의약품 접근권과 특허권의 충돌 문제에서 나타나는 건강권의 비용과 법적 고찰 = A Clash of Rights and Costs: An Examination of Restrictions to the Realization of the Right to Health from the Perspective of International Human Rights Law

국문 초록 (Abstract)

오늘날 건강은 하나의 존엄한 가치로 인식되고 있으나 그것이 사법적인 차원에서 건강권으로 보장되고 있는지에 대해서는 연구가 부족하다. 이 연구는 건강권과 특허권의 충돌에서 나타나는 국제인권법적 문제를 비용의 관점에서 고찰하였다. 백혈병 환자에게 필수적인 항암제인 글리벡(Gleeve)이나 HIV/AIDS 환자에게 항레트로바이러스제(antiretroviral drugs)를 대체하는 치료제인 푸제온(Fuzeon)의 경우 신약의 특허권을 보호하기 위해 환자가 높은 가격을 지불하여야 했다. 다시 말해, 신약에 특허를 가지고 있는 다국적 제약회사들은 대부분 본사가 선진국에 있기 때문에 R&D 기반이 취약한 개발도상국이나 저개발국의 환자들은 가격 장벽으로 인해 필수 의약품에 대한 접근성이 낮았다. 이러한 문제를 타결하기 위하여 세계무역기구의 지적재산에 관한 협정(Trade-Related Aspects of Intellectual Property Rights; TRIPS)에 강제실시권 등을 두어 위기상황에 직면한 국가들이 국민의 건강 보호하기 위해 특허를 제한할 수 있도록 규정하였다. 그러나 이것은 예외주의적 관점에서 제한적으로만 적용되어서 건강권을 두텁게 보호하는데 한계가 있었다. 게다가 특허권을 보호해주어야 신약의 R&D를 활성화하여 인류 전반에 더 큰 혜택을 가져다 줄 수 있다는 인권 제한적인 주장을 옹호하는 입장은 과도한 제약회사화(pharmaceuticals) 경향을 부추기고 있다. 이에 대해 남아프리카공화국의 HIV/AIDS 문제에 대해 전지구적 비영리단체들이 주도한 이른바 치료접근성캠페인(Treatment Action Campaign; TAC)은 많은 교훈을 준다. TAC는 풀뿌리 단체들을 조직화하여 아프리카에서 건강권의 사법심사가능성을 보장하였고 특허권보다 건강권이 더 본질적인 가치로 인정받을 수 있도록 국제인권법의 지평을 확장하였다. 오늘날 여러 국가들이 의약품 접근권에 대한 사법심사가능성을 용인하여 TRIPs가 국제법의 체계 내에서 인권을 보장하는 방향으로 더 개선될 여지를 보여주고 있다. 그러므로 저개발국을 포함하여 인류가 보편적으로 건강권을 향유할 수 있기 위해서 건강권의 보호법익과 상충되지 않는 방향으로 의약품 개발에 대한 인센티브를 보장하면서 저개발국의 국가보건의료시스템을 확충할 필요가 있다.

참고문헌 (Reference)

1 정민수, "인권과 건강의 상호교차성- 보건의료의 측면에서 본 인간 존엄성과 사회적 존엄성 -" 한국의료법학회 21 (21): 7-28, 2013

2 정민수, "생명윤리와 인간존엄, 건강권에 대한 법적 고찰" 동덕여자대학교지식융합연구소 (5) : 2014

3 김도균, "법적 이익형량의 구조와 정당화문제" 법학연구소 48 (48): 31-115, 2007

4 정민수, "건강권의 법적 토대와 그 실현에 대한 국제인권법적 고찰" 한국의료법학회 22 (22): 205-231, 2014

5 Yamin AE, "Will we take suffering seriously? Reflections on what applying a human rights framework to health means and why we should care?" 10 (10): 2008

6 Fassin D, "When bodies remember: Experiences and politics of AIDS in South Africa" University of California Press 2007

7 Marceau G., "WTO dispute settlement and human rights" 13 (13): 2002

8 Pillay A., "Towards effective social and economic rights adjudication: The Role of meaningful engagement" 2012

9 Musungu S, "The use of flexibilities in TRIPs by developing countries: Can they promote access to medicines? Commission on Intellectual Property Rights" Innovation and Public Health 2005

10 Fox M, "The new politics of male circumcision: HIV/AIDS, health law and social justice" 32 : 2012

11 Alston P, "The nature and scope of states parties’ obligations under the international covenant on economic, social and cultural rights" 2 : 186-192, 1987

12 Schackman BR, "The lifetime cost of current human immunodeficiency virus care in the United States" 44 (44): 2006

13 Tang J, "The impact of host genetics on HIV infection and disease progression in the era of highly active antiretroviral therapy" 17 (17): 2003

14 O’Connell P, "The death of socio-economic rights" 74 : 2011

15 Leader S, "The collateral protection of rights in the global economy" 53 : 2008

16 Kapcxynski A., "The access to knowledge mobilization and the new politics of intellectual property" 117 : 2008

17 Morsink J., "The Universal Declaration of Human Rights: Origins, Drafting, and Intent" Pennsylvania University Press 2000

18 Hollis A, "The Health Impact Fund: Making new medicines accessible for all. Incentives for Global Health"

19 Walker S, "The Future of Human Rights Impact Assessments of Trade Agreements" Intersentia 2009

20 Baxi U., "The Future of Human Rights" Oxford University Press 2008

21 Richey LA, "The Fourth Wave: Violence, Gender, Culture & HIV in the 21st Century" UNESCO 2011

22 Holmes S, "The Cost of Rights: Why liberty depends on taxes" WW Norton 1999

23 White LE, "Stones of Hope: How African activities reclaim human rights to challenge global poverty" Stanford University Press 2011

