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In response to the reopening of negotiations on the TB High-Level Meeting (HLM) political declaration, a coalition of U.S.-based civil society stakeholders have submitted a letter to U.S. Ambassador to the UN, Nikki Haley, urging a diplomatic solution to the contentious provisions on access to medicines.
Earlier in July, the South African government took an important and brave step by breaking the ‘silent period’ for the declaration calling attention to the removal of language supporting the use of TRIPS flexibilities and centralizing access to medicines in the declaration. As negotiations continue, this letter was sent to U.S. officials close to the negotiations across the U.S. Mission to the UN, State Dept. and the Health and Human Services Office of Global Affairs (HHS/OGA).
TAG stands with the global community in calling on the U.S. government to come to a diplomatic and political solution to recognize UN member states rights in using every tool possible to address their TB epidemic and expand access to affordable medicines, as agreed upon by international law.


August 2, 2018

The Honorable Nikki Haley
U.S. Permanent Representative to the United Nations
United States Mission to the United Nations
799 United Nations Plaza
New York, NY 10017

Dear Ambassador Haley,

We write you with urgency as U.S.-based civil society stakeholders, communities, and individuals affected and concerned by the growing tuberculosis (TB) crisis worldwide. We encourage the U.S. government to find a political solution to the impasse on text that acknowledges the importance of affordable medical tools in combatting TB regarding access to medicines and health technologies in the political declaration currently being negotiated for the UN High-Level Meeting (HLM) on TB taking place on September 26, 2018.

The HLM and the resulting political declaration is necessary to galvanize the political will, commitment, and resources needed from UN Member States to address the world’s leading infectious killer. However, language in both the preambular and operating paragraphs on promoting equitable access to medicines continues to stall this vital declaration from advancing, thus making it difficult to finalize global consensus that guides a successful response to the global TB epidemic to truly end TB.

We recognize and laud the U.S. government’s tremendous contribution to the global TB response. Ensuring affordable access to current and future medicines is absolutely necessary to combat TB and can help ensure that the important contributions by the U.S. and other governments can save more lives. The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement) includes important public health safeguards that allow governments to exercise their rights to ensure access to medicines and other vital health technologies by taking measures to make them affordable. These safeguards allow governments to better address their public health needs with regard to TB, which has taken the lives of 1.7 million people in 2016 alone. Intellectual property monopolies play a limited role in incentivizing innovation for diseases like tuberculosis without a lucrative market, but play a significant role in impeding access to the lifesaving medical
tools that are developed.

Low-and middle-income countries will continue to struggle to implement the vision of the forthcoming political declaration and meet the Sustainable Development Goals without affordable access to present and future essential TB vaccines, diagnostics, and medicines.

Throughout the negotiations, Member States are taking critical steps to demonstrate political will and commitment to increasing investment in TB prevention, national TB programs, and research and development. However, further delay in the finalization of the political declaration is not in
the interests of the U.S. or global community. As we write, lives are being lost at the rate of 3 individuals every minute from TB, a treatable and preventable disease. The lack of commitments to affordable medicines and health technologies in the operative text of the political declaration for the HLM on TB is alarming. We therefore appeal to the U.S. government to work in good faith to find a political solution that is globally accepted, and that encourages countries to use every tool necessary and available, consistent with international obligations, including TRIPS flexibilities that better balance intellectual property protections with enabling access to urgently needed lifesaving treatments.

Again, we thank the U.S. government for its long leadership on TB and for encouraging other countries to step-up in the fight against TB by being an excellent example of committing the resources and research necessary to address this global epidemic. We respectfully request that you address these concerns and find a political solution to ensure the affordability of the vaccines, diagnostics, and medicines necessary to move the world forward and truly get us across the last mile on the path towards TB elimination.

Thank you,

American Medical Student Association (AMSA)
American Thoracic Society (ATS)
Drugs for Neglected Diseases Initiative, North America (DNDi)
Elizabeth Glaser Pediatric AIDS Foundation (EGPAF)
Health GAP
Interfaith Center on Corporate Responsibility (ICCR)
International Union Against Tuberculosis and Lung Disease (The Union)
Knowledge Ecology International (KEI)
National TB Controllers Association (NTCA)
Oxfam America
People of Faith for Access to Medicines (PFAM)
Public Citizen
Student Global AIDS Campaign
Treatment Action Group (TAG)
Universities Allied for Essential Medicines (UAEM)
We Are TB

CC: Laurie Phipps, Gender, Health and Social Issues, ECOSOC Section, U.S. Mission to the United Nations
Ann Blackwood, Director for Health Programs, Bureau of International Organization
Affairs, U.S. Department of State
Lynn Filpi, Office of Pandemics and Emerging Threats, Office of Global Affairs, U.S. Department of Health and Human Services

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