The role of intellectual property rights on access to medicines in the WHO African region: 25 years after the TRIPS agreement.

BACKGROUND: It is now 25 years since the adoption of the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and the same concerns raised during its negotiations such as high prices of medicines, market exclusivity and delayed market entry for generics remain relevant as highlighted recently by the Ebola and COVID-19 pandemics. The World Health Organization's (WHO) mandate to work on the interface between intellectual property, innovation and access to medicine has been continually reinforced and extended to include providing support to countries on the implementation of TRIPS flexibilities in collaboration with stakeholders. This study analyses the role of intellectual property on access to medicines in the African Region. METHODS: We analyze patent data from the African Regional Intellectual Property Organization (ARIPO) and Organisation Africaine de la Propriété Intellectuelle (OAPI) to provide a situational analysis of patenting activity and trends. We also review legislation to assess how TRIPS flexibilities are implemented in countries. RESULTS: Patenting was low for African countries. Only South Africa and Cameroon appeared in the list of top ten originator countries for ARIPO and OAPI respectively. Main diseases covered by African patents were HIV/AIDS, cardiovascular diseases, cancers and tumors. Majority countries have legislation allowing for compulsory licensing and parallel importation of medicines, while the least legislated flexibilities were explicit exemption of pharmaceutical products from patentable subject matter, new or second use of patented pharmaceutical products, imposition of limits to patent term extension and test data protection. Thirty-nine countries have applied TRIPS flexibilities, with the most common being compulsory licensing and least developed country transition provisions. CONCLUSIONS: Opportunities exist for WHO to work with ARIPO and OAPI to support countries in reviewing their legislation to be more responsive to public health needs.

Herbal medicine use in the districts of Nakapiripirit, Pallisa, Kanungu, and Mukono in Uganda.

BACKGROUND: Traditional medicine (TM) occupies a special place in the management of diseases in Uganda. Not with standing the many people relying on TM, indigenous knowledge (IK) related to TM is getting steadily eroded. To slow down this loss it is necessary to document and conserve as much of the knowledge as possible. This study was conducted to document the IK relevant to traditional medicine in the districts of Mukono, Nakapiripirit, Kanungu and Pallisa, in Uganda. METHODS: An ethnobotanical survey was conducted between October 2008 and February 2009 using techniques of key informant interviews and household interviews. RESULTS: The common diseases and conditions in the four districts include malaria, cough, headache, diarrhea, abdominal pain, flu, backache and eye diseases. Respondents stated that when they fall sick they self medicate using plant medicines or consult western-trained medicine practitioners. Self medication using herbal medicines was reported mostly by respondents of Nakapiripirit and Mukono. Respondents have knowledge to treat 78 ailments using herbal medicines. 44 species, mentioned by three or more respondents have been prioritized. The most frequently used part in herbal medicines is the leaf, followed by the stem and root. People sometime use animal parts, soil, salt and water from a grass roof, in traditional medicines. Herbal medicines are stored for short periods of time in bottles. The knowledge to treat ailments is acquired from parents and grandparents. Respondents' age and tribe appears to have a significant influence on knowledge of herbal medicine, while gender does not. CONCLUSION: This survey has indicated that IK associated with TM stills exists and that TM is still important in Uganda because many people use it as a first line of health care when they fall sick. Age and tribe influence the level of IK associated with herbal medicine, but gender does not.

An Overview of the Traditional Medicine Situation in the African Region

"WHO estimates that about 80of the population in developing countries depends on traditional medicine for their Primary Health Care (PHC) needs. Traditional medicine and its practitioners were officially recognized by the Alma Ata Declaration in 1978 as important resources for achieving Health for All. Since then; member states and WHO governing bodies have adopted a number of resolutions and declarations on traditional medicine. Notable among these are resolution on ""Promoting the role of traditional medicine in health systems: A Strategy for the African Region"" adopted by the WHO Regional Committee for Africa in Ouagadougou; Burkina Faso; in 2000 and the declaration on the Decade of African Traditional Medicine (2001-2010) by the Heads of State and government in Lusaka in 2001. This article will focus on the achievements of countries in the implementation of the priority interventions of the Regional strategy since its adoption in 2000. The article will also cover the challenges countries are facing in implementing the Regional strategy and propose the way forward."

Collaboration between traditional health practitioners and conventional health practitioners: some country experiences

Since the early 1970s; the WHO has repeatedly advocated for the recognition of Traditional Health Practitioners (THPs) as Primary Healthcare (PHC) providers and for the integration of traditional medicine in national health systems. Several calls have been made on governments to take responsibility for the health of their people and to formulate national policies; regulations and standards; as part of comprehensive national health programmes to ensure appropriate; safe and effective use of traditional medicine. One of the priorities of the African Regional Strategy on Promoting the Role of TM in Health Systems is promotion of collaboration between practitioners of traditional and conventional medicine. However; despite the health benefits such collaboration could bring to the populations; decades of disregard of traditional medicine practices and products has created mistrust between the two sectors hampering all the efforts being made to promote this potentially useful partnership. This article outlines the strategies that have been adopted by the WHO to ensure the integration of traditional medicine into national health systems; examples of ongoing collaboration between research institutions and THPs based on research and management of patients; and between THPs and conventional health practitioners in HIV/ AIDS prevention and care and HIV/AIDS/STI/tuberculosis programmes; factors that have contributed to sustaining these partnerships as well as mechanisms for strengthening such collaborations

Natural products research networks in sub-Saharan Africa

Networking is a means of calibrating the quality of work that a group of people is undertaking; fostering international collaboration; pooling of available resources to provide quality training and research in various scientific disciplines and ensuring rapid worldwide dissemination of research information. Several networks involved in research and development of medicinal plants exist in the various sub-regions of the African Region. However; this paper discusses only six such networks of African researchers which share certain common characteristics. These networks aim to foster research on natural products and their sustainable use in human health; and the dissemination of information on research into natural products among others. They also aim to enhance research training capabilities of institutions through national and Regional activities; promote collaboration and research partnerships and mentoring of young researchers in the advancement of natural products research and support the principles of biodiversity conservation. However; these networks have many challenges; mostly financial. A suggestion has been made for the African Network of Drug and Diagnostics Innovation to consider the involvement of other existing networks in its structure for synergizing the efforts to create health products

Intellectual property approaches to the protection of traditional knowledge in the African Region

Traditional knowledge has played a significant role in the healthcare systems in countries of the African Region for centuries. Traditional medicines are presently used by nearly 80of the population. Owing to the global resurgence in the use of natural products and the advent of the biotechnological industry; traditional knowledge is increasingly becoming a source of modern drug development and biotechnological inventions. Despite the important role of traditional knowledge; traditional communities are unable to protect their knowledge through the existing intellectual property system owing to the failure of the knowledge to satisfy the requirements for intellectual property protection; incompatibility in most cases between the traditional knowledge concepts and intellectual property as well as the prohibitive costs involved in patent registration. Studies conducted recently and the outcomes of global debates have suggested some policy and legal approaches that can be used to effectively protect traditional knowledge; including traditional medicine. This paper discusses conceptsof traditional knowledge and provides policy and legal measures that have been developed at the international and regional levels for the protection and utilization of traditional knowledge for the benefit of the knowledge holders and society at large