Remarks by DG Azevêdo

Hello everyone,

Thank you all for joining us for this eighth symposium hosted by the WTO, in cooperation with the WHO and WIPO. 

It's a privilege for me to welcome back to the WTO my friends, Dr Tedros from the WHO and Assistant Director-General Getahun from WIPO. As we mark ten years of cooperation, I’d like to put on record again my appreciation for their positive approach to working together in our efforts to deliver for our organizations and their members. 

Back in July 2010, the first symposium in this series was a pathbreaking initiative. Our shared experiences since then have confirmed the wisdom and the practical value of taking that step.

Our work together represents a clear recognition that we cannot meet the needs and expectations of our members by working in isolation.

More than the specific new issues explored at events like today's, we learn and benefit from one another's technical expertise. 

If we are to have the trade and intellectual property systems delivering for public health, then cooperation, coordination and a shared policy outlook is not just desirable — it is essential.  

The adoption of the Sustainable Development Goals in 2015 only underscored the importance of our partnership in securing better health outcomes for all.

Of course, this collaborative approach has not been limited to our three agencies. It enhanced our cooperation with a wide range of international and regional partners, across the multilateral system and including civil society, academia and industry. 

For the WTO, working together with all these partners has been enormously beneficial for our technical assistance and capacity building work. For instance, in July we joined forces with the WHO, WIPO and the West African Economic and Monetary Union (WAEMU) for a regional workshop to facilitate access to medicines and medical technologies while fostering innovation.

Today, we turn to the challenges presented by cutting-edge medical technologies. The essential insight is that while improving access to existing technologies remains an important priority, it will not suffice to meet future public health challenges. 

Entire new categories of diagnosis, therapy and prophylaxis are being developed to respond to changing public health needs. 

It's essential to see this innovation press forward and to ensure access to the fruits of such innovation. The international IP system, and the flow of international trade, are both critical in bringing to the public the necessary new technologies in safe and effective forms.

The IP system exists, of course, to promote the development of new technologies and to facilitate their dissemination. 

One question you will be exploring today is how IP settings relate to cutting-edge technologies such as gene-editing. This goes beyond technical details about patentability and the scope of rights and exceptions. It also concerns how these rights are deployed. 

For instance, consider CAR-T [(chimeric antigen receptor)] cell therapy, which offers remarkable possibilities for treating certain cancers.  The therapy, which is still under development, involves taking a natural white blood cell and genetically transforming it so that it attacks cancerous cells when it's reintroduced into the patient's body. 

This is a promising area of medical research — one that involves both public and private actors. A recent survey showed that public sector research institutions held 40% of patents in this area, while private firms hold 49%. How they choose to license these technologies will be an important factor in how therapies are rolled out in practice.

And while CAR-T cell therapy represents a dramatic breakthrough with enormous potential, it is also a costly and resource-intensive form of treatment that may strain health budgets.

These are complex questions that will benefit from discussions like this one, bringing together a wide range of actors with a wealth of practical experience.

Trade, in the sense of the cross-border movement of goods and services, also contributes to public health by helping ensure the availability of new technologies.

No single country — and still less, vulnerable developing countries — will ever be fully self-reliant for the medical technologies they need. 

Facilitating trade also means facilitating access to medical technologies and inputs, which reduces the ultimate cost of treatment.  

Let's take, again, that gene-editing T‑cell cancer therapy. In some forms of it, blood cells are taken from the cancer patient, sent to one of the few international centres with the necessary capacity to modify them, and then returned to the original location to be reinfused. 

In many countries without such centres, this treatment can only work well if border linkages are smooth and expeditious, without delays and unnecessary regulatory obstacles. Implementing the WTO Trade Facilitation Agreement, which simplifies and accelerates border procedures, becomes one of many ingredients required for effective access to cutting-edge medical treatment. 

Our cooperation has from the start been about this comprehensive, inclusive, informed approach to working together to achieve practical goals. In this collaborative effort, we have reviewed together the implications of the Sustainable Development Goals, and how innovative technologies can promote healthy lives and well-being.  

We have considered the growing, cross-disciplinary challenges of addressing antimicrobial resistance, and in particular what is required to ensure innovation, access and appropriate use of antibiotics. We have considered the implications of changing business models in medical innovation. And we have considered procurement and pricing policies. 

Throughout this work, the WTO TRIPS Agreement has been a constant touchstone. The Doha Declaration on TRIPS and Public Health was a major turning point. It sent a clear signal that trade rules, and IP rules in particular, have to be seen within their wider policy framework.

The first of our symposia that I had the privilege to host, back in 2015, looked at lessons learned from TRIPS implementation. A key lesson we have learned is that our members have chosen to implement TRIPS principles in diverse ways, according to their domestic needs and circumstances. They have done so while aiming at the Agreement’s objectives of supporting innovation, while also promoting access to the fruits of innovation.  

We have since attained a further milestone, with the 2017 entry into force of the TRIPS amendment that explicitly legalized a new pathway for access to affordable generic medicines. This is critical for countries facing the steepest hurdles to meeting the needs of their populations.  Ensuring the effectiveness of this mechanism has become a key element of outreach and capacity building with our partners — here in Geneva, but also increasingly in developing country regions like Latin America, the Arab region and Africa.

For me, this link between policy dialogue and practical action exemplifies the great benefit of these symposia.  

In Geneva, there is a risk of addressing issues in a rather abstract way.  We have a pretty good idea of what we want to achieve together, but are not necessarily up to date on the best practical ways of actually achieving it. The array of expert speakers today offers a rich and diverse source of hard-won practical wisdom. This helps us ground our understanding of the policy issues, and informs our future work. 

We are therefore very grateful to our expert speakers for making their time and experience available to us. And we are grateful to you all for joining us today for this important conversation, which I hope will stimulate and inform our future dialogue.

Warm thanks again for joining us — and my best wishes for a productive and insightful day's programme.




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