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A lack of access to justice disproportionately affects the poor
by Open Society Justice Initiative
April 2016
On the second Tuesday of every month, in a store-front office in the small town of Bancroft, Canada, two lawyers sit down to do business. Maybe a client has had an argument with a landlord, or a dispute with an employer; perhaps someone has been denied claiming social assistance, or is dealing with tax troubles, or facing discrimination at work. Whatever the problem, the advice is all free, whether given out in person, or over a phone help line; in this small, economically depressed town, most of the clients could not otherwise afford to talk to a legal specialist.
The weekly legal advice clinic is operated by the Community Advocacy and Legal Center, a nonprofit community legal clinic that has been working in this area of Ontario for over 30 years. It is part of a province-wide network of Community Legal Clinics (CLCs) which is a shining example of the provision of legal access—making sure people are not left without the benefits of legal protection just because they can’t afford a lawyer.
Ontario''s well-developed legal services culture has also led to the development of clinics that serve specific populations: the Fair Change clinic in Toronto, for example, focuses on helping homeless people avoid fines for minor street offences.
Such primary legal advice not only benefits low-income clients: it can reduce costs for the justice system as a whole by resolving issues that might otherwise have ended up in more costly litigation before a court. The clinics also seek to go beyond any specific problem, by educating low income clients more broadly about their rights, and engaging in law reform and community development. Ultimately, this effort aims at change that affects the entire low income community.
The UN estimates that up to four billion people globally live outside fair and functioning justice systems. Even when there is a functioning national court system, for most many people getting legal assistance for using law to find solutions to civil and administrative justice problems, to protect and advance their interests is an impossibility.
A lack of access to justice disproportionately affects the poor: without the ability to protect their assets, livelihood opportunities are curtailed; when people do not feel physically safe it stops them accessing healthcare, education or making the most of their own potential as individuals. Socioeconomic costs of unresolved legal problems can be significant and can be detrimental to health. It is clear that barriers to access to justice impact development. The new UN development agenda, the Sustainable Development Goals unequivocally declares that poverty reduction, sustainable development and access to justice are fundamentally linked.
But how can the goal of realizing universal access to justice be realized? The Ontario model shows one way forward. That system grew out of the efforts of local community groups and volunteer lawyers, who after initially relying on philanthropic support managed to secured public funding and the creation of a province-wide system of primary legal assistance. Ontario’s Ministry of the Attorney General now funds both provide formal legal aid services, including criminal and some civil legal issues, as well as clinic law (“poverty law”) services provided by CLCs, which currently consists of 76 independent CLCs across province.
Can this kind of institutionalization and financial sustainability be achieved elsewhere? At the Open Society Foundations, we believe it can. We have launched a new initiative on legal empowerment which aims to institutionalize nationwide community-based justice services targeting nine countries: Macedonia, Moldova, Mongolia, Nepal, Pakistan, Sierra Leone, South Africa, Ukraine, and the United States.
There are clearly considerable differences between these countries: what works in Ukraine, where limited legal advice is dispensed by community law centers, is unlikely to work in South Africa, which has strong but uneven community advice offices staffed by paralegals, built through the struggle against apartheid.
Broadly, we can say that we will be working with our civil society and government partners to support both lawyers and with community based paralegals to combine a range of tools to find solutions to individual and community wide legal problems; and that our efforts will focus on strengthening the delivery of basic services, while simultaneously advancing systemic reform in the interest of the poor.
This new legal empowerment initiative will work to ensure that such services are institutionalized, are widely available at a national level and operate in a financially sustainable manner.
Too often such holistic justice programs are dependent on private funding from foundations or foreign aid rather than public funding. Too often they are ad hoc and dependent on charismatic individuals as opposed to institutional structures. Through this initiative we will work with governments, civil society and donor partners to identify and advance policy solutions for securing high quality services, widespread coverage, independence, and sustainability.
This will be a considerable challenge. But ultimately, it is part of a vision of legal empowerment, which is what happens when ordinary people, even the most marginalized, are able to use the law themselves to find concrete solutions to their day to day justice problems, and to hold authorities to account.

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What’s the point of a life-saving vaccine if the most vulnerable people can’t afford it?
by Médecins Sans Frontières (MSF)
27 April 2016
MSF delivers petition of nearly 400,000 people who demand Pfizer and GSK cut the price of pneumonia vaccine
On the eve of Pfizer’s annual shareholder meeting, the international medical humanitarian organisation Médecins Sans Frontières/Doctors Without Borders (MSF) delivered the names to Pfizer headquarters of nearly 400,000 people who signed a petition demanding that pharmaceutical companies Pfizer and GlaxoSmithKline (GSK) reduce the price of the pneumonia vaccine to US$5 per child in all developing countries and for humanitarian organisations.
Despite there being a vaccine that can prevent it, pneumonia remains the leading global cause of childhood death in many developing countries, killing almost one million kids per year.
“Millions of babies and young kids around the world are left unprotected against pneumonia because Pfizer and GSK charge such high prices for the pneumonia vaccine that many governments and humanitarian organisations can’t afford to vaccinate children,” said Dr. Greg Elder, Medical Coordinator at MSF’s Access Campaign.
“After combined sales of more than $30 billion for the pneumonia vaccine alone, we think it’s pretty safe to say that Pfizer and GSK can afford to lower the price so all developing countries can protect their children from this childhood killer.”
