of it, the government has to grant a CL to import. According
8

to the Decision, the grant of the licence should be in accordance to TRIPS

Article 31 and this Decision.

(v)

Payment of compensation waived

Where a CL has been granted by the importer, and the exporting member has

also issued a CL for the same product, the exporting country has to pay ad­
equate compensation to the patent holder, but the obligation of the importing
country to pay compensation under Article 31(h) shall be waived (Decision,

para 3).
The national law should specify that in the case of granting a CL for import

under the Doha Declaration Paragraph 6 situation (i.e. when the country does
not have adequate manufacturing capacity for the particular drugs), compensa­
tion to the patent holder is waived.

NOTE: The Decision notes that 23 developed countries will not use the sys­
tem set out in the Decision as importing Members. The Chairman’s Statement

also notes that 11 countries (Hong Kong China, Israel, Korea, Kuwait, Macao
China, Mexico, Qatar, Singapore, Chinese Taipei, Turkey, United Arab Emir­
ates) agreed they will only use the system as importers in situations of national
emergency or other circumstances of extreme urgency, as will the 10 countries

EU accession countries (and on joining the EU, these countries will opt out of
using the system as importers).

9

3

Measures Required by the
Exporting Country

THE importing country will need to locate a generic manufacturer that is will­
ing and able to supply the medicines required. The generic manufacturer will

require a CL if the medicine is under patent protection in its country. Any WTO
members (including the developed countries) may grant a CL to its domestic

generic manufacturer to produce and export to the importing country under the
scheme.

The obligations of an exporting Member under Article 31(f) of TRIPS shall be
waived with respect to a CL granted by it, to the extent necessary to produce

pharmaceutical products and its export to an eligible importing member.
The terms and requirements include the following:

(a)

Notify the WTO

When a government decides to grant a CL, it must notify the WTO’s TRIPS

Council of the grant of the CL and its conditions, including the name and ad­
dress of the licensee, the product(s), the quantities for which it has been granted,

the importing countries to which the product is to be supplied, and the duration
of the CL, as well as the address of the website on which information regarding

the product has been posted.

An important footnote states that this notification does not need to be approved

by a WTO body in order to use the system under the Decision.

(b) Conditions of the compulsory licence
The CL issued under the Decision must be subject to the following conditions:

(i)

Only the amount needed by the importing Member may be manufactured

under the licence, and all of this output must be exported to the importing

country.

[Note: The amount needed to be supplied is to be established by the importing
country, which makes the order to the exporting country. To avoid transaction

costs and delays in obtaining a CL, it is possible to consider the granting of an
amendable CL that expands the amount to be supplied based on subsequent
requests by the importing country or countries (Correa 2004, p22).J

(ii)

The products produced under the licence must be clearly identified as be­

ing produced under this system through labeling or marking (e.g., special
packaging and/or colouring/shaping of the products) provided such dis­

tinction is feasible and does not significantly impact on price.

[Note: The Decision recognizes that the labeling or marking required may in
some cases have a significant impact on price. The impact of price can also be
assessed from the importing country’s perspective, since the price would have
an effect on access to the drug. The Decision does not specify who should make

the assessment on whether the impact is significant. It is apparent the supplier
is expected to make this judgment, taking the purchasers’ interests into account

(Correa 2004, p23).]

(iii)

The generic manufacturer is obliged, prior to shipment, to post on a website

information on the quantities supplied to each importing country and the
distinguishing features of product.

11

(c)

Payment of compensation

Where a CL is granted on a product, adequate remuneration (pursuant to Ar­
ticle 31(h) of TRIPS) shall be paid to the patent holder, taking into account the
economic value to the importing Member of the use that has been authorized in

the exporting country. (The importing country need not pay compensation for
the same product).

(d) Regional arrangements
Within a regional trade agreement in which at least half the members are LDCs,

a developing or least developed country' shall enjoy a waiver to Article 31 (f) of

TRIPS to the extent needed to enable a product produced or imported under a
CL to be exported to other countries in the regional trade agreement.

