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A second chance to save millions of lives

Lana Slezic

Canadians want to take concrete action on behalf of those in developing countries who are needlessly suffering from fully treatable ailments. They want to help millions of people worldwide gain access to live-saving, affordable medicine.

Our politicians have this very opportunity in the form of Bill C-398, currently making its way through Parliament. The bill seeks to fix Canada's flawed Access to Medicines Regime (CAMR), an eight-year-old law that was supposed to make it easier to send lower-cost generic drugs to countries that can't afford to pay top dollar for brand-name drugs.

Despite the best intentions, the law never worked. It was so riddled with cumbersome regulations and red tape that only one shipment of medicine has been processed since 2004.

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Bill C-398, a private member's bill, would untangle that red tape once and for all, allowing the legislation to work the way it was intended.

It's the second time in just over a year that the bill has arrived in the House of Commons. Last year, it sailed through with support from MPs from all parties, but died in the Senate when the 2011 federal election was called.

Now MPs and senators have a second chance to do the right thing. It's a simple adjustment that could help the global effort to save millions of lives.

Canada first recognized the need back in 2004 when it passed legislation to create Canada's Access to Medicines Regime. The law permitted generic drug companies here to manufacture much less costly versions of brand-name drugs for export to treat public health problems such as HIV.

Despite noble intent, the system faltered. The one generic drug company that did use CAMR has said it will not attempt the current cumbersome procedure again. So far, developing countries have been reluctant to try, partly because of CAMR's unnecessary restrictions.

What happened? On paper, the law allowed generic manufacturers to bypass Canadian patents by applying for licences – or patent exemptions – in order to manufacture copies of certain drugs for export to eligible countries named in the law.

But from the outset, applicants ran into roadblocks. There is a one-country limit for each licence application and a fixed maximum quantity of medicines for each order that had to be specified in advance. Eliminating the quantity ceiling means generic producers would be able to supply the amount of drugs identified by those countries as their needs arise.

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Potential users are waiting in the wings for reform, and there's no argument that generic drugs have already saved millions of lives.

A little more than a decade ago, only about 200,000 people who needed life-saving AIDS medicine in the developing world were getting treatment. Today, that figure stands at more than six million. The remarkable improvement was made possible because drug prices plummeted, thanks largely to generic competition. But more needs to be done.

Some opponents of reform argue that Bill C-398 would undermine intellectual property rights held dear by brand-name pharmaceutical manufacturers.

But even international trade bodies such as the World Trade Organization have recognized that many developing countries aren't in a position to manufacture their own life-saving drugs and need to rely on imported medicines.

Making CAMR work means cost benefits for Canadians too. Aid money would work more effectively in developing countries because a portion of our financial assistance is earmarked for medicine. If the drug costs were reduced, Canadian aid dollars could buy more.

CAMR reform has the support of medical and legal experts, human-rights organizations, physicians, faith leaders, health activists and international aid workers across Canada and internationally. They're not alone; fully 80 per cent of the public supports fixing CAMR, according to a national opinion poll.

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We believe this is one of the most important pieces of legislation Canada will ever have the chance to pass. It will save lives and help change the world.

James Orbinski is co-founder of Dignitas International and a professor at the Dalla Lana School of Public Health at the University of Toronto. Richard Elliott is executive director of the Canadian HIV/AIDS Legal Network.

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