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WTO, WHO secretariats workshop on affordable drugs

The 8-11 April 2001 meeting in Høsbjør, Norway, brought together about 80 experts from industrialized and developing countries. It was organized jointly by the World Health Organization, the World Trade Organization, the Norwegian Foreign Ministry and the Global Health Council, a broad-based US organization in the healthcare field.


WTO website:
More information about TRIPS
> TRIPS issues: Pharmaceuticals and patents

WHO website
 Press release 11 April 2001
Press note 18 March 2001
Background papers (look for “More equitable pricing for essential drugs: What do we mean and what are the issues?” and “Workshop on differential pricing and financing of essential drugs”)

Norwegian Foreign Ministry
Press release 6 April 2001

Global Health Council website
Press releases, background papers, etc
Press release 11 April 2001

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  • Final report of proceedings, prepared by the WHO and WTO Secretariats.
    > Full report (31 pages): download in Word (1.14MB) or pdf (1.07MB) formats
    > Executive summary only (4 pages): browse, or download in Word format (44KB), pdf format (98KB)

  • The presentations

  • WHO Secretariat background paper “More equitable pricing for essential drugs: what do we mean and what are the issues?” (30 pages): download in Word format (216KB), pdf format (335KB)

  • Background paper, prepared by a consultant to the WTO Secretariat (29 pages): download in Word format (155KB), pdf format (257KB)

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Sunday, 8 April 2001, evening


18:00 – Reception and Buffet Dinner

  • Hosted by Anne Kristin Sydnes, Minister of International Development, Norway
  • Recital Oystein Birkeland, cello and Vebjørn Anvik, piano

Monday, 9 April 2001:

09:00-10:00 - Opening Session - Welcome and keynote remarks

  • Sigrun Møgedal, (State Secretary of International Development, Norway)
  • Gro Harlem Brundtland, (Director General, WHO)
  • Adrian Otten, (Director, Intellectual Property Division WTO Secretariat)
  • Nils Daulaire, (President, Global Health Council)
  • Peter Piot, (Executive Director, UNAIDS)

10:00-12:30 - coffee break

  • Overview of Agenda and Methods of Work

Session I - Access to Essential Drugs in Poor Countries: Key Issues

This session will examine the range of obstacles to adequate access to essential drugs in developing countries, including issues of financing, pricing, supply, selection and distribution. It will, amongst other things, seek to examine the respective importance of the various factors, including the significance of patent protection.

  • Role of government in health care: Patrick Kadama (Uganda)
  • Healthcare and pharmaceutical systems in developing countries: Richard Laing (Boston University)
  • Tariffs and non-tariff trade barriers and access to essential drugs: Adrian Otten (WTO)
  • A research-based industry perspective: Harvey Bale (IFPMA)
  • Ensuring access to essential drugs – framework for action: Jonathan Quick (WHO)

12:30-14:00 – lunch

14:00-15:30 - Session II – The Role of Financing in Ensuring Access to Essential Drugs

This session will consider the financing needs for ensuring adequate access to essential drugs in developing countries, even in an environment of differential pricing, and how such financing can be mobilized.

  • Mobilization of domestic resources in developing countries:
    Suwit Wibulpolprasert (Thailand)
    Paulo Teixeira (Ministry of Health, Brazil)
  • External assistance and pharmaceutical financing:
    Lieve Fransen (European Commission)
    Francoise Varet (Government of France)
  • Health financing and access to health care: Jeffrey Sachs (Harvard University)

15:30-16:00 - coffee break

16:00-18:00 - Session III – Differential Pricing: Concepts and Issues

This session will seek to identify key issues that need to be explored in regard to differential pricing of essential drugs, whether patented or generic, and to examine what economic analysis can tell us about whether, and under what conditions, differential pricing can be a win-win policy and to what extent there could be losers.

Economic analysis

  • Patricia Danzon (University of Pennsylvania)
  • F.M. Scherer (Harvard University)

Conceptual issues:

  • Heinz Redwood (Industry Consultant)
  • Gunther Faber (GlaxoSmithKline)
  • Ellen ‘t Hoen (Médecins Sans Frontières)

Tuesday, 10 April 2001:

08:30-10:30 - Session IV – Current Experience with differential pricing

The purpose of this session is to examine to what extent differential pricing occurs already and what can be learnt from this experience, for example in regard to techniques for ensuring market segmentation and managing reactions in industrial countries.