12

4

Additional Requirements under
the WTO General Council
Chairperson’s Statement

IN addition to the conditions in the Decision, there is another set of conditions

contained in the accompanying Chairperson’s Statement. This may add to the
hurdles that developing countries have to face when they consider making use
of the system under the Decision.

Below are some of the conditions or requirements under the Chairperson’s State­
ment and concerns that arise from them:
(a)

The system should be used in good faith to protect public health, and “not

be an instrument to pursue industrial or commercial policy objectives.”

If this is interpreted strictly, it could prevent the use of the Decision if its use
were to result in an expansion of the generic drugs industry or if the generic

manufacturers were to make any profit. In any case, it adds a layer of uncer­
tainty to how the Decision can be used.

(b)

The Statement also clarifies that the obligation to label and mark the prod­

ucts under this scheme apply not only to formulated pharmaceuticals but also to
active ingredients and finished products produced using such ingredients.
Thus the scope of the products subjected to the special labeling and marking is

clarified to be wider, subjecting more products to cumbersome procedures.

(c)

The Statement states the Members understand that in general special pack­

aging, colouring or shaping should not have a significant impact on prices of
the products.

This seems to suggest that generic manufacturers producing for export under
the Decision will now have to comply with the requirement for special packag­

ing, colouring or shaping, regardless of its impact on the price of the product.

This to some extent dilutes the Decision, which had stated that the products
should be distinguished, provided this is “feasible and does not have a signifi­
cant impact on price”, implying that the requirement need not be fulfilled if it is

unfeasible or has a significant price effect. However, the statement can also be
read to imply that generally there should not be a significant impact on price;

however there also could be a significant impact in specific cases, and thus in

such cases the requirement for marking or labeling need not be fulfilled.
(d)

The Statement says any Member may bring matters relating to interpreta­

tion or implementation of the Decision to the TRIPS Council for expeditious

review, with a view to taking “appropriate action”. Members having concerns
the terms are not fully complied with can use the offices of the Director General

or the TRIPS Council chair to find a mutually acceptable solution.
Thus, the Statement establishes a right and mechanism for Members to chal­

lenge the validity of another Member’s use of the system in the draft decision.

There are concerns that these elements could have a “chill effect” on countries
in their use of the Decision. However, it is also apparent that “bringing the
matters” up to the TRIPS Council or to the Director General is in the nature of
discussion and consultation towards a “mutually acceptable solution” and does

not constitute a formal and binding dispute settlement case in the WTO.

14

5

Comment on the ‘Dampening
Effect’ of the Conditions and
Procedures in the Decision
and Chairperson’s Statement

CONCERNS have been raised that the terms and conditions in the Decision are
burdensome and act as a disincentive or a barrier against the use of the Deci­

sion. This is particularly true of the obligations placed on exporting countries
and the generic producers. Before embarking on an investment to produce for

exports, a generic manufacturer has to be convinced that it would be economi­
cally viable and beneficial for it to apply for a CL and to make use of the system

under the Decision.
If granted a CL, the generic manufacturer may face the conditions of the CL as

stated above, on top of the other usual conditions for obtaining a CL.
It would appear that the requirements may have to be fulfilled anew for each
batch of medicines produced under a CL, and for each and every country to

which the drug will be exported. Besides this, other requirements have to be

satisfied, relating to product registration and drug safety (such as proof of bio­

equivalence of the generic product). For these reasons, there are serious con­
cerns that these conditions may deter a generic manufacturer, in terms of the
cost implications, as well as the bureaucratic red tape.

For prices to be lowered to levels affordable to the majority of the developing
country populations, it would make sense to encourage competition between as
many generic manufacturers as possible. Competition from the introduction of

generics would also bring down prices of patented medicines, and this has been

demonstrated in many studies. However, the generic manufacturers would have
to be able to achieve economies of scale or cost efficiencies to remain viable.

