The Renovation of Institutions to Support Drug Access: Is it Enough? - Innovation in Global Health Governance - page 179

chapter 9

the renovation of Institutions
to Support Drug access:
Is it enough?

Jillian clare cohen-Kohler 1

Pharmaceutical policy is a good example of the most basic resource allocation
questions of who gets what and how much. Governments around the world struggle
to find ways to produce public policies that can lead to happy outcomes in both the
health and economic areas. but the struggle between satisfying commercial interests
and fulfilling public health needs in the pharmaceuticals area is often uneasy and
messy. this is seen most clearly when examining the impact of international trade
imperatives on access to medicines. Moreover, despite the general awareness
of the importance of access to essential medicines, too many of the world's poor
are faced with limitations. Despite unprecedented levels of international funding,
thanks largely to the influx of aid to health from private donors, and a plethora of
programmes devoted to improving global pharmaceutical access, there remains a
drug gap, which constitutes a major moral conundrum in international drug policy.
when 15 percent of the world's population consumes more than 90 percent of the

15 percent of the world's population consumes more than 90 percent of the
world's pharmaceuticals, there is a crisis in health (oxfam International 2007). with with

this knowledge, one might assume that efforts would be made to identify what factors
are causing this gap and to correct them. but this is not the case, particularly with
regard to the impact of international trade law on drug access. as Joseph Stiglitz
(2006, 59) points out in discussing development gains,

(oxfam International 2007). with . with

there are few success stories … the rest of the world cannot solve the problems of the
developing world. they will have to do that for themselves. but we can at least create
a more level playing field. It would be even better if we tilted it to favor the developing
countries.

as part of a move to make conditions more favourable for developing countries,
access to essential medicines is now a central topic at the international policy-
making level. It is expressed as a fundamental human right, with international human
rights law placing attendant obligations on states to ensure access (cullet 2003).
Specifically, established in 2000, article 12 of the United nations International
covenant on economic, Social, and cultural rights outlines the 'right to the highest