Increasing Global Access to Medicines and Encouraging Appropriate Use :

1. Increasing Global Access to Medicines and Encouraging Appropriate Use : ‘7 years after ICIUM 2004’ - What happened and what lies ahead? Dr.Suwit Wibulpolprasert Ministry of Public Health, Thailand

2. What happened in the last 7 years: • The governments • The IGOs • The Community and Civil Society • The industries

3. The Developed Countries Governments • Commited more to Global Health - MDGs, WHO, UHC, GF, GAVI, etc. – influence n control • Pushed for stronger IP – TRIPs plus • Limit the scope of TRIPs flexibilities n forget Doha • Support aggressive marketing of the industries • “No or little commitments to Improving Use of Medicines”

4. Developing Countries Governments • Committed more to health – Abuja declaration, MDGs, UHCs • Challenges of sustainability - GF, GAVI • Protecting TRIPs flexibilities and Doha • Corruptions and vested interests “Little interests in Improving Use of Medicines”

5. IGOs and GHPs • IGOs especially WHO - weak and less effective with financial crisis and WHO reform • GHPs - more influential – participatory and inclusive • Challenges and battles between IGOs and GHPs • GHPs challenges of being bureaucratic IGOs itself – based withini UN structures

6. The Community and NGOs • Much stronger - more significant roles • Engaged in the governing structures Challenges of becoming implementing bodies and weaken itself • Also not much interests in IUM

7. The industries • More merger and aquistion – bigger and more influential • More aggressive in the marketing of drugs • Get more involved in the IGOs including WHO • Get actively involved in the GHPs, especially GF and GAVI (directly and indirectly)

8. The 3rd World War !!1 • We never aware that a long lasting 3rd world war has already started almost two decades ago. It threaten to kill all of us. • A war that recognizes no national boundaries against ‘invisible enenies’ • A war against ourselves, our greed and our selfishness

9. INRUD and ICIUM • “Never underestimate the ability of a small group of committed individuals to change the world. Indeed, they are the only ones who ever have” Margaret Mead, anthropologist • Apariha Niya Dhamma – prevent failure in working together – Lord Buddha

10. Future of INRUD – an INGOs ? • WHO – “knows everything but does nothing” • UNICEF – “Does everything but knows nothing” • WB – “Knows everything and does everything – but wrong most of the time” • UNDP – “Knows nothing and does nothing” VISION - “A knowledge based social advocator to change the way medicines are used or not used”

11. Universities RIs IHCAR Industries MSH Knowledge WHO MANAGEMENT TNRUD Comm. INRUD Parties Consumers Cabinet Politics Society Media Professionals Bureaucrats “TRIANGLE THAT MOVES THE MOUNTAIN”