The producer may be dependent on large enough production runs to stay in

business. The trade diversion prevention measures, in requiring each batch of
medicines to be manufactured in different shapes or colours, will be obstacles

to achieving this.

The Chairperson’s Statement, with its “understandings”, adds further to the

deterrent effect that hinders countries from actually making use of the “solu­
tion." The Chairperson’s Statement has been criticised by civil society

organisations as another set of obstacles that restricts or limits the effectiveness
of an already imperfect solution to the Paragraph 6 problem.

16

6

Limited Area of Applicability
of the Decision

THE 30 August Decision applies only in some circumstances, and these are
specific and limited.

The Decision does not reduce the affirmations of the Doha Declaration, nor
does it reduce the existing flexibilities in the TRIPS Agreement. On the con­

trary, it does provide an addition to the flexibilities available, by giving a waiver
(however cumbersome and imperfect) to the implementation of article 31 .f with
regard to having to produce under CL “predominantly for the domestic mar­
ket.” Paragraph 9 of the Decision affirms that the Decision is “without preju­

dice to the rights, obligations and flexibilities....under the TRIPS Agreement

other than paragraphs (f) and (h) of Article 31, including those reaffirmed by
the (Doha) Declaration and to their interpretation.”

The Decision does not affect whether WTO Members may issue CLs and on

which grounds. The TRIPS Agreement (article 31) and the Doha Declaration
are clear that WTO Members are allowed to grant CLs on any grounds, pro­

vided that certain procedural and substantive conditions are fulfilled.

The Decision thus deals only with the case of WTO members wishing to export
a predominant part of their production under CL. Where a predominant part of
the production under CL is provided for the domestic market, the Decision

would not apply. In such cases, the limitations and conditions placed on ex­

ports under Article 31(f) is not relevant.

The Article 31(f) restriction on export does not apply (and thus the waiver un­
der the Decision is not required) under some situations, including the follow­

ing:

(a)

Where production of medicines is under a CL and the portion to be ex­

ported does not constitute a “predominant” part of the output (for example, if

the exported part is less than 50% of the output);
(b)

Where a CL is granted on grounds that such a license is needed to correct

anti-competitive behaviour on the part of the patent holder, under Article 31 (k)

ofTRIPS.
Therefore, it would appear that where a Member seeks to export under these
circumstances, it need not meet any of the terms and conditions specified under

the Decision. WTO Members should therefore explore the means of using these

rights and flexibilities as an alternative or in conjunction with the Decision.
In addition, the Decision does not apply and the waiver is not needed if the
product is not under patent protection in the producing country.

18

7 Conclusions
IT remains to be seen whether and how well the developing countries will be
able to make use of the “interim solution” and if it will in fact, make access to
affordable medicines more of a reality. The Decision will be put to the test

when developing countries attempt to make use of it. It will then be better
known whether the measures and conditions contained in the Decision and the

Chairperson’s statement can be complied with, or whether they are an insur­
mountable obstacle.
Developing country governments will have to take the appropriate measures,
including establishing appropriate legal provisions that enable them to exercise

the best policy options, and issuing CLs for the import of generic medicines,

where needed.
Generic manufacturers in other countries will have to respond to the needs of
the importing countries by making applications for CLs to produce and export.

In the cases where CLs are required, the governments will have to issue CLs for
production and export by their generic manufacturers to produce and export,
and to establish appropriate laws that also enable them to make full use of the

policy flexibilities available.
When the share of production for exports rises to be so high that it almost over­
takes the share of production for the domestic market, then the companies and
governments concerned will have to invoke the waiver and comply with the

measures required for using the 30 August Decision. Meanwhile, the devel­

oped countries can also grant CLs for export if these are applied for by their
own generic manufacturers.
The Decision represents only one aspect of the broad framework that the Doha

