The following correction was printed in the Guardian's Corrections and clarifications column, Monday December 11 2006

In the case study, accompanying the article below, we said that 1.42 billion people in India could not afford the drugs they needed to save their lives. That is the figure Oxfam gives for developing countries such as India, rather than India alone.





Poor people are needlessly dying because drug companies and the governments of rich countries are blocking the developing world from obtaining affordable medicines, a report says today.

Five years to the day after the Doha declaration - a groundbreaking deal to give poor countries access to cheap drugs - was signed at the World Trade Organisation, Oxfam says things are worse.

The charity accuses the US, which champions the interests of its giant pharmaceutical companies, of bullying developing countries into not using the measures in the Doha declaration and the EU of standing by and doing nothing. Doha technically allows poor countries to buy cheap copies of desperately needed drugs but the US is accused of trying to prevent countries such as Thailand and India, which have manufacturing capacity, making and selling cheap generic versions so as to preserve the monopolies of the drug giants.

"Rich countries have broken the spirit of the Doha declaration," said Celine Charveriat, head of Oxfam's Make Trade Fair campaign. "The declaration said the right things but needed political action to work and that hasn't happened. In fact, we've actually gone backwards. Many people are dying or suffering needlessly."

The Indian generics firms make most of the cheap drug cocktails that are now being rolled out to people with HIV in Africa and are keeping more than a million people alive. They brought the price of a basic three-drug cocktail down from $10,000 (£5,250) a year to less than $150 (£79). But new Aids drugs will soon be needed because the virus will become resistant to the basic ones now in use - as has happened in the EU and the US.

Those newer Aids drugs, together with drugs for cancer and diabetes, are under patent. The Oxfam report points out that 4 million people were newly infected with HIV in 2005 and cancer and diabetes are expanding faster in developing countries than in the richer world.

The report says that, since the signing of the Doha declaration on November 14 2001, "rich countries have failed to honour their promises. Their record ranges from apathy and inaction to dogged determination to undermine the declaration's spirit and intent. The US, at the behest of the pharmaceutical industry, is uniqely guilty of seeking ever higher levels of intellectual property protection in developing countries."

The US has pursued its own free trade agreements with developing countries, tying them into much tighter observance of patent rights than anticipated at Doha. "The USA has also pressured countries for greater patent protection through threats of trade sanctions," the report says.

The drugs firms are also fighting to have patents observed. Pfizer is challenging the Philippines government in a bid to extend its monopoly on Norvasc, a drug pressure drug. Novartis is engaged in litigation in India to enforce a patent for Glivec, a cancer drug, which could save many lives if it were available at generic prices.

The Stop Aids campaign, a coalition of 90 NGOs of which Oxfam is a member, is calling for the government to champion the issue at the G8 summit next year. Three-quarters of HIV drugs are still under monopoly and unaffordable in poor countries, it said. More than 75% of those who need HIV treatment urgently are still not getting it. Only 8% of children with HIV are on drugs, which cost four times more than those for adults.

"Sadly, promising words have not translated into life-saving treatments and five years is too long to wait when the stakes are so high," said Steve Cockburn, campaign coordinator.

Case study

Premavati, a 60-year-old widow living in Delhi who is suffering from non-Hodgkins lymphoma, a cancer of the lymphatic system, has spent around $900 (£470) on medicines. "My husband died two years ago," says Premavati. "We have absolutely no savings. Of my two sons one is a casual labourer, the other has no job. My daughter is 30, has two children and is also a widow." She is one of 1.42 billion people in India who cannot afford the drugs they need to save their lives. Their country is the leading producer of inexpensive generic drugs but about 67% of the output is exported, and it is under pressure to stop copying new patented drugs. The future looks bleak for Premavati. "How will I raise the money for my treatment?" she says, "Already, I've spent what we had. If nobody helps I will just go back to my daughter and will have to die without medicines."