Health, equity, and trade:
A failure in global governance
President, International Council of Médecins sans Frontières
The mission of Médecins sans Frontières (MSF) is to relieve suffering, to seek to restore dignity, to reveal injustice, and to locate political responsibility. Why is the MSF movement—a medical humanitarian organization—now concerned with trade and the WTO? Quite simply, because our patients are dying. This is the problem. It is wholly unacceptable from any perspective that millions of people are dying and will die because trade is privileged over their dignity as human beings and over their right to access health care. Our diagnosis and recommended treatment demand that a balance be struck between private and public interests—a balance that gives priority to equitable access to essential medicines as a right over the rules governing their trade and, in effect, the research and development (R&D) process for new innovative drugs. Finding a solution will involve not only the World Trade Organization (WTO), but also the World Health Organization (WHO), national governments and their intergovernmental institutions, and the pharmaceutical industry. Ultimately it is a question of global health and governance, and not simply a matter of rules made by trade specialists. But first, let us define the problem.
In MSF's 400 projects around the world, equitable access to essential life-saving medicines is not improving, but getting worse. We are witnessing not an improvement in health access, but a deterio-