Global health. The current scenario and future perspectives

261 17. Impact of Regional Cooperation and Free Trade Agreements on Access to Medicines Tatiana Tobar Aravena Introduction and a National Historical Perspective This article reviews various aspects of intellectual property that have impacted access to medicines, by analyzing some of the trade agreements that Chile has signed, as well as regional integration and collaboration initiatives in which it has participated in order to advance towards fair pricing. The analysis is based on the premise that medicines play a socially important role, as they are an integral part of achieving a fundamental human right: the right to health. Therefore, they are classified as essential goods and it is emphasized that they should be accessible to all individuals (WHO, 2001), a topic currently under discussion in the proposed Law on Pharmaceuticals 2 (Gobierno de Chile, 2015). A significant development in this field was the creation in Chile of the National Drug Formulary (NF) in 1969, making the country a pioneer in the Americas region for developing a public health policy based on access to generic drugs (Gobierno de Chile, 1968a). This initiative preceded the publication of the World Health Organization’s List of Essential Medicines. According to the Sanitary Code, this NF shall contain a list of indispensable pharmaceutical products in the country for efficient therapy: a basic arsenal that should be available at every healthcare facility to respond and treat society’s most common diseases (Gobierno de Chile, 1968b). To understand its importance, analyzing it just from the perspective of physical access to medicines is not enough. We must also consider that it is a list of “generic products”. These are medications distributed without any brand association or ties to pharmaceutical companies or potential loyalty from prescribing professionals. They correspond only to products identified by their official health nomenclature defined by the WHO, known as International Nonproprietary Names or INN. The INN nomenclature was established in 1950 to provide unique names exclusively for public use and non-appropriable to active ingredients, which are the ones that exert therapeutic action within a pharmaceutical product. Thus doctors, pharmacists, scientists and patients can easily recognize and identify them worldwide (WHO, 2018). It is a useful tool for