Quito, October 12th  2009

Señor Economista
Rafael Correa Delgado
Presidente de la República del Ecuador

Dear President Correa,

We, organizations of civil society, treatment advocates, development advocates, people living with HIV, and access to medicines movements the world over, congratulate Ecuador on its courageous plans to grant compulsory licenses for medical patents.

Over the last ten years, competition of generic medicines with branded medicines has fueled a revolution in HIV/AIDS treatment.  Competition has reduced costs of first-line antiretroviral therapy by over 98%, from $10,000 per person, per year to near $100 today.  As a result, four million people worldwide now have access to life-saving drugs. 

But monopoly drug pricing problems in developing countries extend far beyond first-line HIV/AIDS treatments. Many people living with HIV and AIDS are graduating to second and third-line treatments, many of which are patented and sold at high cost.  Heart medicines, cancer medicines, medicines against opportunistic infections and more are also often sold at prices far beyond peoples’ ability to pay.  High costs constrain the essential services public health programs could otherwise provide.   Today, multinational pharmaceutical companies are intensifying their global registration of patents.  We confront the deadly prospect of monopolized drug markets. 

Compulsory licensing is, has been, and will be an essential safeguard of competition.   Each country that uses this safeguard – enshrined in the World Trade Organizations' TRIPS Agreement – makes it simpler for the next.  As compulsory licenses open markets to competition, they also help generate the necessary economies of scale to further reduce costs, and incentivize the broader reach of generic medicines. While advancing access to medicines imperatives, compulsory licensing is compatible with ensuring reasonable compensation for patent holders and supporting medical innovation. 

The example of Brazil is telling. Since 2001, Brazil has provided hundreds of thousands of people with HIV/AIDS treatment and saved more than US$1 billion through a combined approach of national production of medicines, imports of generics, negotiation and compulsory licensing. 

As so eloquently stated in the Political Constitution of Ecuador, Article 363, in access to medicines, the interests of public health prevail over those of mere profit.  Your recent remarks position Ecuador to advance the politics and principle of access to medicines for all, in Latin America and around the world. 

We stand with you.  Please count on our support as you pursue your vision of intellectual property as “a mechanism for development for the people.”


Abg. Peter Maybarduk
Essential Action

P.O. Box 19405
Washington, D.C. 20036



Eurasian Harm Reduction Network


Lawyers Collective HIV/AIDS Unit India

Health GAP (Global Access Project) USA

Mesa de Organizaciones con Trabajo en VIH/SIDA Colombia

International Treatment Preparedness Coalition Russia

Asia Pacific Network of People Living with HIV/AIDS (APN+)

Third World Network

Health Action International Africa

Health Action International Europe

Health Action International Global

Positive Malaysian Treatment Access & Advocacy Group (MTAAG+).

BUKO Pharma-Kampagne Germany

Foundation For Consumers (FFC) Thailand

Canadian HIV/AIDS Legal Network

Treatment Action Group USA

Health Care is Not for Commerce LAC

Center for Policy Analysis on Trade and Health (CPATH) USA

American Medical Student Association


c.c.       Ab. Andrés Ycaza Mantilla

            Presidente IEPI


            Dra. Caroline Chang

            Ministra de Salud Pública

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