Declaration provides to safeguard against unaffordable prices for much-needed

medicines. The Doha Declaration affirms the right of WTO Members to em­
ploy other measures to facilitate the protection of public health and promote
access to medicines.
The implementation of these measures in developing countries is far from com­

plete. Therefore, countries should take urgent measures to adopt and adapt their
national patent laws, so as to make full use of the flexibilities in the TRIPS

Agreement, as affirmed by the Doha Declaration.
The Doha Declaration also granted the right to not provide for pharmaceutical

patents to least-developed WTO Members (LDCs) until 2016. Therefore, these

countries do not have to enforce or provide for patents on pharmaceutical prod­

ucts until 2016 at the earliest. LDCs should use this flexibility to enable them
to structure their patent laws and data protection rules, so as to better protect

public health and promote access to affordable medicines.

The negotiations leading up to the Doha Declaration and the recent Decision
have highlighted the effects of patents on the prices of, and access to, medi­

cines. The implications of the TRIPS Agreement on public health and access to
medicines are now better understood. International public opinion will judge of
whether the declarations and decisions in the WTO have had a real impact on

improving people's access to affordable medicines. If it is judged that these
have not been effective, it may be that pressures will then begin for more far-

reaching changes.
Finally, the Decision recognizes that its measures constitute only a temporary

mechanism through a interim waiver. It recognizes that a permanent solution is

required, involving an amendment to the TRIPS Agreement. The deadline for
finding the permanent solution had been set (by the Decision) for the end of
20

June 2004 and this has been extended to March 2005. It is hoped that this “per­
manent solution”, when it materializes, will be more effective and expeditious

than the present “temporary solution.”

21

REFERENCES
Correa, Carlos (2004). Implementation of the WTO General Council Decision on
Paragraph 6 of the Doha Declaration on the TRIPS Agreement and Public Health.
Geneva: World Health Organisation.

Third World Network (2003). Manual on Good Practices in Public-Health-Sensi­
tive Policy Measures and Patent Laws. Penang: Third World Network.

World Trade Organisation (2003). Implementation of Paragraph 6 of the Doha Dec­
laration on the TRIPS Agreement and Public Health: Decision of 30 August 2003.
World Trade Organisation (2003). The General Council Chairperson’s Statement,
30 August 2003.

22

ANNEX 1
IMPLEMENTATION OF PARAGRAPH 6 OF THE DOHA
DECLARATION ON THE TRIPS AGREEMENT AND
PUBLIC HEALTH
Decision of 30 August 2003

The General Council,
Having regard to paragraphs 1, 3 and 4 of Article IX of the Marrakesh Agreement
Establishing the World Trade Organization (“the WTO Agreement”);

Conducting the functions of the Ministerial Conference in the interval between
meetings pursuant to paragraph 2 of Article IV of the WTO Agreement;
Noting the Declaration on the TRIPS Agreement and Public Health (WT/MIN(01)/
DEC/2) (the “Declaration”) and, in particular, the instruction of the Ministerial
Conference to the Council for TRIPS contained in paragraph 6 of the Declaration
to End an expeditious solution to the problem of the difficulties that WTO Mem­
bers with insufficient or no manufacturing capacities in the pharmaceutical sector
could face in making effective use of compulsory licensing under the TRIPS Agree­
ment and to report to the General Council before the end of 2002;
Recognizing, where eligible importing Members seek to obtain supplies under the
system set out in this Decision, the importance of a rapid response to those needs
consistent with the provisions of this Decision;
Noting that, in the light of the foregoing, exceptional circumstances exist justifying
waivers from the obligations set out in paragraphs (f) and (h) of Article 31 of the
TRIPS Agreement with respect to pharmaceutical products;

23

Decides as follows:

1.