MSF delivered the petition during a stunt outside Pfizer’s global headquarters in New York, where dozens of people placed flowers at the company’s door. One flower was laid for every child lost to pneumonia each day, resulting in 2,500 flowers – representing the number of kids who would die from pneumonia that day – piled in front of Pfizer’s front door. Reams of paper with the names of the nearly 400,000 people from 170 countries who signed MSF’s ‘A FAIR SHOT’ petition lay in an empty baby crib.
The petition urges the two companies making the pneumonia vaccine to drop the price to $5 per child (for all three doses). With Pfizer having earned more than $6 billion in sales for this vaccine just last year alone, signatories of the petition sent a strong signal to Pfizer’s CEO, board and shareholders that the company should not put billions of dollars in profits over children’s lives.
Last year, 193 governments at the World Health Assembly unanimously passed a landmark resolution demanding more affordable vaccines and increased transparency around vaccine prices. The governments of more than 50 countries underlined the rising inequities among them caused by the increased financial burden of new vaccines, with many stating that the high price of new vaccines, such as the pneumonia vaccine, either prohibited them from introducing it or threatened their ability to maintain it in their routine immunisation programmes.
Countries such as Algeria, Bosnia, Egypt, Indonesia, Jordan, Thailand, and Tunisia, among others, have expressed that they are not able to introduce the pneumonia vaccine because of its high price.
MSF has vaccinated children caught in emergencies with the pneumonia vaccine in the Central African Republic, Ethiopia, South Sudan, Uganda and other countries. After more than five years of struggling to get Pfizer and GSK to sell the vaccine to MSF at an affordable price, MSF last year launched its ‘A FAIR SHOT’ campaign to push the companies to reduce the price of the pneumonia vaccine to $5 per child (for all three doses).
In 2015, MSF released its vaccine pricing report, The Right Shot: Bringing Down Barriers to Affordable and Adapted Vaccines, which showed that in the poorest countries it is now 68 times more expensive to vaccinate a child than in 2001, with many parts of the world unable to afford new high-priced vaccines like that against pneumonia.
“We’ve seen too many children die of pneumonia, and we’re not going to stop until we know that all countries can afford this life-saving vaccine,” said Elder. “It’s tremendous to see that nearly 400,000 people globally have joined us to tell Pfizer and GSK they must drop the price so more kids’ lives can be saved. What’s the point of a life-saving vaccine if the most vulnerable people can’t afford it?”
21 April 2016
New threat against affordable medicines in trade negotiations with India and ASEAN
Access to affordable medicines could be severely restricted for millions of people around the world under the current proposals in the Regional Comprehensive Economic Partnership (RCEP) trade agreement, Médecins Sans Frontières (MSF) warned today. MSF sounded the alarm regarding the potential harmful consequences of the trade deal ahead of the next round of RCEP negotiations starting in Perth, Australia this Sunday.
“Proposals in the RCEP negotiations are trying to introduce intellectual property measures far tougher on access to medicines than what is required under international trade rules”, said Leena Menghaney, South Asia Head of MSF’s Access Campaign.
“If accepted, the agreement would restrict access to affordable generic medicines for people in many countries that will be part of the agreement– including Indonesia, Thailand, Myanmar, Cambodia and Laos – and for the millions of people around the world who rely on life-saving affordable generic medicines from India.”
Text from the negotiations’ leaked chapter on intellectual property shows that Japan and South Korea have made proposals that go beyond what international trade rules require undermining access to affordable generic medicines.
“Many of the intellectual property provisions that have been tabled mirror those in the Trans-Pacific Partnership agreement, considered the worst trade deal ever for access to medicines”, said Brian Davies, East Asia Head for MSF’s Access Campaign.
“Countries that did not join the TPP –particularly India and key members of the Association of Southeast Asian Nations (ASEAN) – will be pushed to adopt similar standards in the RCEP negotiations.”
The measures that would harm access to affordable medicines are all the more concerning given India is one of the countries included in the RCEP negotiations. India—often known as the ‘pharmacy of the developing world’ for its wide-scale production of generic medicines—supplies life-saving affordable medicines needed to treat communicable and non-communicable diseases in developing countries. Two thirds of all the drugs MSF purchases to treat HIV, TB and malaria are generic medicines from India.
In Perth, India will be under increasing pressure to roll back some of the hard-fought protections for access to medicines that have been secured by its negotiators in trade agreements in the past, who have stood firm against the most harmful provisions—such as extended patent terms and data exclusivity—which had been proposed but rejected both in the India-Japan Comprehensive Economic Partnership Agreement, and the ongoing negotiations for an EU-India Free Trade Agreement.
One of the most damaging measures is data exclusivity, which would act like a patent to block the entry of more affordable generic medicines to the market, even for drugs that are already off patent, or do not deserve a patent to begin with.
Other clauses harmful to access to medicines remain on the table, including extending patent terms, and introducing controversial aspects of intellectual property enforcement without the safeguards needed to prevent abuse and protect access to medicines.
“If the measures in this agreement prevent people from getting the generic medicines they need, the health consequences for any delay or interruption of treatment for many diseases, like HIV, could be serious”, said Dr Greg Elder, Medical Coordinator for MSF’s Access Campaign.
“97% of the HIV medicines MSF uses to treat 230,000 people living with the disease are generics sourced from India. The reality is, without generic medicines, we wouldn’t be able to treat as many people as we do. We urge Indian and ASEAN negotiators to make sure the terms of any trade agreement reached do not impede the supply of generic medicines upon which we and so many people in developing countries rely.”

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