In a letter to trade ministers of the World Trade Organisation, European Union trade commissioner, Pascal Lamy, proposed yesterday that taking advice from the WHO would be one way to solve a long standing international trade dispute about access by developing countries to affordable medicine.

At issue is the question of whether poor countries will be able legally to import cheap, generic copies of drugs from non-patent holders when a WTO agreement — Trade Related Aspects of International Property — comes into full force in 2005. For several years trade officials have struggled to reach an agreement about what will happen then. The most recent — failed — attempt was last December when the US was willing to agree to such imports only if the generics related to a restricted list of diseases, including HIV/AIDS, malaria and TB, but excluding large classes of drugs for other conditions such as cancer. Vaccines and other products of the pharmaceutical industry were also excluded.

"Basically the concern of some countries," says Jonathan Quick, Director of WHO's Department of Essential Drugs and Medicines Policy, "is that it <an unrestricted list> is an open door to break all patents, and what's needed is an assurance that it won't be. And the question is what can provide the assurance. The EU's hope is that WHO could provide enough reassurance that things can proceed."

However, Quick is not happy with a fixed list. "We'd like a solution that's sufficiently robust that it's good 10, 20, 30 years from now. Disease patterns shift with time — no one was predicting AIDS 25 years ago — so "from a public health point of view you'd like a flexible agreement," he says.

The EU's proposed solution is that If a country considers it needs to import generics for some condition, WHO's role would be to provide evidence and advice on the magnitude if the disease, and to recommend treatment – "on or off patent". The legal steps would then be up to WTO.

"We don't want [this agreement] to cover every disease" said Quick. "The point is that there needs to be flexibility, with an evidence-based assessment based on the national morbidity etc."