For the puqroscs of this Decision:

(a) "pharmaceutical product" means any patented product, or product manufac­
tured through a patented process, of the pharmaceutical sector needed to address
the public health problems as recognized in paragraph 1 of the Declaration. It is
understood that active ingredients necessary for its manufacture and diagnostic kits
needed for its use would be included1;

(b) "eligible importing Member" means any least-developed country Member, and
any other Member that has made a notification2 to the Council for TRIPS of its
intention to use the system as an importer, it being understood that a Member may
notify at any time that it will use the system in whole or in a limited way, for
example only in the case of a national emergency or other circumstances of ex­
treme urgency or in cases of public non-commercial use. It is noted that some Mem­
bers will not use the system set out in this Decision as importing Members3 and that
some other Members have stated that, if they use the system, it would be in no more
than situations of national emergency or other circumstances of extreme urgency;
(c) “exporting Member” means a Member using the system set out in this Decision
to produce pharmaceutical products for, and export them to, an eligible importing
Member.

2. The obligations of an exporting Member under Article 31(f) of the TRIPS
Agreement shall be waived with respect to the grant by it of a compulsory licence
to the extent necessary for the purposes of production of a pharmaceutical product(s)
and its export to an eligible importing Member(s) in accordance with the terms set
out below in this paragraph:

This subparagraph is without prejudice to subparagraph 1(b).
It is understood that this notification does not need to be approved by a WTO body in
order to use the system set out in this Decision.
3 Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Greece,
Iceland, Ireland, Italy, Japan, Luxembourg, Netherlands, New Zealand, Norway,
Portugal, Spain, Sweden, Switzerland, United Kingdom and United States of
America.

1
2

24

(a) the eligible importing Member(s)4 has made a notification2 to the Council for
TRIPS, that:

(i)

specifies the names and expected quantities of the product(s) needed5;

(ii)

confirms that the eligible importing Member in question, other than a
least-developed country Member, has established that it has insufficient
or no manufacturing capacities in the pharmaceutical sector for the
product(s) in question in one of the ways set out in the Annex to this
Decision; and

(iii)

confirms that, where a pharmaceutical product is patented in its terri­
tory, it has granted or intends to grant a compulsory licence in accor­
dance with Article 31 of the TRIPS Agreement and the provisions of
this Decision6;

(b) the compulsory licence issued by the exporting Member under this Decision
shall contain the following conditions:

(i)

only the amount necessary to meet the needs of the eligible importing
Member(s) may be manufactured under the licence and the entirety of
this production shall be exported to the Member(s) which has notified
its needs to the Council for TRIPS;

(ii)

products produced under the licence shall be clearly identified as being
produced under the system set out in this Decision through specific la­
belling or marking. Suppliers should distinguish such products through
special packaging and/or special colouring/shaping of the products them­
selves, provided that such distinction is feasible and does not have a
significant impact on price; and

Joint notifications providing the information required under this subparagraph may be
made by the regional organizations referred to in paragraph 6 of this Decision on
behalf of eligible importing Members using the system that are parties to them, with
the agreement of those parties.
5 The notification will be made available publicly by the WTO Secretariat through a
page on the WTO website dedicated to this Decision.
6 This subparagraph is without prejudice to Article 66.1 of the TRIPS Agreement.

25

(iii)

before shipment begins, the licensee shall post on a website the follow­
ing information:
the quantities being supplied to each destination as referred to in
indent (i) above; and
the distinguishing features of the product(s) referred to in indent (ii)
above;

(c) the exporting Member shall notify78the Council for TRIPS of the grant of the
licence, including the conditions attached to it.s The information provided shall
include the name and address of the licensee, the product(s) for which the licence
has been granted, the quantity(ies) for which it has been granted, the country(ies) to
which the product(s) is (are) to be supplied and the duration of the licence. The
notification shall also indicate the address of the website referred to in
subparagraph (b)(iii) above.

3. Where a compulsory licence is granted by an exporting Member under the
system set out in this Decision, adequate remuneration pursuant to Article 31 (h) of
the TRIPS Agreement shall be paid in that Member taking into account the eco­
nomic value to the importing Member of the use that has been authorized in the
exporting Member. Where a compulsory licence is granted for the same products in
the eligible importing Member, the obligation of that Member under Article 31(h)
shall be waived in respect of those products for which remuneration in accordance
with the first sentence of this paragraph is paid in the exporting Member.