24 Forbath W, "Stones of Hope: How African activities reclaim human rights to challenge global poverty" Stanford University Press 2011

25 Heywood M, "South Africa’s treatment action campaign: Combining law and social mobilization to realize the right to health" 1 : 2009

26 Liebenberg S., "Socio-Economic Rights: Adjudication under a transformative constitution" Juta 2010

27 Langford M, "Social Rights Jurisprudence: Emerging trends in international and comparative law" Cambridge University Press 2008

28 Clarke L, "Responsibility of international organizations under international law for the acts of global health public-private partnerships" 12-, 2011

29 Freeman LP, "Realising the Right to Health" Ruffer & Rub 2009

30 Cassese A., "Realising Utopia: The future of international law" Oxford University Press 2012

31 Rimmer M, "Race against Time: The export of essential medicines to Rwanda" 1 : 2008

32 Heywood M, "Preventing mother-co-child HIV transmission in South Africa" 19 : 2003

33 Mitchell A, "Patents and public health in the WTO, FTAs and beyond: Tension and conflict in international law" 43 : 2009

34 Cullet P., "Patents and medicines: The relationship between TRIPS and the human right to health" 79 (79): 2003

35 Yamin AE, "Our place in the world: conceptualizing obligations beyond borders" 12 (12): 2010

36 MDG Gap Task Force, "Millennium Development Goal 8: Delivering on the global partnership" UN 2008

37 Yamin AE, "Litigating Health Rights: Can courts bring more justice to health?" Harvard University Press 2011

38 Yamin AE, "Litigating Health Rights: Can courts bring more justice to health?" Harvard University Press 2011

39 Cooper C., "Litigating Health Rights: Can courts bring more justice to health?" Harvard University Press 2011

40 Grosheide W., "Intellectual Property and Human Rights: A paradox" Edward Elgar 2010

41 Farmer P, "Infection and Inequalities: The modern plagues" University of California Press 1999

42 Young KG, "Incentives for Global Public Health:Patent law and access to essential medicines" Cambridge University Press 2010

43 Burton-Macleod J., "Incentives for Global Public Health: Patent law and access to essential medicines" Cambridge University Press 2010

44 Epstein S., "Impure Science" University of California Press 1996

45 Weissbrodt D, "Human rights approach to intellectual property protection: The genesis and application of sub-commission resolution 2000/7" 5 : 2003

46 Koch I., "Human Rights as Indivisible Rights: The protection of socio-economic demands under the European Convention on human rights" Martinus Nijhoff 2009

47 Helfer LR, "Human Rights and Intellectual Property: Mapping the global interface" Cambridge University Press 2011

48 Fredman S., "Human Rights Transformed: Positive rights and positive duties" Oxford University Press 2008

49 Pieterse M., "Health, social movements, and rights-based litigation in South Africa" 35 : 364-, 2008

50 London L., "Health and Human Rights" Ashgate Publishing 2007

51 Murphy T, "Health and Human Rights" Oxford University Press 2013

52 Morgan D, "HIV-1 infection in rural Africa: is there a difference in median time to AIDS and survival compared with that in industrialized countries?" 16 (16): 2002

53 Salomon ME, "Global Responsibility for Human Rights: World Poverty and the Development of International Law" Oxford University Press 2007

54 The Joint UN Programme on HIV/AIDS, "Global Report: UNAIDS Report on the Global AIDS Epidemic 2012" UNAIDS 2012

55 Petryna A, "Global Pharmaceuticals:Ethics, Markets, Practices" Duke University Press 2006

56 Biehl J., "Global Pharmaceuticals: Ethics, Markets, Practices" Duke University Press 2006

57 Langford M, "Global Justice, State Duties: The extraterritorial scope of economic, social, and cultural rights in international law" Cambridge University Press 2013

58 Toebes B, "Global Health and Human Rights: Legal and philosophical perspectives" Routledge 2010

59 Aginam O, "Global Governance of HIV/AIDS: Intellectual property rights and access to essential medicines" Edward Elgar 2012

60 UN Development Programme, "Global Commission on HIV and the Law, ‘Risks, Rights, and Health" UNDP 2012

61 Forman L., "Global AIDS funding and the re-emergence of AIDS “exceptionalism”" 6 : 2011

62 Goldblatt B, "Giving money to children: The state’s constitutional obligations to provide child support grants to child headed households" 20 : 2004

63 Klugman B., "Effective social justice advocacy: A theory-of-change framework for assessing progress" 19 : 2011

64 Jung M, "Effect of media use on HIV/AIDS-related knowledge and condom use in Sub-Saharan Africa: A cross-sectional study" 8 (8): 2013

65 Heywood M., "Democratising development: The politics of socio-economic rights in South Africa" Martinus Nijhoff 2005

66 World Health Organization, "Continuity and Change: Implementing the third WHO medicine strategy 2008-2013" WHO 2013

67 The Commission on Social Determinants of Health, "Closing the Gap in a Generation: Health equity through action on the social determinants of health"

68 Farmer P., "Challenging orthodoxies: The road ahead for health and human rights" 10 (10): 2008

69 England R., "Are we spending too much on HIV?" 334 (334): 344-, 2007

70 Mureinik E., "A bridge to where? Introducing the interim bill of rights" 10 : 1994

71 UNAIDS, "2009 Report on the Global AIDS Epidemic" UNAIDS 2010