Evian, France, 02 Jun 2003
Global health crises call for close international co-operation on policies and methods. We reaffirm our commitment to achieving the development goals set out in the Millennium Summit and at the World Summit on Sustainable Development. We will work in partnership with developing countries, the private sector, multilateral organisations and non-governmental organisations (NGOs) to help achieve these health goals. Multilateral and bilateral Official Development Aid as well as private efforts from companies and NGOs should match and complement existing efforts to improve health outcomes.
1. Fighting HIV/AIDS, Tuberculosis And Malaria
1.1 We express our continued concern at the increase in the global HIV/AIDS pandemic. We welcome the increased bilateral commitments for HIV/AIDS, whilst recognising that significant additional funds are required. We commit, with recipient countries, to fulfil our shared obligations as contained in the Declaration of Commitment on HIV/AIDS for the 2001 United Nations General Assembly Special Session.
1.2 We reiterate our commitment to fight against AIDS as well as Tuberculosis and Malaria as agreed in Okinawa, through further actions in such areas as institutional building, public-private partnerships, human resource development, research activities and promotion of public health at the community level. We will strengthen our efforts in this fight, both bilaterally and multilaterally.
1.3 We reaffirm our support for the Global Fund to fight AIDS, Tuberculosis, and Malaria.
1.4 We welcome and support the proposal to host, in collaboration with the Global Fund, an international donors' and supporters' conference bringing together governments, international organisations, NGOs and members of the private sector active in this field in Paris this July. The purpose will be to develop strategies for mobilising resources in order to secure sustainable long term financing for the Fund and other complementary efforts, and to achieve cost effective results-targeted management of the Global Fund.
1.5 We call upon those that have not yet done so to consider increasing their support to the Global Fund as well as to other multilateral and bilateral efforts to combat these infectious diseases.
2. Strengthening health systems
2.1 We emphasise the importance of strengthening health systems as a framework for increasing access of the neediest populations of developing countries to health care, drugs and treatments. We call upon these countries to develop and prioritise their own health strategies and policies. Multilateral and bilateral development assistance, as well as private sector efforts from companies and NGOs, are essential to improving these health systems. Adequate support and financing of health care are needed to increase the number and retention of health care personnel, advance the rational use of medicine, and strengthen drug distribution systems. These efforts are essential to improving access and quality of health care in poor countries.
2.2 We will encourage and support where appropriate the use of information and communication technologies for medical treatment.
3. Access to medicines
3.1 Building on strengthened health systems, in partnership with others, including public-private partnerships, we will work to develop an integrated approach that will facilitate the availability and take-up of discounted medicines for the poorest in a manner that is fair, efficient and sustainable. We recognise the complexity of increasing access to medicines in developing countries which, among other factors, depends on affordable prices. We welcome pharmaceutical companies' voluntary long-term commitments to providing essential medicines at substantially discounted prices to developing countries and strongly encourage further efforts, including through supply competition. We will also work with developing countries to encourage greater uptake of such offers of free and discounted drugs, as are now being made. We support and encourage developing countries to contribute to the goal of affordable medicines by reducing their tariffs and fees on discounted and donated products.
3.2 We will take the steps necessary to prevent the diversion of those medicines away from the countries or regions for which they were intended. We call on recipient governments to do the same and we undertake to provide technical support to assist them to do so. We will not use the preferential prices offered to the developing world as benchmarks for pharmaceutical products on our own markets.
3.3 To address the practical problems faced by developing countries with no or insufficient manufacturing capacities, we note that, pending a WTO solution, many of us have instituted moratoria on challenging any Member of the WTO that, according to the scope and modalities defined in their respective moratoria, would want to export to a country in need medicines produced under compulsory license for addressing public health crises, including those relating to HIV/AIDS, tuberculosis and malaria and other epidemics. We direct our ministers and officials, working urgently with WTO partners, to establish a multilateral solution in the WTO to address the problems faced by these countries, rebuilding the confidence of all parties, before the Cancun Ministerial.
4. Fighting Diseases Mostly Affecting Developing Countries
We will encourage research into diseases affecting mostly developing countries.
4.1 In order to expand the development of effective, safe and affordable drugs for diseases affecting mostly developing countries ("neglected diseases"), we are committed to seeking ways to support world-wide the development of research on health technologies for prevention (including vaccines), control, treatment and cure for these diseases. In particular we will:
- work with developing countries to increase their own ability to contribute to research and development on these diseases, including to create incentives and the necessary regulatory systems to support ethical and safe clinical trials;
- encourage research into these diseases, in our countries too, including by providing appropriate incentives;
- continue to support work already underway in the non-governmental sector.
4.2 We will encourage relevant international organisations to keep the situation under active review.
5. Eradicating polio
We will work to fully eradicate this disease.
5.1 Efforts to eradicate polio have made good progress. But a limited number of countries still register cases.
5.2 In keeping with our pledge at Kananaskis to provide, on a fair and equitable basis, sufficient resources to eradicate polio by 2005, we have pledged an additional US$ 500 million and remain committed to playing our full part to ensure that the remaining funding gap is closed.
6. Confronting the threat of SARS
We will work together and with others to contain this disease.
6.1 The spread of SARS demonstrates the importance of global collaboration, including global disease surveillance, laboratory, diagnostic and research efforts, and prevention, care, and treatment.
6.2 Strengthening international co-operation is key to containing, treating and eventually eradicating this disease. The measures that we take at national levels to effectively handle SARS will benefit from us working together.
6.3 We will continue to work closely with the World Health Organisation, to undertake research and investigation at a high level and to develop appropriate means of international co-operation.