Ecuador Uses WTO Rules to Make Medicines More Accessible

Posted December 11, 2009

People before Profits! In the United States, the motto can be seen on signs at protests or health care rallies, though it is a plea historically ignored by lawmakers in Washington. But in Ecuador, President Rafael Correa has translated this phrase into policy.

On Oct. 26 President Correa announced that he would use the World Trade Organization´s TRIPS agreement to issue compulsory licenses in order to manufacture and import generic and affordable medications, saying that access to medicines is a “human right.

Ecuador´s constitution states that “health is a right ensured by the State” and that the government must “ensure availability and access to quality, safe and effective medicine, regulate the commercialization thereof and promote domestic production and use of generic drugs that meet the epidemiological needs of the population. In access to medicines, public health interests shall take precedence over economic and commercial interests.”

The decision was praised by UNASUR´s Ministers of Health at a meeting in Quito last month.

Ecuador´s Health Minister, Caroline Chang, said at the meeting that Ecuador will continue working to eliminate “not only the pain of the poor, but remove the reasons that cause poverty in our country.”

Oscar Ugarte Ubillús, Peru´s Minister of Health, said Ecuador´s decision is an “exercise of sovereignty, is a positive, and appeared in the context of the international standards,” and something everyone at the meeting as ministers and health officials can support.

Andres Ycaza, president of Ecuador’s Intellectual Property Institute (IEPI), believes that President Correa´s decision will significantly reduce the cost of medicines. He noted that in 2002, after a local lab requested a license to produce a GSK-patented antiretroviral, the British company in turn cut the price from $350 to $60.

“High costs, insufficient production and a lack of research have contributed to the fact that millions of people do not enjoy equitable access to medicines in developing countries such as Ecuador,” said Ycaza.

There are 2,214 patents that the Ecuadorian government will review to determine whether it is necessary to produce generics domestically, or import generic versions from other countries. Ycaza said Ecuador would pay royalty payments between 0.5 percent and 3 percent. According to IEPI, the average cost of medicine drops over 90 percent when the market is open to competition.

“This sets a useful global precedent,” said Peter Maybarduk, an attorney with Essential Action. “As more drugs fall under patents the probability of monopoly drug pricing grows greater and greater.”

Essential Action provides technical assistance for a variety of governments and civil society groups promoting access to medicines.

Meanwhile, the Pharmaceutical Industry of Investigation, or IFI, which represents local units of European and US companies, stated in a press release “We accept the democratic decision… to legally implement this extraordinary measure.”

While the industry body would have liked to have been invited to participate in the process, something that is not required by law, and had no choice but to accept the decision, it added that “No legal right is superior to the requirements of public health, especially in such serious circumstances.”

“We´re hopeful Ecuador will serve as an excellent example for countries in the region and around the world who are promoting access to medicines,” said Essential Action´s Maybarduk.

Cyril Mychalejko is an editor at, an online magazine covering politics and activism in Latin America. He also serves on the board of the Canary Institute.