The defense of the right of poor countries to access medicines within an equitable context has committed the Colombian Germán Velásquez, in an unequal crusade against all the interests that encompasses the pharmaceutical market in the world.
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Economist, philosopher and extensively aware of the arguments that polarize world welfare between health and economics, Velásquez has always demonstrated a consistent position in defense of the social that has earned him risks, but has not diminished his enlightened belligerence that puts more than one powerful on the planet in trouble. (Profile: Germán Velásquez, the Colombian who challenged an empire)
He has been an outstanding worker for more than two decades in the World Health Organization (WHO), of which he was director of the Medicines Program; honorary doctorate from several universities and current special adviser for policies and health of the South Center (an organization made up of more than 59 countries based in Geneva).
Many of the positions that he has defended for several decades, and that have made him a target of intimidation, are gaining strength in the midst of the crisis caused by the coronavirus.
On numerous occasions, Velásquez has expressed his concern about the inequitable distribution of vaccines against covid-19, which, initially, should be distributed immediately, equally and balanced in all parts of the world.
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He also lamented the ratified rejection by some countries of the patent exception request, a situation that considerably affects developing countries, declaring that vaccines are “a global public good and, therefore, cannot be patent”.
Because of his numerous battles and services to the community in this field of health, yesterday, in Cartagena, Velásquez received the Order of the Colombian Congress, in the Commander’s Degree, a recognition granted by the Senate of the Republic on behalf of the people Colombian citizens or institutions that have served and contributed to the country.
Next, the text that he pronounced when receiving the award:
Paraphrasing Gabriel García Márquez, who says in One Hundred Years of Solitude: ‘There is no medicine that cures what does not cure happiness’, we could say that ‘there is no medicine that cures what does not cure peace’.
I want to thank the Senate of the Republic of Colombia for this distinction that is granted to me today, and which I humbly receive as an encouragement to continue fighting for the cause of access to medicines for all.
I would like to give special thanks to Senator Iván Darío Agudelo, who was at the origin of this initiative. With Senator Agudelo we share many things, among them, his vision of peace and his fight for innovation, technology and access to health for all Colombians.
The fact that this decoration is awarded to me in the city of Cartagena has a deep meaning for me. In addition to Cartagena being the city we all know for its history, Cartagena was recently the witness city of the peace accords after 50 years of war.
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I had the privilege of attending this ceremony in September 2016, and the impact of this act marked me forever.
Peace is the condition for development and happiness. Peace is a common good to which we all must cling. From it, different economic and social models of organization of society may be postulated; more liberal or more socializing models, as we observe today in Colombia in the pre-election period. Different models of society and different forms of development can be proposed, but peace is only one and it is the condition to be able to develop and build.
Within the different development models, 40 years of experience in the health sector have led me to convictions that I would like to share with you today.
Simplifying, we could say that there are three types of health systems.
In the first place, the single universal system, guaranteed by a Welfare State where all citizens have equal access, without any kind of discrimination.
In this model, access to health is a right and everyone, without exception, has access to necessary medical care, hospitalization and treatment. Examples of this system are the single health system in Brazil or the systems of Western European countries.
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The second model of health systems is based on private insurance, as is the case of the health system of the United States of America. Depending on the insurance you take out, this will give you access to a certain type and level of benefits. It is a class medicine. If you have to pay more, then you will get more and better care and coverage.
Finally, the third model is the mixed one (public-private), like many developing countries, including Colombia (subsidized system and contributory system), where not everyone has access to the same quality, diversity of services and health benefits.
I am, logically, a defender of a single system, guaranteed by the State, that is, a system where access is a citizen’s right. This system can be built and function in different models of economic and social development with certain limits. Limits such as the guarantee that the State allows everyone a decent life.
In societies with such aberrant inequalities as is the case in Colombia, hundreds and thousands of children can die, having their health card and before going to the hospital. They simply die of malnutrition.
The central theme of my fight in the last 15 years is that a drug that can save a life cannot be the object of a monopoly protected by a patent. That is why I think and believe that vaccines and treatments for covid-19 should be considered a common public good.
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To finish, I could not fail to say something about the pandemic that we have been experiencing for more than two years. Covid-19 is the biggest health, economic and social disaster in the last 100 years.
What lessons or questions could we ask ourselves after two years of fighting the pandemic?
First of all, if covid-19 has taught us anything, it is that we must completely rethink the value we place on health. The billions needed to prevent and respond to health crises are nothing compared to the trillions lost in business closures; job losses and the paralysis of the economy are being the cost for the world economy, after a health emergency such as the covid-19 pandemic.
On the other hand, the unprecedented massive mobilization of public funds for research and development of vaccines has shown us that there are resources to fight diseases.
A third lesson from the pandemic is the need to reinforce power and authority in the World Health Organization (WHO). Only a public, multilateral and democratic body can defend the interests of the populations of all countries.
Likewise, despite the fact that the R&D of vaccines and treatments has been carried out mainly with public funds, the management of the covid-19 pandemic has been in the hands of for-profit commercial interests rather than health interests.
The mechanisms designed by the WHO and the group of countries that could ensure equity in access to vaccines, such as the so-called Covax, failed.
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Finally, after two years of the covid-19 crisis, many questions remain unanswered, such as the duration of vaccine coverage or whether we are heading towards an annual or semi-annual vaccination of the entire world population.
We can also ask ourselves to what extent the States should continue to accept the demand of the industry not to be responsible for the possible secondary effects generated by biologicals. Another unanswered question is whether the international community will continue to allow the patenting of vaccines that many of us today consider to be global public goods.
Governments and the WHO will have to understand that the management of a health crisis like the current one or similar ones that could come in the future has to be public, guided by the common interest and not by private interests for profit as manufacturers intend to do today of vaccines.
It is around these concerns and questions that the South Center, the intergovernmental organization where I am now, works and investigates to support developing countries in the search for innovative solutions based on public interest.
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In this situation of international crisis and in the context of the recent movements of young people, unprecedented in Colombia, it is perhaps time to rethink what role health should play in the different programs that are being proposed.
Thanks a lot.
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