Demand Solutions for Improving Lives is an open innovation model that brings together entrepreneurs, investors, and public and private institutions in order to come up with and promote innovative ideas for improving people’s lives. The initiative is organized by the Inter-American Development Bank and the Multilateral Investment Fund (MIF) and was also held in 2013, 2014, and 2015. The 2016 event took place at the Usina del Arte (link in Spanish), Buenos Aires, on November 15 and 16.
The first day of the event was called WeXchange and involved an innovative space for women entrepreneurs from Latin America and the Caribbean to connect with mentors and investors working in areas that are not traditionally perceived as being for women: science, technology, engineering, and math (STEM). The aim of the event was to promote access to science for all and tear down the myths around STEM.
The event finished with a Venture Night, when innovative and disruptive start-ups from Latin America and the Caribbean presented their solutions to improve access to healthcare, drinking water, sanitation, and nutrition. Topics included:
Those who took part in WeXchange met women entrepreneurs and venture capitalists representing investment funds that specialize in new technologies seeking to take on the greatest challenges facing humanity: access to healthcare, water, and food.
This article covers just some of the technological developments that were presented at WeXchange and which turned out to be a source of great inspiration and an example of the commitment that those who took part have shown to human development. These women entrepreneurs showed confidence in the achievements that their knowledge and skills have brought them, something they communicated clearly to the audience at the event.
Isabel Hoffmann, entrepreneur in preventative medicine, technology, mobile healthcare, and education. The CEO and founder of Tellspec, Ms. Hoffman has created the first consumer food scanner. The device allows you to detect the melamine content of food products in seconds. Melamine is an organic chemical that is regularly used to adulterate food for pets and humans and has been detected in baby formula, making it toxic.
Gabriela León, founder of Gresmex, a company that specializes in nanotechnology research and development. In response to a health problem that her son was having, this biochemical engineer developed a nanobiomolecule called NBELYAX, which can completely deactivate all types of virus, bacteria, fungi, spores, trypanosomes, and microbacteria to create biosecure spaces. In 2015 Gabriela León was named a Technology Pioneer by the World Economic Forum for her revolutionary contribution to healthcare.
Geraldine Mlynarz founded Diagnotec and ActivaQ, biotech firms that specialize in the diagnosis and control of infectious disease in animals using advanced technology to carry out early diagnoses of the IPVN virus, which affects salmon throughout the world. The roads she traveled to reach her achievements were long and winding, but her sights were always set on her professional goals and what she wanted to contribute to society. Geraldine took part in the event as an Endeavor entrepreneur (link in Spanish).
Viviana Bernath, founder and CEO of Genda. She holds a PhD in biology and specializes in molecular genetics. She founded one of the first genetic diagnostic and forensic genetics laboratories in Argentina. In recent years she started Zoigen, a firm which focuses on personalized genomic medicine, a new way of predicting and preventing illnesses through DNA analysis.
WeXchange also included the announcement of the six STEM finalists from the Pitch Competition (link in Spanish) organized by MIF and NXTP Labs. The Pitch Competition was open to entrepreneurs with a strong scientific and technical background and included presentations on products and services related to biotechnology, health monitoring, data transmission, and online marketplaces.
Of the 169 competitors from 14 countries in Latin America and the Caribbean, the following six were chosen as winners: Emilia Díaz, Kaitek Labs (Chile); Victoria Simón, Alquilando (Argentina); Hannah Kim, Mifiel (Mexico); Melina García Herrera, Life Monitor (Mexico); Yanina Powazniak, Biomakers (Argentina); Komal Dadlani, Lab4U (Chile), presented by Marta Cruz, founding partner at NXTP Labs, all of whom presented innovative solutions to a panel of investors.
The second day of Demand Solutions included the Venture Night organized by the IDB and MIF in partnership with the Department of Creative Economy and Foreign Trade at the Government of the Autonomous City of Buenos Aires’s Ministry of Modernization, Innovation, and Technology; the Secretariat of Small and Medium-Sized Enterprise and Regional Development (SEPYME) at Argentina’s Ministry of Production, and the investment fund and business accelerator NXTP Labs. At the Venture Night, the most disruptive start-ups in Latin America working in the fields of healthcare, water, sanitation, and hygiene presented their solutions to improve lives. These start-ups were selected and evaluated by a panel of expert judges.
The Venture Night included the IDB/FEMSA Water and Sanitation Award, which went to three of the most innovative start-ups present.
Demand Solutions Focuses on Access to Healthcare, Water, Sanitation, and Nutrition.
In 2002, the United Nations re-interpreted the International Covenant on Economic, Social and Cultural Rights and specified that water should be seen as a human right, as it is indispensable for leading a life in human dignity. It is a prerequisite for the realization of other human rights.
