RESUMO
Health care raises structural issues in a democratic society, such as the role assigned to the central government in the management of health risk and the redistributive consequences generated by the implementation of social insurance. These are often cause of strong political controversy. This paper examines the United States of America health reform, popularly known as "ObamaCare". Its three main elements, namely individual mandate, creation of new health insurance exchanges, and the expansion of Medicaid, generated a redistribution of health risks in the insurance market of that country after almost a century of frustrated legislative efforts to guarantee minimum universal coverage. The article proposes that a change of this magnitude in the United States will produce effects in a forthcoming parliamentary discussion on the health reform in Chile, which still maintains a highly deregulated private health system.
Assuntos
Humanos , Reforma dos Serviços de Saúde/normas , Cobertura Universal do Seguro de Saúde/normas , Patient Protection and Affordable Care Act/normas , Estados Unidos , Chile , Medicaid/normasRESUMO
Entre los mayores obstáculos que enfrenta en todo el mundo el acceso a los medicamentos se encuentran las cuestiones relativas a los derechos de propiedad intelectual y la falta de competencia, unido al retardo y postergación en la generación de investigación y desarrollo (I+D) sobre aquellas enfermedades que afectan de manera importante a la población de países en desarrollo y países menos adelantados. En este trabajo se analiza el fortalecimiento de la patente farmacéutica contemplada en el Acuerdo sobre los Aspectos de los Derechos de Propiedad Intelectual (ADPIC) de la Organización Mundial de Comercio (OMC) y el actual régimen de incentivo imperante para medicamentos nuevos, sus consecuencias y actuales conflictos. En ellos suelen enfrentarse los intereses de países desarrollados, presionados por una poderosa industria farmacéutica, con los intereses de países en desarrollo y países menos adelantados.
Topics related to intellectual property rights and lack of competency are found among the major obstacles facing the access to drugs in the world, together with the delay and postponement in the generation of R+D about those diseases affecting disproportionately to the population of developing countries and least developed countries. In this study, the strengthening of pharmaceutical patents included in the Agreement on trade-related aspects of intellectual property rights of the World Trade Organization (WTO) and the current prevailing incentive towards new drugs, their consequences and current conflicts are analyzed. In these, generally, the developed countries interests are confronted -pressed by a powerful pharmaceutical industry- with the interests of developing countries and least developed countries.
Entre os maiores obstáculos que enfrenta em todo o mundo, o acesso aos medicamentos se encontram as questões relativas aos direitos de propriedade intelectual e a falta de competência, aliado ao retardo e postergação na geração de I+D sobre aquelas enfermidades que afetam de maneira desproporcionada a população dos países em desenvolvimento e países menos adiantados. Neste trabalho se analisa o fortalecimento da patente farmacêutica contemplada no Acordo sobre os Aspectos dos Direitos de Propriedade Intelectual (ADPIC) da Organização Mundial de Comércio (OMC) e o atual regime de incentivo imperante para medicamentos novos, suas consequências e atuais conflitos. Neles devem ser enfrentados os interesses de países desenvolvidos -pressionados por uma poderosa indústria farmacêutica- com os interesses de países em desenvolvimento e países menos adiantados.
Assuntos
Acessibilidade aos Serviços de Saúde , Propriedade Intelectual de Produtos e Processos Farmacêuticos , Saúde Pública , Pesquisa Científica e Desenvolvimento TecnológicoRESUMO
El fortalecimiento mundial de la patente farmacéutica tensiona el acceso a los medicamentos esenciales. De acuerdo a este trabajo ello ha derivado en la colisión del derecho de propiedad intelectual que impulsa el Acuerdo sobre los Aspectos de los Derechos de Propiedad Intelectual relacionados con el Comercio (ADPIC) de la Organización Mundial del Comercio (OMC), con el derecho a la salud previsto en el Pacto Internacional de Derechos Económicos, Sociales y Culturales (PIDESC). Diversas controversias ventiladas en la OMC ilustran el enfrentamiento entre países con una poderosa industria farmacéutica y los intereses de países en desarrollo. Se concluye que las normas ADPIC-plus suscritas en tratados de libre comercio por países en desarrollo, que confieren al titular de la patente farmacéutica más derechos que los previstos en el propio Acuerdo sobre los ADPIC, son incompatibles con las obligaciones que asumen respecto del acceso a medicamentos esenciales en el marco del derecho a la salud del PIDESC.
The strengthening of pharmaceutical patent protection globally puts strains on access to essential medicines. According to the present paper, this process has led to the collision of the intellectual property rights adopted in the World Trade Organization (WTO) Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement and the right to health stated in the International Covenant on Economic, Social and Cultural Rights (ICESCR). Several controversies disputed in the WTO illustrate the confrontation between countries with a powerful pharmaceutical industry and the interests of developing countries. It is concluded that the TRIPS-plus rules subscribed to by developing countries in free trade agreements which give the pharmaceutical patent holder more rights than those stipulated in the original TRIPS Agreement are incompatible with the obligations to provide access to essential medicines under the right to health of the ICESCR.