Globalization is clearly revealed in the GATT's Uruguay Round Final Act, which Dr. Correa accurately presented regarding Health services and medicines. This process is also referred to by Peter O'Brien, who contrasts it with the regional integration processes.
From the Uruguay Round two aspects can be pointed out in this area:
a) A very wide concept of trade policy which includes patents and intellectual property.
b) Massive integration of developing countries, many of which promote free trade but whose expectations have been frustrated to a large extent.
The Uruguay Round, according to Dr. Correa, has hardly benefited developing countries as regards access to markets. On the other hand, it has imposed new rules which restrict a country's policies for trade and industry, especially in the field of intellectual property. The TRIP's Agreement establishes minimum standards based on the models for protection of intellectual property which exist in industrialized countries. Introducing these standards in developing countries will entail high costs, particularly in the pharmaceutical field.
There has been an attempt to support the TRIP's Agreement alleging its favourable effects on innovation, direct foreign investments or the transfer of technology - in the pharmaceutical field - towards developing countries. However, according to experts in the group, these effects are either nonexistent or are of little significance. Nevertheless, opinion is unanimous regarding the effects on prices for new medicines of introducing patents or extending their time span. Prices will be higher. Prof. Scherer is also of the opinion that it is very unlikely that this greater financial burden for developing countries may be compensated by the benefits obtained from accelerating the discovery and introduction of new medicines.
Negative effects from new protection standards of intellectual property can be minimized, however, by an adequate application of the TRIP's Agreement at the national level:
a) Using its time limits for transition to their maximum extent.
b) Establishing the principle of international exhaustion of rights.
c) Regulating different types of compulsory licences in circumstances such as:
- Refusal to grant a contractual licence under reasonable trade conditions.
- Anti-competitive practices.
- Government use.
- Public health or public interest reasons.
d) Limiting the «reversal in the burden of the proof» to patents for processes related to new chemical entities.
e) Establishing exceptions to exclusive patent rights, including the possibility of experimenting and testing before their expiration date.
The consequences of the financial burden which results from higher prices for new medicines may be limited or lessened:
a) By taking advantage of existing therapeutically relevant products with an expired patent. The use of these could be encouraged by restrictive formularies and by boosting the use of generics with an adequate organization and incentives for substitution.
b) By pointing out the scarce or limited payment capacity of the country, during negotiations with companies regarding prices of important products with no substitutes.
Amongst the remaining factors which contribute to globalization, one can point out:
a) The development and international acceptance of quality standards and rules, encouraged by the WHO in areas such as Pharmacopoeia, Good Manufacturing and Laboratory Practices, a Programme for certifying quality, etc.;
b) The great world presence, international scope and global strategies of large pharmaceutical corporations.