On July 28, 2010, UN General Assembly Resolution A/RES/64/292 formally recognized the human right to clean drinking water and sanitation, describing these as being essential to the realization of all human rights and calling upon states and international organizations to provide financial resources, health capacity building and technology transfers to all countries, in particular developing countries, to provide “safe, clean, accessible, and affordable drinking water and sanitation for all” .
The UN Millennium Goals aimed to “halve the proportion of people without access to improved sources of water.” According to figures from the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation, 2.6 billion people have no access to basic sanitation, and 884 million people lack access to safe drinking water.
Access to safe water also determines food security and thus potential access to adequate nutrition.
Right of access to adequate food and nutrition is part of the United Nations Universal Declaration of Human Rights (1948). There are currently 7 billion people on the planet to be fed, and according to UN figures, this number is expected to grow to 9 billion by 2050. This implies that we need to increase food production by 50% for 2030 and 70% for 2050.
The World Food Summit (FAO, 1996) defined food security as existing when “all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life.”
To achieve global food and nutritional security, commitments and investments are needed to produce more nutritious food with less water; focus on human capacities and institutional frameworks—agricultural development in the least developing countries lies mainly in the hands of smallholders, a large majority of whom are women; and improve the value chain through efficient water and food recycling strategies.
The Goal of Global Access to Healthcare
The goal of the World Health Organization (WHO) is to reach the highest possible level of health for all people using international cooperation as an essential mechanism for achieving this. However, 4.8 billion people (80% of the world’s population) live in developing countries, where communicable diseases account for 50% of the burden of disease. In these countries, 2.7 billion people live on less than US$2 a day, which excludes them from any possibility of acquiring health products and medical devices for the diagnosis, treatment, cure, or prevention of disease.
“Health is at the heart of the 2030 Sustainable Development Agenda. Promoting health is, therefore, central to delivering on the SDGs. The 9th Global Conference on Health Promotion, which will be held in Shanghai from November 21 to 24, 2016, will chart a new course for the next 15 years, aimed at inspiring national governments, municipal leaders and other stakeholders to grasp the great potential of promoting health across all sectors of society” (WHO, November 1, 2016).
Working toward ensuring access to health care for the most vulnerable sectors of society is one of the keys to achieving universal health coverage, one of the Sustainable Development Goals. This is a crosscutting challenge that involves a wide range of interconnected issues including: trade-related aspects of intellectual property; technology transfer; research, development, and innovation; access to medicaments and treatments; and access to financing. It is also connected to disciplines such as competition policies; acquisition policies; tariff and nontariff measures; data protection; freedom to operate; innovation policies; regulation to ensure quality, safety, and effectiveness; international trade agreements; monitoring; human rights; and so on.
Source: WIPO Magazine, 2013, No. 5.
Trade and the Right to Healthcare
The multilateral trading system guarantees its members the right to protect public health. The General Agreement on Tariffs and Trade (GATT) of 1947 gives countries the flexibility to take restrictive trade measures when necessary to protect human, animal, or plant life or health under certain conditions set out in paragraph (b) of article XX.
GATT, paragraph (b), article XX. “Subject to the requirement that such measures are not applied in a manner which would constitute a means of arbitrary or unjustifiable discrimination between countries where the same conditions prevail, or a disguised restriction on international trade, nothing in this Agreement shall be construed to prevent the adoption or enforcement by any contracting party of measures:…
(b) necessary to protect human, animal or plant life or health…”
Likewise, the General Agreement on Trade in Services (GATS) contains a similar condition in paragraph (b) of article XIV (General Exceptions).
Article 8 of the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) of 1994 adopts measures to protect public health and nutrition provided that these are consistent with the provisions of the agreement.
Art. 8, TRIPS: “Members may, in formulating or amending their laws and regulations, adopt measures necessary to protect public health and nutrition, and to promote the public interest in sectors of vital importance to their socio-economic and technological development, provided that such measures are consistent with the provisions of this Agreement.”
All countries depend on imported medicines and other products to cover their healthcare needs, especially developing countries, whose local production capacity for medical technology is lower. In this sense, trade policy affects the way that medical technology markets open up to competition from imported goods and services.
The principle of nondiscrimination is one of the basic principles governing international trade relations and is set out in the basic principles of the WTO: national treatment and most-favored nation treatment and are also reflected in the GATT (trade in goods), GATS (trade in services), and TRIPS (intellectual property). The principle of nondiscrimination includes exceptions such as special and differential treatment for developing countries and within free trade agreements. In the case of GATT and GATS, major exceptions apply, particularly special provisions on special and differential treatment in favor of developing countries and free trade agreements (GATT, art.XXIV).
