[Congressional Record Volume 152, Number 79 (Monday, June 19, 2006)]
[House]
[Pages H4203-H4205]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         MORALITY TALE ON AIDS

  Mr. McDERMOTT. Mr. Speaker, I ask unanimous consent to speak out of 
order.
  The SPEAKER pro tempore. Without objection, the gentleman from 
Washington is recognized for 5 minutes.
  There was no objection.
  Mr. McDERMOTT. Mr. Speaker, I come to the floor tonight to really 
tell a morality tale that the American people may well not know 
anything about. Many things go on in the world, and we learn nothing in 
our press. But if you read widely, as I do, and read something called 
the Asia Times, which is one of many newspapers around the world, you 
find out very interesting things are going on.
  Everyone knows that there is a problem with AIDS worldwide, and the 
problem with AIDS is that we, today, have the ability to actually treat 
people with AIDS with the triple therapy drugs that will make their 
life longer, allow them to continue working, allow them to take care of 
their children,

[[Page H4204]]

create less orphans. There are many, many positive benefits from triple 
therapy around the world.
  The problem is the drugs are made in the Western world where they are 
very, very expensive. In the Asia Times story, an article entitled 
World Health, A Lethal Dose of U.S. Politics, that is dated 6/19/2006, 
that I will enter into the Record, this article talks about a veteran 
World Health Organization professional by the name of William Aldis, 
who found himself in such conflict with the World Health Organization 
that he was fired. Now, they called it a promotion. They put him 
elsewhere. But basically they put him in a position where he would have 
no power similar to what he had before. He was the representative to 
Thailand.
  Now, Thailand's use of these medications has reduced their level of 
deaths from AIDS by 79 percent. These drugs are effective, but very 
expensive. And the problem is that under the World Trading Organization 
rules, countries are allowed to make their own or to develop generics 
that are much less expensive.
  Now, Thailand comes to the point where they want to develop a 
bilateral trade relationship with the United States. And the United 
States, at that point, uses their muscle to say to the Thais, you no 
longer can have this loose standard of developing drugs. You must abide 
by United States intellectual property law.

                              {time}  1845

  Therefore, you are cut off from an inexpensive source of the 
medication that is in use in Thailand today and in many other countries 
in the world.
  Now, this is a question of morality. We have the capacity to treat 
the millions of people who are living with AIDS and thousands of them, 
millions dying every year. We have the ability to treat them. But on 
the other side, we have the pharmaceutical industry that says we want 
to get the last nickel, we want to get the most money out of this 
situation that we can get. And the United States Government is helping 
the pharmaceutical industry squeeze the Third World.
  Now, a lot of people say why does the rest of the world dislike 
America? It is this kind of stuff that goes on under the radar screen 
of most people in this country who do not understand what is going on 
who, therefore, do not understand why the rest of the world looks at us 
as being in it for ourselves and no one else. We can talk all we want 
to about liberty, and we can talk all we want about the free enterprise 
system and all these things, but when it comes down to money we put the 
squeeze on.
  Now, you say, well, hasn't the President been generous? Hasn't he put 
$15 billion out there to deal with the AIDS epidemic? Yes, in theory he 
has made that and some of that money has been appropriated out of this 
House, but it is being used to buy drugs that are much more costly. We 
could buy many more drugs if we would buy generics produced in these 
countries by themselves.
  Now, recently there was a Congressional Research Service report, and 
this is our research service in the Library of Congress, that said that 
the United States' main purpose for pursuing bilateral FDAs is to 
advance U.S. intellectual property protection rather than promoting 
free trade.
  This is wrong, and the American people should know about it and 
insist that their government make available the drugs for the rest of 
the world's treatment.
  The material previously referred to is as follows:

              World Health: A Lethal Dose of U.S. Politics

                         (By Dylan C. Williams)

