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Competing AIDS drug bills meet some opposition

Tories, Liberals stalling on attempts to reform Canada's Access to Medicines Regime

There are now two bills making their way through Parliament to reform Canada’s Access to Medicines Regime (CAMR) laws that enable generic drug manufacturers to more easily provide cheap AIDS drugs to places like Africa. But both have met some surprising opposition.

The first bill, S-232, was introduced by Liberal Senator Yoine Goldstein at the end of March, but has since been taken over by Senator Sharon Carstairs. It has just completed second reading and been referred to the Senate Committee on Banking, Trade and Commerce, as it deals with an amendment to the Patent Act.

The other bill, C-393, was recently tabled in the House of Commons by NDP MP Judy Wasylycia-Leis and is currently in second reading, where there was surprising opposition from some Liberals.

“I know I’ve got a lot of work to do to get some support because in the first hour of debate, the Conservatives were particularly antagonistic to the ideas, suggesting that they were taking appropriate action when in fact the facts say opposite,” says Wasylycia-Leis. “The Liberals surprisingly were very resistant to the ideas, and it was Marc Garneau who spoke, and I guess I was a bit surprised to see that kind of opposition in the first stages of the bill.”

The Bloc has said that they will support the bill, but have amendments for it in the committee stage.

“Our international reputation is at stake, and we have a moral obligation to free up drugs and flow them to other countries that need them for HIV/AIDS, tuberculosis, malaria and other things,” says Wasylycia-Leis.

Liberal industry critic Marc Garneau says that while the bill’s intentions are laudable, he feels its attentions are misplaced.

“Unfortunately in the past four years [CAMR has] only been used once, and that was to Rwanda,” Garneau says. “Other countries with similar kinds of legislation have not actually done any actual transfers. If one looks at why this is, I’ve come to the conclusion that the main reason is that at the receiving end, the infrastructures are not in place.”

Garneau cites medical staff, distribution networks, refrigeration systems necessary for certain medicines, money and awareness of CAMR as what is really lacking.

“If we decide as a policy that CIDA should focus on trying to provide ways at the receiving end to help distribute these, then I think we’ll do far more to achieve our aim than by taking Bill C-393, as well-intentioned as it is, through the legislative process,” says Garneau.

The government is arguing that the system is working as it stands.

“A statutory legislative review of CAMR was completed [in 2008] which found that not enough time had passed and not enough evidence had accumulated to warrant any changes to the legislation,” says a spokesperson for the Industry Minister.

The process has been complicated by the lobbying of large pharmaceutical companies, who are keen to see that the bill is quashed.

“We’ve seen in recent weeks a campaign of misinformation and misdirection from Rx&D, the lobby group for big pharma,” says Richard Elliott, executive director of the HIV/AIDS Legal Network. “It seems a number of parliamentarians have been simply accepting their half-baked arguments without thinking critically.”

Elliott points out that contrary to Rx&D claims, the proposed reforms would not contravene Canada’s World Trade Organization obligations, but would use the flexibility in those rules to create a more straightforward regime.

“It’s true that in many places the health system needs to be strengthened — but if you can’t afford to pay for high-priced, brand-name patented medicines, then you still haven’t solved a key aspect of ensuring access to treatment, be it for people with HIV or other health problems,” says Elliott. “Rx&D is trying to divert attention from the issue that fixing CAMR is supposed to address — namely, the need to create and sustain market competition so as to bring the prices of AIDS medicines and other medicines down for developing countries.”

Senator Carstairs says that while the Liberals in the Senate are supportive of her bill, she hopes to convince her Commons colleagues of the merits of both bills.

“I think the overwhelming humanitarian need is greater than spats between generic and non-generic companies,” says Carstairs. “The bottom line of this bill is to save lives in Africa and other under-developed places in the world, and that has to be the major thrust of this legislation.”

Carstairs and Wasylycia-Leis have agreed to support each other’s bill should one progress faster than the other.

But considering the the original CAMR legislation passed unanimously in 2004, what has changed?

“We have a more mean-spirited government in place that clearly doesn’t honour the Millennium Development Goals, on any fronts,” says Wasylycia-Leis. “I think its agenda is anathema to the goals of global responsiveness. And the Liberals, quite frankly, seem to have been caught up in the power of the corporations as well, and we’ve got to somehow remind everyone of our international obligations and keep the pressure on, and try to come back to those basic principles.”