The Right to Health from a Legal Perspective
From the legal perspective, the current debate on universal access to healthcare focuses on two main issues: on the one hand, access to medicines, which has been a core aspect of the human right to health since the signing of the International Covenant on Economic, Social and Cultural Rights (ICESCR) in 1966; and access to drugs and patents, on the other.
TRIPS sets out the legal scope of patent protection in the health sector. The expansion of medical patents and technological development in this sector have deepened the connection between the right to health and medical patents, which have come to occupy a central position internationally. This has become especially evident given the surge in epidemics such as HIV, Influenza A, Ebola, and so on, and the need for populations in developing countries, which are the worst affected by these viruses, to access medicines to treat them.
In 2001, the DOHA Declaration on the TRIPS Agreement and Public Health confirmed that intellectual property should not be an obstacle to developing countries accessing medicines. However, the absence of a patent also does not guarantee effective access to a medicine or medical innovation, as this depends on a balance of factors including accessible prices, sustainable financing, and reliable healthcare systems.
TRIPS provides a compulsory international regulatory framework for all WTO member countries by listing obligations in relation to technological inventions. However, Article 4 of the Doha Declaration on the TRIPS Agreement and Public Health leaves a margin of flexibility for member countries to “develop their own patent and intellectual property laws on the basis of their own development needs”, in order to be able to comply with their own national goals of access to health and food.
Article 4: We agree that the TRIPS Agreement does not and should not prevent members from taking measures to protect public health. Accordingly, while reiterating our commitment to the TRIPS Agreement, we affirm that the Agreement can and should be interpreted and implemented in a manner supportive of WTO members’ right to protect public health and, in particular, to promote access to medicines for all.
One of the most controversial flexibilities in the agreement is related to the possibility of an administrative or legal authority authorizing compulsory licenses, which consists of the use of products or patented inventions without the consent of the owner of the rights to these. Developing countries consider these licenses to be of fundamental importance to guaranteeing the implementation of more ambitious public policies, in line with the provisions of the TRIPS Agreement.
Access to Healthcare and Technology Transfer
TRIPS signatory countries committed to providing incentives to firms and institutions in their territories to promote and facilitate North–South and South-South technology transfer.
Art. 7… “The protection and enforcement of intellectual property rights should contribute to the promotion of technological innovation and to the transfer and dissemination of technology, to the mutual advantage of producers and users of technological knowledge and in a manner conducive to social and economic welfare, and to a balance of rights and obligations.”
Article 66.2: “Developed country Members shall provide incentives to enterprises and institutions in their territories for the purpose of promoting and encouraging technology transfer to least-developed country Members in order to enable them to create a sound and viable technological base.”
Patents are a controversial issue in this regard, as they have the potential to both facilitate and restrict access to new drugs. On the one hand, in accordance with article 3 of the Doha Declaration on the TRIPS Agreement and Public Health, patents protect innovation and promote the spread of knowledge through incentives to investment in research and development in the health sector, particularly in developed countries. However, on the other hand, they lead to an increase in the relative prices of patented drugs. this dichotomy is a source of tension between the goals of the pharmaceutical industry, which seek to recoup their investments, and those of public policy, which must promote access to healthcare, particularly for low income sectors of the population.
Article 3: We recognize that intellectual property protection is important for the development of new medicines. We also recognize the concerns about its effects on prices.
Chapters on Intellectual Property in Free Trade Agreements. Latin America’s Involvement.
Latin America is the region that has signed the most bilateral and regional free trade agreements with the United States, the European Union, the European Free Trade Association (EFTA), and Japan, countries that have a tradition of including chapters on intellectual property that go beyond the minimum standards countries commit to as part of the TRIPS Agreement.
Of the 20 free trade agreements (FTAs) the United States has negotiated, 11 are with countries in the Americas: Canada, Chile, Colombia, Costa Rica, the Dominican Republic, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, and Peru.
Another example of agreements containing intellectual property-related obligations that go beyond what has been negotiated at the WTO are the agreements between the European Union and countries in the region, including the CARIFORUM (with the 15 CARICOM countries, Cuba, and the Dominican Republic); Peru, Colombia, and Central America.
The EFTA countries have signed 26 FTAs with 36 countries, 7 of which are in the Americas (Canada, Costa Rica, Panama, Chile, Colombia, Mexico, and Peru).
Japan has 10 FTAs with countries that include Chile, Mexico, and Peru.
Some 12 countries are currently taking part in the negotiations toward the Trans-Pacific Partnership (TPP), which includes an ambitious chapter on intellectual property.
