Drug access,patents and global health: 'Chaffed and waxed sufficient'

In July 2000 the UN Committee on Economic, Social and Cultural Rights issued a General Comment on the Right to the Highest Attainable Standard of Health. At paragraph 10 the Committee makes the following admission: 'Since the adoption of the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights in 1966 the world health situation has changed dramatically and the notion of health has undergone substantial changes and widened in scope. More determinants are being taken into consideration, such as resource distribution and gender differences. A wider definition of health also takes into account such socially related concerns as violence and armed conflict. Moreover, formerly unknown diseases, such as HIV and AIDS, and others that have become more widespread, such as cancer, as well as the rapid growth of the world population, have created new obstacles for the realisation of the right to health which need to be taken into account when interpreting article 12.'¹ The need to understand why and how 'the notion of health has undergone substantial changes and widened in scope', the forces that are contributing to this redefinition, and the implications for governments, multinational pharmaceutical companies and ordinary people is the subject of this article. In particular global health is assessed according to the extent of global access to life improving-medicines, and the surmountable barriers that prevent this.