4. In order to ensure that the products imported under the system set out in this
Decision are used for the public health purposes underlying their importation, eli­
gible importing Members shall take reasonable measures within their means, pro­
portionate to their administrative capacities and to the risk of trade diversion to
prevent re-exportation of the products that have actually been imported into their
territories under the system. In the event that an eligible importing Member that is
a developing country Member or a least-developed country Member experiences
difficulty in implementing this provision, developed country Members shall pro­

7

8

26

It is understood that this notification does not need to be approved by a WTO body in
order to use the system set out in this Decision.
The notification will be made available publicly by the WTO Secretariat through a
page on the WTO website dedicated to this Decision.

vide, on request and on mutually agreed terms and conditions, technical and finan­
cial cooperation in order to facilitate its implementation.
5. Members shall ensure the availability of effective legal means to prevent the
importation into, and sale in, their territories of products produced under the sys­
tem set out in this Decision and diverted to their markets inconsistently with its
provisions, using the means already required to be available under the TRIPS Agree­
ment. If any Member considers that such measures arc proving insufficient for this
purpose, the matter may be reviewed in the Council for TRIPS at the request of that
Member.
6. With a view to harnessing economies of scale for the purposes of enhancing
purchasing power for, and facilitating the local production of, pharmaceutical prod­
ucts:

(i)

where a developing or least-developed country WTO Member is a party to a
regional trade agreement within the meaning of Article XXIV of the GATT
1994 and the Decision of 28 November 1979 on Differential and More
Favourable Treatment Reciprocity and Fuller Participation of Developing
Countries (L/4903), at least half of the current membership of which is made
up of countries presently on the United Nations list of least-developed coun­
tries, the obligation of that Member under Article 31(f) of the TRIPS Agree­
ment shall be waived to the extent necessary to enable a pharmaceutical prod­
uct produced or imported under a compulsory licence in that Member to be
exported to the markets of those other developing or least-developed country
parties to the regional trade agreement that share the health problem in ques­
tion. It is understood that this will not prejudice the territorial nature of the
patent rights in question;

(ii)

it is recognized that the development of systems providing for the grant of
regional patents to be applicable in the above Members should be promoted.
To this end, developed country Members undertake to provide technical co­
operation in accordance with Article 67 of the TRIPS Agreement, including
in conjunction with other relevant intergovernmental organizations.

7. Members recognize the desirability of promoting the transfer of technology and
capacity building in the pharmaceutical sector in order to overcome the problem
27

identified in paragraph 6 of the Declaration. To this end, eligible importing Mem­
bers and exporting Members are encouraged to use the system set out in this Deci­
sion in a way which would promote this objective. Members undertake to cooper­
ate in paying special attention to the transfer of technology and capacity building in
the pharmaceutical sector in the work to be undertaken pursuant to Article 66.2 of
the TRIPS Agreement, paragraph 7 of the Declaration and any other relevant work
of the Council for TRIPS.

8. The Council for TRIPS shall review annually the functioning of the system set
out in this Decision with a view to ensuring its effective operation and shall annu­
ally report on its operation to the General Council. This review shall be deemed to
fulfil the review requirements of Article IX:4 of the WTO Agreement.

9. This Decision is without prejudice to the rights, obligations and flexibilities that
Members have under the provisions of the TRIPS Agreement other than paragraphs
(f) and (h) of Article 31, including those reaffirmed by the Declaration, and to their
interpretation. It is also without prejudice to the extent to which pharmaceutical
products produced under a compulsory licence can be exported under the present
provisions of Article 31(f) of the TRIPS Agreement.

