Ethics and Security Aspects of Infectious Disease Control: Interdisciplinary Perspectives

260 Pages·2012·2.643 MB·English

by  Christian Enemark, Christian Enemark, Michael J. Selgelid

Informal norms In Global Governance
Global Health
Series Editor: Professor nana K. Poku,
John ferguson Professor, University of bradford, UK
The benefits of globalization are potentially enormous, as a result of the increased
sharing of ideas, cultures, life-saving technologies and efficient production
processes. Yet globalization is under trial, partly because these benefits are not yet
reaching hundreds of millions of the world’s poor and partly because globalization
has introduced new kinds of international problems and conflicts. Turmoil in one
part of the world now spreads rapidly to others, through terrorism, armed conflict,
environmental degradation or disease.
This timely series provides a robust and multi-disciplinary assessment of the
asymmetrical nature of globalization. Books in the series encompass a variety
of areas, including global health and the politics of governance, poverty and
insecurity, gender and health and the implications of global pandemics.
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Ethics and Security Aspects of Infectious Disease Control
Interdisciplinary Perspectives
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The Political Economy of Pharmaceutical Patents
US Sectional Interests and the African Group at the WTO
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The Politics of AIDS Denialism
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Informal Norms in
Global Governance
Human Rights, Intellectual Property Rules
and Access to Medicines
WOlFGANG HeIN
GIGA German Institute of Global and Area Studies, Germany
sUerIe moon
Harvard University, USA
© Wolfgang Hein and Suerie Moon 2013
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or
transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise
without the prior permission of the publisher.
Wolfgang Hein and Suerie Moon have asserted their right under the Copyright, Designs and Patents
Act, 1988, to be identified as the authors of this work.
Published by
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British Library Cataloguing in Publication Data
Hein, Wolfgang, 1949-
Informal norms in global governance : human rights,
intellectual property rules and access to medicines. --
(Global health)
1. Drug accessibility--International cooperation. 2. Right
to health. 3. Agreement on Trade-Related Aspects of
Intellectual Property Rights, (1994) 4. Intellectual
property (International law) 5. Foreign trade regulation--
Health aspects. 6. Non-state actors (International
relations) 7. Drugs--economic aspects. 8. Antiretroviral
agents--Patents. 9. Drugs--Patents.
I. Title II. series III. moon, suerie.
344'.04233-dc23
Library of Congress Cataloging-in-Publication Data
Hein, Wolfgang, 1949-
Informal norms in global governance : human rights, intellectual property rules and access to
medicines / by Wolfgang Hein and Suerie Moon.
p. cm. -- (Global health)
Includes bibliographical references and index.
ISBN 978-1-4094-2633-2 (hbk) -- ISBN 978-1-4094-2634-9 (ebook) 1. Public health--
International cooperation. 2. Right to health--Developing countries. 3. Drugs--Prices--Developing
countries. 4. Foreign trade regulation--Developing countries. 5. Patents (International law) I. Moon,
suerie. II. Title.
ra441.H45 2012
362.1--dc23
2012026010
Isbn 9781409426332 (hbk)
Isbn 9781409426349 (ebk – PDf)
Isbn 9781409470908 (ebk – ePUb)
III
Printed and bound in Great britain by the
MPG Books Group, UK.
Contents
List of Figures and Tables ix
Foreword xi
Preface xiii
List of Abbreviations xv
1 Introduction 1
(a) Formal and informal norms in the governance
of a global society 1
(b) The emergence of the “access to medicines” norm 4
(c) Informal norms and human rights 8
(d) Overview of the book 11
2 Towards a Global Society 15
(a) Globalization 15
(b) From international relations to global governance 18
(c) Transnational actors in global governance 23
(d) Post-Westphalian global health governance 28
(e) Interfaces, nodal governance, and polylateral diplomacy:
Elements of the social construction of global health
governance (GHG) 34
(f) Global society, global politics and human rights 42
3 Access to Medicines: A Matter of Human Rights 45
(a) The right to health and to access to essential medicines 47
(b) Sources of formal and informal norms on access to medicines 51
(c) The UN Special Rapporteur on the Right to Health 52
4 Access to Medicines and Intellectual Property 55
(a) Medicines and the global public goods problem 55
(b) Introducing the WTO 57
(c) Introduction to TRIPS—basic issues 59
(d) TRIPS, TRIPS+ and the fight for social issues 64
5 The HIV/AIDS Crisis: The Rise of the Access Norm 67
(a) A brief introduction to HIV/AIDS medicines 67
(b) AIDS treatment and IP rules in the developing world:
The special role of Brazil 68
vi Informal Norms in Global Governance
(c) A window of opportunity: The 1999–2001 “policy crisis” 71
(d) The Doha Declaration on the TRIPS Agreement and
Public Health 75
(e) Early debates on disease scope: The WTO medicines (§6)
decision and the TRIPS amendment 79
(f) Improved access to medicines: Using TRIPS flexibilities 82
(g) The first developing country compulsory licenses:
Zimbabwe and Malaysia 84
(h) Thailand: Regularizing the use of compulsory licensing 86
(i) Role and character of finance for treatment 96
(j) The rise of access to medicines: Timeline of decisions and
increased use of compulsory licensing, 2001–2010 100
6 Beyond HIV in Africa: Solidification and
Expansion of the Access Norm 107
(a) Solidification of the access norm 107
(b) Inclusiveness of the access norm:
Which medicines are essential? 113
(c) The inclusiveness of the access norm:
Middle-income countries as the new battlefield? 123
7 Challenges to the Stability of Informal Norms 131
(a) Challenges in access to HIV/AIDS medicines 132
(b) Free trade agreements 133
(c) WTO accession agreements 136
(d) Alternate channels for IP rulemaking 137
8 Re-framing the Access Norm: Incorporating Innovation 143
(a) From expert commissions to global strategies 144
(b) Innovation and access: I+A 148
(c) Changing expectations for the MICs: Contributions to R&D 153
9 The Impact of Non-state Actors on Informal Norms:
Nodal Governance and Global Democracy 159
(a) Nodal governance and informal norm-building 159
(b) Nodal governance: Interfaces between IGOs, governments
and non-state actors in global politics 165
(c) Role and power of non-state actors in global norm-building 170
(d) Transnational democracy: Problems of legitimacy,
accountability, power and authority in the open-source
anarchy of global politics 174
Contents vii
10 Conclusions 181
(a) Formal and informal norms 181
(b) Implications for health and implications
for global governance 188
Annex 1 The 2001 WTO Doha Declaration on TRIPS
and Public Health 193
Annex 2 Timeline of Key Events 195
References 199
Index 231
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List of Figures and Tables
Figures
2.1 International agreements in traditional IR theory 19
2.2 Global politics in a post-Westphalian system 19
2.3 Composition of the GAVI Board 31
2.4 Development assistance for health from 1990 to 2010
by channel of assistance 33
5.1 Thailand Ranking on USTR Special 301 Reports: 1989–2010 93
5.2 ARV price trends 200–2011 97
5.3 Timeline of decisions and conflicts around IPRs and access
to medicines 102
6.1 Changes in export markets 2001–2009 124
9.1 Nodal governance—Geneva as a super-node in GHG 162
Tables
5.1 Publicly-announced compulsory licenses on medicines 2001–2012 104
6.1 TRIPS-related disputes at the WTO DSB (1995–2011) 127
6.2 Selection of intra-country inequality scores 127