       Bangkok.--When World Health Organization (WHO) director 
     general Lee Jong-wook died of a cerebral hemorrhage last 
     month before the start of the United Nations agency's annual 
     World Health Assembly, the world's most prominent public-
     health official was arguably of a conflicted mind.
       The WHO veteran was caught in the middle of an intensifying 
     global debate over how to reconcile intellectual-property 
     protection with the pressing public-health need to expand and 
     access to expensive life-saving medicines, a hot-button issue 
     that has sharply divided WHO member states along developed- 
     and developing-country lines.
       An Asia Times Online investigation reveals that at the time 
     of his death, Lee, a South Korean national, had closely 
     aligned himself with the U.S. government and by association 
     U.S. corporate interests, often to the detriment of the WHO's 
     most vital commitments and positions, including its current 
     drive to promote the production and marketing of affordable 
     generic antiretroviral drugs for millions of poor infected 
     with the human immunodeficiency virus (HIV), which can cause 
     AIDS.
       According to senior and middle-ranking WHO officials 
     familiar with the situation, Lee blatantly bent to U.S. 
     government pressure in March when he made the controversial 
     decision to recall the WHO country representative to 
     Thailand, William Aldis, who had served less than 16 months 
     in what traditionally has been a four-year or longer posting.
       Aldis had made the mistake of penning a critical opinion 
     piece in the Bangkok Post newspaper in February that argued 
     in consonance with WHO positions that Thailand should 
     carefully consider before surrendering its sovereign right to 
     produce or import generic life-saving medicines as allowed by 
     the World Trade Organization (WTO) in exchange for a 
     bilateral free-trade agreement (FTA) with the United States, 
     which is currently under negotiation.
       The WHO official also wrote that the stricter intellectual-
     property protection measures in the proposed U.S.-Thailand 
     FTA would inevitably lead to higher drug prices and thereby 
     jeopardize the lives of ``hundreds of thousands'' of Thai 
     citizens who now depend on access to locally produced cheap 
     medicines to survive. He noted too that the Thai government's 
     current production of generic treatments had allowed the 
     country to reduce AIDS-related deaths by a whopping 79 
     percent.
       Aldis' arguments directly mirrored stated WHO positions, 
     but significantly were at direct odds with the objectives of 
     current U.S. trade policy, which through the establishment of 
     bilateral FTAs aims to bind signatory countries into 
     extending their national intellectual-property legislation 
     far beyond the parameters of current WTO agreed standards.
       A recent U.S. Congressional Research Service report states 
     that the United States main purpose for pursuing bilateral 
     FTAs is to advance U.S. intellectual-property protection 
     rather than promoting more free trade. The Bipartisan Trade 
     Promotion Authority Act of 2002, the applicable U.S. 
     legislation for bilateral FTAs, states explicitly that Trade-
     Related Intellectual Property Standards, or TRIPS, are by law 
     non-negotiable and must reflect a standard of protection 
     similar to that found in U.S. law.
       A U.S. ambassador to the U.N. in Geneva paid a private 
     visit to Lee on March 23 to express Washington's displeasure 
     with Aldis' newspaper commentary, according to WHO officials 
     familiar with the meeting. A follow-up letter from the U.S. 
     government addressed to Lee strongly impressed Washington's 
     view of the importance of the WHO to remain ``neutral and 
     objective'' and requested that Lee personally remind senior 
     WHO officials of those commitments, according to a WHO staff 
     member who reviewed the correspondence.
       The next day, Lee informed the regional office in New Delhi 
     of his decision to recall Aldis.
       Perhaps strategically, Aldis' removal coincided with the 
     height of Thailand's recent political crisis, and failed to 
     generate any local media attention at the time. Internally, 
     Lee had characterized Aldis' transfer to a research position 
     of considerable less authority in New Delhi as a promotion.
       But a Geneva-based WHO official familiar with the situation 
     said the article ``was seen as stepping over unseen 
     boundaries which the director general set for himself and his 
     staff when dealing with the U.S. It was a disappointing 
     reaction, a sad reaction, but under Lee's administration not 
     a surprise.''
       Suwit Wibulpolprasert, senior adviser to the Thai Ministry 
     of Public Health, early this month sent a formal letter to 
     acting WHO director general Anders Nordstrom, requesting an 
     official explanation for Aldis' abrupt removal.
       According to a WHO official in Geneva with knowledge of the 
     correspondence, the letter raised questions about possible 
     U.S. influence behind the irregular personnel rotation and 
     said that if the WHO decision was motivated by Aldis' 
     comments on the U.S.-Thai FTA, then the WHO should reconsider 
     the transfer.
       Suwit also raised his concerns about the level of 
     transparency and freedom of speech inside the WHO. In e-mail 
     communication with this correspondent, Suwit said WHO 
     officials had already denied that Aldis' recall was related 
     to the opinions stated in the Bangkok Post article. A 
     regional WHO official in New Delhi told a senior Thai public-
     health official that Aldis' removal was related to 
     ``inefficiency'' in performing his functions--a 
     characterization that Thai officials who worked alongside him 
     through the 2004 tsunami and ongoing avian-influenza scare 
     have privately contested.
       News of Aldis' transfer, which oddly was first leaked by a 
     Bangkok-based U.S. official, quickly spread through the 
     global health organization. The June edition of the highly 
     regarded medical journal The Lancet, which otherwise painted 
     a flattering portrait of Lee's tenure, drew on anonymous WHO 
     sources to characterize Lee's decision on Aldis as a ``clear 
     signal of U.S. influence on WHO.''
       A senior WHO official who spoke to Asia Times Online on 
     condition of anonymity believes that Lee's decision and its 
     subsequent leak by the U.S. government was specifically