10. Members shall not challenge any measures taken in conformity with the provi­
sions of the waivers contained in this Decision under subparagraphs 1(b) and 1(c)
of Article XX11I of GATT 1994.
11. This Decision, including the waivers granted in it, shall terminate for each
Member on the date on which an amendment to the TRIPS Agreement replacing its
provisions takes effect for that Member. The TRIPS Council shall initiate by the
end of 2003 work on the preparation of such an amendment with a view to its
adoption within six months, on the understanding that the amendment will be based,
where appropriate, on this Decision and on the further understanding that it will not
be part of the negotiations referred to in paragraph 45 of the Doha Ministerial
Declaration (WT/MIN(01)/DEC/l).

28

ANNEX 2
ASSESSMENT OF MANUFACTURING CAPACITIES IN THE
PHARMACEUTICAL SECTOR

Least-developed country Members are deemed to have insufficient or no manu­

facturing capacities in the pharmaceutical sector.
For other eligible importing Members insufficient or no manufacturing capaci­

ties for the product(s) in question may be established in either of the following

ways:

(i)

the Member in question has established that it has no manufac­

turing capacity in the pharmaceutical sector;

OR
(i)

where the Member has some manufacturing capacity in this

sector, it has examined this capacity and found that, excluding any

capacity owned or controlled by the patent owner, it is currently in­
sufficient for the purposes of meeting its needs. When it is estab­

lished that such capacity has become sufficient to meet the Member’s

needs, the system shall no longer apply.

29

ANNEX 3
THE GENERAL COUNCIL CHAIRPERSON’S STATEMENT
30 AUGUST 2003

The General Council has been presented with a draft Decision contained in

document IP/C/W/405 to implement paragraph 6 of the Doha Declaration on
the TRIPS Agreement and Public Health. This Decision is part of the wider
national and international action to address problems as recognized in para­

graph 1 of the Declaration. Before adopting this Decision, I would like to place
on the record this Statement which represents several key shared understand­

ings of Members regarding the Decision to be taken and the way in which it
will be interpreted and implemented. I would like to emphasize that this State­

ment is limited in its implications to paragraph 6 of the Doha Declaration on

the TRIPS Agreement and Public Health.

First, Members recognize that the system that will be established by the Deci­
sion should be used in good faith to protect public health and, without prejudice
to paragraph 6 of the Decision, not be an instrument to pursue industrial or

commercial policy objectives.

Second, Members recognize that the purpose of the Decision would be de­

feated if products supplied under this Decision are diverted from the markets

for which they are intended. Therefore, all reasonable measures should be taken

to prevent such diversion in accordance with the relevant paragraphs of the
Decision. In this regard, the provisions of paragraph 2(b)(ii) apply not only to
formulated pharmaceuticals produced and supplied under the system but also
to active ingredients produced and supplied under the system and to finished

products produced using such active ingredients. It is the understanding of

30

Members that in general special packaging and/or special colouring or shaping

should not have a significant impact on the price of pharmaceuticals.

In the past, companies have developed procedures to prevent diversion of prod­

ucts that are, for example, provided through donor programmes. “Best prac­
tices” guidelines that draw upon the experiences of companies are attached to

this statement for illustrative purposes. Members and producers are encouraged

to draw from and use these practices, and to share information on their experi­
ences in preventing diversion.
Third, it is important that Members seek to resolve any issues arising from the

use and implementation of the Decision expeditiously and amicably:


To promote transparency and avoid controversy, notifications under

paragraph 2(a)(ii) of the Decision would include information on how
the Member in question had established, in accordance with the An­
nex, that it has insufficient or no manufacturing capacities in the phar­
maceutical sector.


In accordance with the normal practice of the TRIPS Council, notifi­
cations made under the system shall be brought to the attention of its

next meeting.
Any Member may bring any matter related to the interpretation or

implementation of the Decision, including issues related to diver­

sion, to the TRIPS Council for expeditious review, with a view to

taking appropriate action.
If any Member has concerns that the terms of the Decision have not
been fully complied with, the Member may also utilise the good of­

fices of the Director General or Chair of the TRIPS Council, with a
view to finding a mutually acceptable solution.

