Maximize the use of TRIPS Flexibilities to improve the access to treatment for PLHIV in the context of sustainability of HIV responses in Indonesia

Maximize the use of TRIPS Flexibilities to improve the access to treatment for PLHIV in the context of sustainability of HIV responses in Indonesia

Project

The use of TRIPS Flexibilities should be maximized in order to increase access to affordable medicines in Indonesia.

Over the span of three years Indonesia AIDS Coalition (IAC) has extensively advocated to ensure harmful FTA clauses were not adopted. This has been done by providing workshops to the government, thoroughly analyzing the IPR chapters in the FTA, raising awareness through a public campaign, collaboration with local partners, training community members and organizing meetings with all relevant stakeholders. IAC managed to ensure communities were involved in this discussions and successfully ensured that the TRIPS Plus clauses were not implemented in the FTA's (RCEP and I-EU CEPA).
IAC aimed to strengthen the TRIPS flexibilities in the Indonesian patent law by capacity building, creating public exposure, stimulating discussions on affordable medicine. Furthermore IAC continuously encouraged the government to utilize the existing TRIPS flexibilities as much as possible, to improve the access to medicines for PLHIV in Indonesia.

Project details

Time frame
02 January 2018 - 31 December 2020
Budget
€ 227,800
Active in
Indonesia

Objectives

The objectives of this project are: 1) Repelling harmful provisions in free trade agreements; 2) Incorporating flexibilities in national patent laws; and 3), Ensuring that existing flexibilities are used, including the opposition to new patents or issuing compulsory licenses.
In order to meet the outcomes of the program, three overarching, interlinked strategies will guide the implementation of this program. These strategies will be research, capacity-building and advocacy and will be used as approaches which contribute to the achievement of three outcomes.
The researches that are conducted are an analysis of the regulations on TRIPS Flexibilities in the new Patent Law, an analysis of the related IPR chapter in the FTA which will harm the access to medicines, an analysis of the current use of TRIPS Flexibilities in Indonesia and other topics that become barriers in the use of IPR in Indonesia.
The result of those studies will be used as the base to develop advocacy strategies and to increase the community capacity to educate, organize, mobilize and engage the relevant stakeholders so they can be involved in the advocacy activities on this programs to eliminate the TRIPS Plus clause in the FTA, to strengthen the TRIPS flexibilities regulation in the patent law and to encourage the government to utilize the maximum TRIPS flexibilities.
Those strategies are complementary for the overall project design and ensures that the three strategies operate in an integrated framework. Essentially the result of the studies and analysis is expected to enhance community capacity and enhance the advocacy results; building the community capacity is expected to add to the strategic use of evidence and information; it leads to better advocacy outcomes and it increases the impact of the program and it generates increased interest among community and key stakeholders in such dialogues. It is designed to contribute to the achievement of advocacy objectives, and vice-versa.

Community groups

IAC is the leading advocacy actor on HIV and AIDS program to reduce the price of HIV and TB logistic. This effort has a significant impact on supporting the country capacity to provide more access to testing, treatment and laboratory for most affected communities to achieve 90-90-90.
One of the challenges faced by Indonesia to increase treatment coverage is the high price of ARV medicines that are procured by the government. Patent barriers are the major reason for the high prices in Indonesia, removing these barriers would be important to improve treatment coverage, to provide new regiments, and safer and better affordable ARV for PLHIV in Indonesia. As of 2017, the number people on ARV treatment is only 14% (85.000) from PLHIV estimated. IAC targets, when referring to their national target set by NAP, to increase the number PLHIV on treatment to 40% by 2020 (270.000).

Background

The AIDS response in Indonesia is still in a critical situation, meanwhile the Indonesian government has agreed on the goal to end the AIDS epidemic as a public health threat, as stated in the WHO Global Health Sector Strategy aligned with the UNAIDS 90-90-90 treatment target. Compared to other countries in the region, Indonesia lags behind in terms of ART coverage. In 2020, ARV treatment coverage in Indonesia was only 26%, which is the lowest in Asia Pacific. Procurement prices are concerningly high and considered as one of the highest prices in the world. At the same time Indonesia is also facing the transition to an upper middle-income country which means Indonesia is no longer eligible to receive funding from external donors, which is a requisite to scale up treatment. Due to these factors increasing treatment coverage can only be realized through reduced prices of key medicines.

The availability of ARV medicines in Indonesia is limited. People Living with HIV (PLHIV) in Indonesia only have a few treatment options. Children living with HIV (CLHIV) in Indonesia also have limited access to ART, and the majority of these children have to take crushed adult medicines. In order to improve access to treatment, the Indonesian government implemented compulsory licensing in 2004, 2007 and in 2012. By implementing compulsory licensing the government allows someone else to produce a patented product or process without the consent of the patent owner. Compulsory licensing is one of the TRIPS Flexibilities, and has proven to increase the number of PLHIV using ARV in Indonesia since 2004. Nevertheless, HIV epidemics in Indonesia continue, and it seems like the government is still not optimally making use of the TRIPS Flexibilities.

Furthermore, Indonesia, as one of the ASEAN members, has been negotiating the Regional Comprehensive Economic Partnership (RCEP) and the Indonesia – European Union’s Comprehensive Economic Partnership Agreement (I-EU CEPA). During both negotiations the Intellectual Property Right (IPR) Chapter about TRIPS-Plus, that will harm the access to medicines, will be discussed.

In addition, the Indonesian government had just passed the new Patent Law No. 13 in 2016, which has been used as the base to negotiate in the free-trade agreement. However, the implementation setting rules of TRIPS Flexibilities in Patent law NO. 13 is considered to be weak. Indonesia will have a weak policy bargain, which will risk the negotiations on free trade agreement and it will also reduce utilization of TRIPS flexibilities related to the access to treatment for PLHIV in Indonesia.

Goals

Everyone living with HIV worldwide receives treatment
100%
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