New York/Quito - Trade objectives proposed by the United States are threatening access to affordable lifesaving medicines for people with HIV/AIDS and other diseases in Latin America and the Caribbean, according to Medecins Sans Frontieres (MSF).

On the eve of the VII Ministerial Meeting for the creation of the Free Trade Area of the Americas (FTAA) in Quito, Ecuador, this week, the US is pushing countries to impose trade standards on pharmaceuticals that far exceed requirements in the World Trade Organization (WTO) Agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS) and flaunt the WTO Doha Declaration on the TRIPS Agreement and Public Health which firmly placed health needs above commercial interests in trade treaties.

MSF calls on the US to abandon these "TRIPS-plus" negotiating objectives in the interest of public health in the region, saying that FTAA negotiators must not renege on the historic agreement reached in Doha.

"By proposing provisions in Quito that go beyond TRIPS and undermine the spirit and letter of the Doha Declaration, the US is breaking the promise it made to developing countries to ensure that when it comes to world trade and intellectual property rights, public health takes priority over patents," stated Rachel Cohen, US liaison for the MSF Campaign for Access to Essential Medicines. "Less than one year ago in Doha, all 142 WTO members, including the US and Canada, reaffirmed the right of countries to take all available measures to promote access to medicines for all, and now the US is using regional trade agreements to chip away at these hard-won gains."

The US negotiating position at the FTAA Quito Ministerial this week undercuts TRIPS and the Doha Declaration by placing restraints on generic competition, the most effective tool that countries have for driving down prices of essential medicines. US negotiating objectives would dramatically limit the circumstances under which a country can issue a compulsory license on pharmaceuticals, and therefore weaken a country's ability to remedy patent abuses and foster competition to lower prices.

The US delegation in Quito is also seeking to extend patent terms on pharmaceuticals beyond the 20-year minimum required in TRIPS, pressing for regulatory authorities to grant exclusive rights over pharmaceutical test data, and seeking other measures that limit or delay generic competition.

"If the US gets what it wants in Quito, countries in Latin America and the Caribbean will lose the most important mechanism they have to access affordable medicines generic competition," states Rachel Cohen. "If FTAA had been in place six years ago, the Brazilian AIDS program would have never been able to achieve the success it has in saving and improving lives by using local generic production and competition to procure the lowest-priced quality drugs to treat the largest number of people."

The World Health Organization (WHO) estimates that there are 1.8 million people living with HIV/AIDS in Latin America and the Caribbean, and 110,000 AIDS deaths were recorded in the region in 2001. The Caribbean is the second-most HIV/AIDS affected region in the world, after sub-Saharan Africa.

"In Honduras, the price of certain brand name AIDS drugs are on average four times the price of WHO-approved generic forms of the same drugs, which means that we can treat four times as many patients with generics on the same budget," says Dr. Nick Silberstein, a medical coordinator for MSF in Honduras. "If the FTAA creates a system that blocks use of equivalent but cheaper drugs, it will be a catastrophe for our patients and for all people with HIV in the region. The difference in price can be the difference between life and death for patients in Latin America and the Caribbean."

In the Americas, MSF currently has projects in Bolivia, Brazil, Colombia, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Mexico, Nicaragua, Panama, and Peru. MSF teams provide medical care for people with HIV/AIDS, malaria, Chagas disease, leishmaniasis, trachoma, and other diseases, as well as primary care, maternal/child health care, and other services for displaced and homeless populations and for indigenous people.