Tuberculosis (TB) is one of the world’s biggest global health crises; 1.7 million people died of the disease in 2016. New data suggest that the global scope of multidrug-resistant tuberculosis (MDR-TB) is much larger than previously estimated, in turn requiring concerted international efforts in combating this deadlier form of the disease. BRICS nations (Brazil, Russia, India, China and South Africa) together account for over 40% of TB and over 50% of drug-resistant TB cases.

The disease has started receiving political attention not only domestically but also internationally. To fast-track progress in tackling TB, the United Nations is to hold the first-ever UN high-level meeting, on September 26 in New York. Here. global leaders will decide strategies on how to tackle one of the deadliest infectious diseases.

Negotiators and missions of member countries in New York are working this month to finalise the text of the political declaration that will be released in September by global leaders and set the direction in which policy and resources on TB and drug-resistant TB will move globally.

Sticking points

Countries negotiating the final declaration text are coming under significant pressure by the United States to drop all references to protecting the rights of countries to take fully legal actions to access affordable medicines for their people.

One of the final sticking points remains the language on public health safeguards enshrined in the World Trade Organization’s (WTO) Agreement on Trade-related Aspects of Intellectual Property Rights (TRIPS). This allows governments, among other things, to issue ‘compulsory licences’ to override patents in the interest of public health, so that they can allow generic versions of medicines to be produced or imported and more people can receive needed treatment.

The affordability of medicines and use of TRIPS flexibilities has been agreed upon in multiple international fora, including the UN high-level declaration on anti-microbial resistance.

But the U.S., backed by its powerful big pharma lobbies, is pushing to remove any mention of the need for medicines to be affordable.

The U.S. is exerting extreme pressure on the ‘Group of 77’ bloc — of developing countries — by refusing to sign the declaration at the U.N. General Assembly in September if language such as the paragraph that “recognises the importance of affordable medicines” and “urges countries to enforce intellectual property rules in ways that promote access” is included.

Countries, including those in the Group of 77, and BRICS that have a high burden of drug-resistant TB, need to urgently stand up right now against the bullying that aims to keep newer oral TB medicines out of the hands of the people in their countries who need treatment.

The upcoming TB Summit is an important opportunity to address drug-resistant TB. Blocking more affordable generic versions of safer oral medicines that are needed to scale up effective treatment for people with drug-resistant tuberculosis, or DR-TB, will not be the way to do it.

Leena Menghaney is the South Asia Head for Médecins Sans Frontières – Access Campaign

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