Access to Healthcare and Its Connection with Different Trade Disciplines
There follows a list of some of the trade disciplines that are directly connected to access to healthcare.
The competition policy is one of the regulatory instruments available to governments to take on public health problems. This discipline is a key tool for accessing medical technology and promoting the development of new drugs. Competition promotes the lowering of prices and the price-quality relationship, freedom of choice, innovation, and productivity.
Competition policy and health regulation are also interrelated, which encourages coordinated work between government organizations that regulate competition and price regulators for medical product prices and the health sector.
The use of competition legislation may prevent anticompetitive practices that originate in sectors involved in developing medical technologies; or practices that may limit research and development; restrict the availability of resources for producing innovation in the healthcare sector; hamper the competitiveness of generic products; reduce distribution channels and thus limit consumer choice; create pharmaceutical cartels; and so on.
One of the main achievements of multilateral negotiations over time has been reductions in tariffs, the instrument traditionally used to protect national industries. The role of tariffs has gradually been occupied by nontariff measures: sanitary and phytosanitary measures, technical regulations, prior inspections, import licensing, price control measures, charges and taxes, and restrictions on distribution and postsales services. The WTO covers these issues and regulates them through various of its agreements.
Nontariff measures can impact trade in pharmaceutical products and have direct consequences on public health. In this sense, the Sanitary and Phytosanitary (SPS) Agreement contains specific standards for countries to ensure food safety and prevent the transmission of diseases of animal or plant origin to people via trade.
The Technical Barriers to Trade (TBT) Agreement brings together technical regulations and standardization-related issues for products that are not included in the SPS Agreement, including quality requirements for pharmaceutical products, labeling standards for food products, and security standards for x-ray machinery. The goals of the TBT Agreement include the protection of health and they our flexible provided that the measures to be adopted do not constitute an unnecessary restriction to trade.
Health services are essential to ensuring the availability and appropriate use of pharmaceutical products and medical technologies (services related to prevention, diagnosis, and treatment, and support services and technical support). There is a close relationship between access to medical technology and the provisions that regulate the participation of foreign suppliers in local markets.
GATS identifies four forms of service provision that may apply to the supply of a health service:
GATS, Art. 1: For the purposes of this Agreement, trade in services is defined as the supply of a service: (a) from the territory of one Member into the territory of any other Member; (b) in the territory of one Member to the service consumer of any other Member; (c) by a service supplier of one Member, through commercial presence in the territory of any other Member; (d) by a service supplier of one Member, through presence of natural persons of a Member in the territory of any other Member.
Telemedicine is an example of cross-border supply that is also known as Mode 1. A patient traveling to another country to receive medical attention is known as consumption abroad, or Mode 2. The establishment of a hospital subsidiary overseas or investment in existing facilities abroad is known as commercial presence, or Mode 3. Finally, the movement of a health professional abroad to work in a foreign-owned clinic is called presence of natural persons, or Mode 4.
The regulation of trade in all health services falls under GATS and is categorized as follows: i) hospital services; ii) other human health services; iii) social services; iv) medical and dental services; and v) services provided by midwives, nurses, physiotherapists, and paramedical personnel. Also listed are the different service sectors that enable access to medical technologies: R&D on medical sciences; the pharmacy, wholesale and retail sale of various pharmaceuticals, medical and surgical goods and devices; maintenance and repair services for medical equipment; and technical testing and analysis services.
However, it is important to stress that many public health sector services do not fall under GATS as this does not cover services “supplied in the exercise of governmental authority” (those supplied neither “on a commercial basis” nor “in competition with one or more service suppliers”).
 The MIF is an innovation laboratory for the IDB Group. It carries out high-risk experiments to test new models to attract and inspire the private sector to solve economic development problems in Latin America and the Caribbean. The MIF addresses poverty and vulnerability by focusing on start-ups and small-scale agricultural producers that could expand and create economic opportunities.
 Endeavor is a company that identifies high-impact entrepreneurs and gives them strategic support to develop their companies. It also connects entrepreneurs from throughout Argentina with one another and promotes the development of large-scale support systems for them.
 UN-Water Decade Programme on Advocacy and Communication (UNW-DPAC).
 Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property, WHO, 2011.
 “Imported and locally produced goods should be treated equally—at least after the foreign goods have entered the market. The same should apply to foreign and domestic services, and to foreign and local trademarks, copyrights, and patents.”
 “Under the WTO agreements, countries cannot normally discriminate between their trading partners. Grant someone a special favour (such as a lower customs duty rate for one of their products) and you have to do the same for all other WTO members.”
 TRIPS, art. 31, Part II: Standards concerning the availability, scope and use of Intellectual Property Rights