Fourth, all information gathered on the implementation of the Decision shall be
brought to the attention of the TRIPS Council in its annual review as set out in

paragraph 8 of the Decision.
In addition, as stated in footnote 3 to paragraph 1 (b) of the Decision, the follow­

ing Members have agreed to opt out of using the system as importers: Australia,
Austria, Belgium, Canada, Denmark. Finland, France, Germany, Greece, Ice­

land, Ireland, Italy, Japan, Luxembourg, Netherlands, New Zealand, Norway,

Portugal, Spain, Sweden, Switzerland, United Kingdom and United States of
America.
Until their accession to the European Union. Czech Republic, Cyprus, Estonia,

Hungary, Latvia, Lithuania, Malta, Poland. Slovak Republic and Slovenia agree

that they would only use the system as importers in situations of national emer­
gency or other circumstances of extreme urgency. These countries further agree

that upon their accession to the European Union, they will opt out of using the
system as importers.

As we have heard today, and as the Secretariat has been informed in certain
communications, some other Members have agreed that they would only use
the system as importers in situations of national emergency or other circum­
stances of extreme urgency: Hong Kong China, Israel, Korea, Kuwait, Macao

China, Mexico, Qatar, Singapore, Chinese Taipei, Turkey, United Arab Emir­

ates.

32

ANNEX 4
“BEST PRACTICES” GUIDELINES

Companies have often used special labelling, colouring, shaping, sizing, etc. to
differentiate products supplied through donor or discounted pricing programmes

from products supplied to other markets. Examples of such measures include
the following:



Bristol Myers Squibb used different markings/imprints on capsules sup­
plied to sub Saharan Africa.



Novartis has used different trademark names, one (Riamet®) for an antimalarial drug provided to developed countries, the other (Coartem®) for

the same products supplied to developing countries. Novartis further dif­
ferentiated the products through distinctive packaging.



GlaxoSmithKline (GSK) used different outer packaging for its HIV/AIDS

medications Combivir, Epivir and Trizivir supplied to developing coun­
tries. GSK further differentiated the products by embossing the tablets
with a different number than tablets supplied to developed countries, and

plans to further differentiate the products by using different colours.


Merck differentiated its HIV/AIDS antiretroviral medicine CRIX1VAN

through special packaging and labelling, i.e., gold-ink printing on the cap­

sule, dark green bottle cap and a bottle label with a light-green background.



Pfizer used different colouring and shaping for Diflucan pills supplied to
South Africa.
33

Producers have further minimized diversion by entering into contractual ar­
rangements with importers/distributors to ensure delivery of products to the
intended markets.

To help ensure use of the most effective anti-diversion measures, Members
may share their experiences and practices in preventing diversion either infor­
mally or through the TRIPS Council. It would be beneficial for Members and

industry to work together to further refine anti-diversion practices and enhance
the sharing of information related to identifying, remedying or preventing spe­
cific occurrences of diversion.

34

IMPORTS BY AND EXPORTS TO COUNTRIES WITH
INSUFFICIENT OR NO MANUFACTURING CAPACITIES
IN THE PHARMACEUTICAL SECTOR
Measures Required by the WTO Decision of 30 August 2003
in Relation to the TRIPS Agreement and Public Health

This TWN report is on the measures required by countries lacking drug
manufacturing capacity and wishing to import generic drugs and measures required
by countries able and willing to export generic drugs and wishing to overcome the
constraints imposed by TRIPS Article 31(f) that production under compulsorylicence has to be supplied predominantly for the domestic market. It is based on
the Decision of 30 August 2003 adopted by the WTO General Council.
This report is a supplement updating the Manual on Good Practices in PublicHealth-Sensitive Policy Measures and Patent Laws, published by the Third World
Network.

TWN INTELLECTUAL PROPERTY RIGHTS SERIES
is a series of papers published by the Third World Network to provide
a critical analysis of intellectual property rights protection from a Third
World perspective. A particular focus is given to the WTO Agreement on
Trade-Related Aspects of Intellectual Property Rights (TRIPS) and its
implications for developing countries.

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