[[Page H4205]]

     designed to engender more self-censorship among other WHO 
     country representatives when they comment publicly on the 
     intersection of U.S. trade and WHO public-health policies.
       A large number of WHO staff members are employed on 
     renewable 11-month contracts, meaning that their standing 
     inside the organization is on perpetually shaky ground and 
     hence curbs their ability to voice critical opinions.
       Aldis, a U.S. national and permanent WHO staffer, was known 
     among his colleagues for privately airing views critical of 
     the Bush administration and its policy toward the WHO, 
     particularly in relation to the U.S. government's alleged 
     tendency to mix its commercial and public-health agendas.
       Aldis reportedly chafed at WHO regional headquarters' 
     instructions to receive representatives from U.S. 
     corporations and introduce them to senior Thai government 
     officials to whom the private company representatives hoped 
     to sell big-ticket projects and products.
       In recent months, major U.S. companies such as 
     pharmaceutical giant Pfizer and technology company IBM have 
     asked the WHO in Thailand to facilitate access to senior Thai 
     officials. In turn, some senior WHO staff members have 
     expressed their concerns about a possible conflict of 
     interests, as the requested appointments were notably not 
     related to any ongoing WHO technical-assistance program with 
     the Thai government.
       It's not the first time that the U.S. has played hardball 
     with the WHO and Thailand. In 1998, when member nations 
     proposed that the WHO be granted more power to monitor 
     international trade agreements and their effects on global 
     public health, particularly in relation to the access to 
     patented medicines in developing countries, the U.S. 
     government threatened to withhold funding to the 
     organization.
       Under that financial threat, the WHO has since 
     largely refrained from commenting critically on the drug-
     patent issue. International and independent non-
     governmental organizations (NGOs) such as Oxfam and 
     Medecins Sans Frontieres have filled the WHO's leadership 
     vacuum on the issue by filling the information gap with 
     highly critical research reports.
       From the United States perspective, Aldis, and by 
     association the WHO, had publicly sided with Thailand on the 
     pivotal drug-patent debate during a crucial stage in the FTA 
     negotiations. Washington reportedly hopes that the 
     comprehensive deal it is pursuing with Thailand will serve as 
     a template for other bilateral trade pacts in the region, 
     including soon-to-be-negotiated deals with Malaysia and 
     Indonesia.
       Thai civil-society groups, meanwhile, have complained about 
     the lack of transparency surrounding the negotiations, which 
     caretaker Prime Minister Thaksin Shinawatra has unilaterally 
     conducted without consultations with parliament.
       The U.S. and Thailand have in the past sparred over the 
     Thai government's decision to use its WTO-approved compulsory 
     licensing rights to produce certain generic antiretroviral 
     drugs for HIV carriers and AIDS sufferers. In 2001, for 
     example, Washington threatened retaliatory trade sanctions, 
     including curbs on sensitive Thai export products, if the 
     Thai government allowed the production of certain generic 
     antiretroviral drugs.
       Thai activists, meanwhile, have given certain U.S. 
     pharmaceutical companies legal fits. In 2001, for instance, 
     they challenged the legality of U.S. pharmaceutical company 
     Bristol Meyer Squibb's patent over the antiretroviral drug 
     didanosine, or DDI, because it was originally developed by a 
     public U.S. agency, the National Institutes of Health.
       In 2002, a Thai court cited international statutes when it 
     ruled that Thai HIV/AIDS patients could be injured by patents 
     and had legal standing to sue if drug makers holding patents 
     restricted the availability of drugs through their pricing 
     policies.
       The verdict was upheld in January 2004, and as part of an 
     out-of-court settlement, Bristol Meyer Squibb decided to 
     ``dedicate the [DDI] patent to the people of Thailand'' of 
     that particular version of the drug by surrendering it to the 
     Thai Department of Intellectual Property.
       The dedication, however, did not carry over to third 
     countries. Under the provisions of a U.S.-Thai FTA, future 
     legal challenges to U.S.-held drug patents would be nearly 
     impossible, Thai activists and international NGOs contend.
       Lee's unexpected death has already engendered some serious 
     soul-searching inside the WHO. Lee was widely lauded after 
     his death, but his final legacy to the organization he served 
     for 23 years is very much in doubt.
       U.S. President George W. Bush said, ``Lee provided 