  • Experience with vaccines: Jacques-François Martin (Global Fund for Children's Vaccines)
  • Experience with contraceptives: Christian Saunders (UNFPA)
  • Experience with generic drugs: Cecile Miles (Ranbaxy)
  • Experience with HIV/AIDS-related drugs:
    Dorothy Ochola (Uganda Improved Access to HIV/AIDS Drugs)
    John Wecker (Boehringer-Ingelheim)
  • Experience with access to essential medicines for tropical diseases: Maria Neira (WHO)
  • Experience with drug donations:
    Ivermectin: Jeffrey Sturchio (Merck & Co., Inc.)
    Fluconazole: Chuck Hardwick (Pfizer, Inc.)

10:30-11:00 - coffee break

11:00-12:30 - Session V – Market Segmentation: techniques, actors and incentives

This session will seek to examine the different ways in which the segmentation of markets necessary for differential pricing can be made effective, taking into account the need to ensure consistency with WTO and other international trade rules. Also considered will be the extent to which competition law puts constraints on the use of market segmentation techniques.

Marketing strategies by manufacturers and contractual approaches:

  • Market segmentation and price differentiation: A Novel Approach: Albert Itschner (Novartis)
  • Purchase undertakings (including security and prevention of diversion): Keith McCullough (Vuna Healthcare Logistics)
  • Ex post reimbursement techniques: Clifford Wong (Kaiser Permanente, retired; MedImpact)

Governmental measures:

  • Role of regulatory authorities: Guy Woods (Lacuna Research, Ltd.)
  • Export controls: John Bisonga (Customs and Excise Department, Kenya)

12:30-14:00 - lunch

14:00-15:30 - Session V (continued)

The use of intellectual property rights:

  • Richard Wilder (Powell, Goldstein, Frazer & Murphy)
  • Carlos Correa (University of Buenos Aires)

Competition policy considerations:

  • Harvey Applebaum (Covington & Burling)
  • Alberto Heimler (Autorità Garante della Concorrenza e del Mercato, Italy)

15:30-16:00 - coffee break

16:00-17:30 - Session VI – Purchaser Perspectives and Incentives for Differential Pricing

This session will consider the perspectives of purchasers in high and low income markets and consider their influence on the price of essential drugs. It will ask whether differential pricing for low income countries will put downward pressure on prices in industrialized countries even with market segmentation. It will consider existing and potential fiscal and other incentives for companies to implement differential pricing.

  • ACAME bulk purchasing of essential drugs: Pascal Hessou (ACAME)
  • International procurement agency: Hanne Bak Pedersen (UNICEF)
  • Incentives for differential pricing (tax, legal, other measures): Malaya Harper (Department for International Development, UK)
  • A consumer perspective: K. Balasubramaniam (Consumers International)
  • Market segmentation and international reference pricing: Ed Schoonveld (Cambridge Pharma Consultancy)

Wednesday, 11 April 2001:

09:00-10:30 - Session VII – Perspectives on Financing and Differential Pricing

This session will provide an opportunity for a range of views on the issues under discussion in the Workshop to be provided from different perspectives, and for general discussion of these matters. Among the questions to be considered will be how to deal with problems of the political acceptability in developed country markets of lower prices in developing countries.

  • A pharmacoeconomic perspective: David Henry (Newcastle University, Australia)
  • Public/private partnership: Seth Berkley (IAVI)
  • A developed country consumer perspective: Jamie Love (Consumers Project for Technology)
  • A pharmacy professional perspective: Mabel Torongo (International Pharmacy Federation)
  • A generic manufacturer’s perspective: Bill Haddad (CIPLA)

10:30-11:00 – coffee break

11:00-12:00 – Session VIII – Perspectives on Financing and Differential Pricing

  • A developed country government perspective: Paul Vandoren (European Commission, DG Trade)
  • An African government perspective: Desmond Johns (Government of South Africa)
  • A research-based industry perspective: Mark Speaker (Bristol-Myers-Squibb, Co.)

12h:00-13:00 - Session IX – Round-up Discussion

  • Synopses of main points


Ensuring access to essential drugs includes issues of selection, affordability, financing, and health systems. Within this context, the purpose of the workshop is to analyse factors related to financing and differential pricing of essential drugs. Financing considerations include the requirements and mechanisms for securing adequate amounts through international and domestic sources.

Differential pricing (sometimes referred to by WHO and some others as “equity pricing”), for both patented and generic esential drugs, will be analysed from a number of different perspectives. By differential pricing is meant the adaptation of prices charged, in some measure, to the purchasing power of governments and households in different countries. The aim is to examine the legal, institutional and political conditions that would be conducive to companies to engage in differential pricing, acting independently of each other and not as part of any concerted arrangement among themselves.