Fourteen international NGOs have termed the WTO deal on TRIPS and Public Health as a gift bound in "red tape". Terming the current decision as a temporary waiver, they called upon the WTO member countries to draft an amendment to the TRIPS that simplifies and clarifies the procedures and removes unnecessary obstacles to the export of medicines to address public health problems. WTO is to go for a permanent amendment to the TRIPS in 2004.

They opined that the as a measure of trade policy, the terms and conditions that accompany the "gift", contradicts the basic principles of the WTO and free trade. The NGOs, however, appreciated the developing countries' successful resistance against the pressure from the United States, the European Union, Japan and other developed economies to limit the agreement to only a few diseases or for only extraordinary circumstances.

"For a WTO "deal" to be more than a public relations exercise for a new round of trade rules, it should actually work in practice. The WTO took a 52-word mechanism that was endorsed by the European Parliament in 2002 and created a 3,200-word maze of red tape that was plainly designed to frustrate and undermine the objective of protecting public health and promoting access to medicine for all," the NGOs said in a joint statement.

According to them, the main problems with the rules are:
1 The WTO is requiring the issuance of two compulsory licenses when the new mechanism is used.

2. The WTO has added many constraints on the business practices of the generic companies.

3. The WTO deal introduced an extra layer of uncertainty by stating that the system should not be an instrument to pursue industrial or commercial policy objectives, creating uncertainty over the role that will be played by the businesses that manufacture and sell generic drugs.

4. The decision leaves unclear whether or not economic efficiency is a grounds for determining a lack of manufacturing capacity in the importing country. The lack of clarity on this issue has been defended as a matter of "creative ambiguity", but already the US is telling the Philippines and other countries that they will oppose "economic efficiency" as grounds for allowing a country to import generics.

5. The deal gives the WTO itself new authority to second guess and interfere in the granting of individual compulsory licenses to generic companies.

6. The United States and other Developed Economies now have greater opportunities to pressure and stop developing countries from issuing compulsory licenses.

The NGOs pointed out that the current decision is only a temporary waiver, and a permanent amendment to the TRIPS is scheduled for 2004. "We call upon the WTO member countries to draft an amendment to the TRIPS that simplifies and clarifies the procedures and removes unnecessary obstacles to the export of medicines to address public health problems," they said.

"We also call upon every country that does not have access to medicines for all to begin to use the TRIPS flexibilities, and the August 30, 2003 decision, to provide affordable medicines to the poor. We urge counties to resist implementation of TRIPS plus obligations in regional or bilateral trade agreements. If the framework imposed on countries by the WTO cannot be used effectively to promote public health and access to medicines for all, then poor countries should not be obligated to issue patents on medicines."

The joint statement was issued by ACT Up Paris, Consumer Project on Technology, Consumers International, Essential Action, European AIDS Treatment Group, Health Action International, Health GAP, International People's Health Council, Médecins sans Frontières, OXFAM International, People's Health Movement, SEATINI, Third World Network and Women in Development.