     tremendous leadership to the international community as it 
     confronted the challenges of the 21st century.'' U.N. 
     Secretary General Kofi Annan, Microsoft founder Bill Gates 
     and former U.S. President Jimmy Carter all made similar 
     eulogies to Lee's long commitment to improving global public-
     health standards.
       Lee frequently denied allegations that U.S. political 
     pressure influenced his decision-making, most notably perhaps 
     during a recent television interview with the British 
     Broadcasting Corp. However, it is just as likely that Lee 
     will be remembered for the many times he caved to U.S. 
     pressure on crucial public-health issues, frequently in areas 
     where WHO positions and commitments required that he take a 
     stronger stand, some WHO officials contend.
       Moreover, the secretive way that Lee sometimes conducted 
     WHO business, apparently in some instances at the United 
     States behest, already has some officials inside the U.N. 
     agency talking about the need for greater transparency and 
     accountability under the next director general. ``It will be 
     very rough waters ahead for the new [director general],'' 
     said a Geneva-based WHO official, speaking on condition of 
     anonymity.
       As the United States strong influence over Lee comes into 
     posthumous light, the selection process for his replacement 
     will almost certainly be politicized along rich- and poor-
     country lines, and if the U.S. openly pushes its favored 
     candidate, that divide could widen into a full-blown schism 
     inside the traditionally cohesive organization. Those sharp 
     lines are already emerging.
       A report by a WHO-mandated independent commission recently 
     recommended that as a general rule governments should avoid 
     bilateral free-trade treaties that reduce access to medicines 
     in developing countries. An annex to that report, signed by 
     mainly Western experts who adhered to positions held by big 
     pharmaceutical companies, highlighted the glaring differences 
     in opinion emerging among WHO member states.
       For its part, the U.S. has long advanced the argument that 
     without strong intellectual-property protection, the 
     pharmaceutical industry will not have the commercial 
     incentive to conduct research and development for crucial new 
     medicines.
       However, Brazil and Kenya recently claimed that about 90 
     percent of total global health-related research and 
     development of Western pharmaceutical companies went toward 
     addressing the medical needs of about 10% of the world's 
     population. Those two countries have since called on the WHO 
     to adopt systems for intellectual-property protection that 
     would increase developing countries' access to health 
     innovations and medicines.
       WHO staffers say they resent what they view as the United 
     States political agenda toward vital public-health concerns, 
     ranging from reproductive-health issues to promoting good 
     dietary standards.
       At the 2004 World Health Assembly (WHA), the U.S. broke 
     with the meeting's proposed resolution that reproductive and 
     sexual rights should be considered human rights, and strongly 
     protested the meeting's focus on the public-health risks of 
     unsafe abortions. Lee had earlier that year held up a list of 
     essential WHO-recommended medicines drafted by an independent 
     expert committee for more than two months because of U.S. 
     objections about two listed abortifacient drugs that could be 
     used to induce abortions in emergencies.
       The U.S. delegation to another recent WHA took issue with a 
     WHO-proposed diet and health resolution, particularly 
     concerning the acceptable level of sugar content in foods, 
     which by the WHO's expert assessment would have cast U.S. 
     fast-food and soft-drink companies in an unfavorable light. 
     Lee famously bent to the U.S. objections and signed off on a 
     significantly watered-down version of the original 
     resolution.
       U.S. interference with U.N. personnel and policy decisions, 
     of course, isn't an entirely new phenomenon. The U.S. is the 
     largest donor to the U.N. and by association to the WHO, and 
     in light of the U.S.-inspired events in Bangkok, senior WHO 
     representatives throughout the organization are likely to be 
     more guarded when commenting on public health issues that 
     Washington considers sensitive.
       The Bush administration's tactics, often cloaked as reform 
     measures, in reality aim to bring U.N. agencies like the WHO 
     more in line with U.S. commercial and political interests.
       At the WHO, at least, that process has come at the expense 
     of the U.N. agency's stated mission, commitments and, perhaps 
     most significant, its global credibility as an impartial and 
     apolitical actor.

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