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Friday, July 19, 2024

TJUE: ASUNTOS T-689/21 Y T-761/21 (CONTRATOS COVID, TERAPIAS GÉNICAS Y CONVENIO DE OVIEDO (III))

 

Las SSTJUE T-689/21y T-761/21, puesto que se refieren meramente a las obligaciones de información de la CE referidas a los contratos COVID, sostienen, como obiter dicta, que la exlusión de la responsabilidad de los fabricantes de las vacunas objeto de los contratos por ellos celebrados con la UE no se opone al Derecho de la Unión.

Como han señalado De GRAAF y otros MPs, dicha conclusión no incluiría las "terapias génicas", cuando las vacunas deban clasificarse -como se ha sostenido en las referencias más abajo incluidas- como tales.

Adicionalmente, en el caso de todos los estados miembros de la UE signatarios del Convenio de Oviedo (incluida España; ver lista a continuación), la exclusión de la responsabilidad de los fabricantes sería contraria a dicho Convenio de Oviedo y ello debería afectar a la validez de las consecuencias derivadas de la contratación de la UE en dichos países.

Explanatory Report

 Article 13 – Interventions on the human genome See the Addendum

89. The progress of science, in particular in knowledge of the human genome and its application, has raised very positive perspectives, but also questions and even great fears.
Whilst developments in this field may lead to great benefit for humanity, misuse of these developments may endanger not only the individual but the species itself. The ultimate fear is of intentional modification of the human genome so as to produce individuals or entire groups endowed with particular characteristics and required qualities. In Article 13, the Convention provides the answer to these fears in several ways.


90. In every case, any intervention which aims to modify the human genome must be carriedout for preventive, diagnostic or therapeutic purposes. Interventions aimed at modifying geneticcharacteristics not related to a disease or to an ailment are prohibited. As long as somatic cell gene therapy is currently at the research stage, its application can be allowed only if it complies with the standards of protection provided for in Article 15 and the following Articles.


91. Interventions seeking to introduce any modification in the genome of any descendants are prohibited. Consequently, in particular genetic modifications of spermatozoa or ova for fertilisation are not allowed. Medical research aiming to introduce genetic modifications in spermatozoa or ova which are not for procreation is only permissible if carried out in vitro with the approval of the appropriate ethical or regulatory body.


92. On the other hand the article does not rule out interventions for a somatic purpose which might have unwanted side-effects on the germ cell line. Such may be the case, for example, for certain treatments of cancer by radiotherapy or chemotherapy, which may affect the reproductive system of the person undergoing the treatment.

 
Artículo 15. Regla general.

La investigación científica en el ámbito de la biología y la medicina se efectuará libremente, a reserva de lo dispuesto en el presente Convenio y en otras disposiciones jurídicas que garanticen la protección del ser humano.

Artículo 16. Protección de las personas que se presten a un experimento.

No podrá hacerse ningún experimento con una persona, a menos que se den las siguientes condiciones:

i) Que no exista un método alternativo al experimento con seres humanos de eficacia comparable.

ii) Que los riesgos en que pueda incurrir la persona no sean desproporcionados con respecto a los beneficios potenciales del experimento.

iii) Que el proyecto de experimento haya sido aprobado por la autoridad competente después de haber efectuado un estudio independiente acerca de su pertinencia científica, comprendida una evaluación de la importancia del objeto del experimento, así como un estudio multidisciplinar de su aceptabilidad en el plano ético.

iv) Que la persona que se preste a un experimento esté informada de sus derechos y las garantías que la ley prevé para su protección.

v) Que el consentimiento a que se refiere el artículo 5 se haya otorgado expresa y específicamente y esté consignado por escrito. Este consentimiento podrá ser libremente retirado en cualquier momento.

 https://www.boe.es/buscar/doc.php?id=BOE-A-1999-20638

 

 "Marcel de Graaff

Request for the direct suspension of marketing authorizations
Brussels, 4 October 2023

In response to the COVID-19 pandemic,a new Regulation was hastily introduced and became effective on July 18, 2020 (refer to Article 5).


The key provisions of significance are found in Articles 2(1) together with (2) and 4(1) of Regulation 2020/1043/EU. This regulation pertains to the conduct of clinical trials involving medicinal products designed for human use that contain or consist of genetically modified organisms and are intended for the treatment or prevention of coronavirus disease (COVID-19), as well as the supply of such medicinal products

 

This Regulation allowed for a temporary derogation from the very strict rules of Directive 2001/18/EC

(...)

Regulation 2020/1043/EU is void because it is not based on the correct legal basis. Articles 114 or 168(4)(c) of the Treaty on the Functioning of the European Union (TFEU) cannot be invoked in this case. This means that the rules of Directive 2001/18/EC continued to apply in full and that a technical dossier and an environmental report should therefore have been submitted. Having failed to do so, all the permits issued were thus unlawfully granted to the pharmaceutical companies.

(...)

The recommendations for categorisation and interpretation of the law is reflected in the EMA's guidelines.


Reflection paper on classification of advanced therapy medicinal products 2015


According to this paper, and especially paragraph 2.3.3, mRNA is considered an example of gene
therapy.

( 2.3.3. Gene therapy medicinal product versus cell therapy medicinal product


Another borderline scenario relates to products that are modified by adding a mRNA sequence, for example dendritic cells (DC) electroporated with mRNA in vitro and administrated to the patient to elicit a specific immune response. One could argue that the claimed mechanism of action is directly related to the expression of the mRNA encoded antigens to stimulate e.g. tumour specific immune responses. However, due to its relatively short half-life there may be little or no residual mRNA at the time of re-administration of the dendritic cells to the patient. Thus, it can be claimed that a recombinant nucleic acid is not administered to human beings with a view to adding a genetic sequence, but rather the mRNA electroporated DCs could be seen as an intermediate in the manufacturing process where the phenotype is finally altered without alteration of the genotype of the cells. Therefore, the product was considered not to comply with the definition of a gene therapy medicinal product. Instead the CAT considered that the product was a somatic cell therapy product as it consists of cells which were administered to human beings with a view to treating a disease through the immunological action of the modified cell populations.)

 
Reflection paper on criteria to be considered for the evaluation of new active substance (NAS) status of biological substances 2023


According to this paper and especially 5.8 which states that any significant change in the sequence of mRNA requires a new application.


Thereby, it must be established that parts of Regulation 2020/1043/EU47 and Regulation 2021/756/EU48 are contrary to the classification system and the security system, as argued in the COGEM report, they are thus contrary to Articles 141 and 168 TFEU.
In addition, 2019/5 was used in violation of Article 290(1) of the Treaty on the Functioning of the European Union ("TFEU"):

"A legislative act may delegate to the Commission the power to adopt non-legislative acts of general application to supplement or amend certain non-essential elements of the legislative act."
 

It is clearly stated that delegation of powers is not about legislative acts. If classification and categorisation acts and provision are in conflict with existing classification and categories it is WELL legislation, thus all such acts are null and void. In addition, the same line can be followed as the changes lead to a greater risk to public health (see Article 168 TFEU).


The issues are discussed in detail in this publication by Helene Banoun, 9 June 2023, International Journal of Molecular Sciences"

We should bring here the attention of the MEPs to the additional legal requirements on EMA and the Member States arising from the Oviedo Convention and the European Charter of Fundamental Rights.

 The following EU members ratified the Oviedo Convention:

Bulgaria31/05/2001 23/04/2003 01/08/2003






Croatia07/05/1999 28/11/2003 01/03/2004
R.




Cyprus30/09/1998 20/03/2002 01/07/2002






Czech Republic24/06/1998 22/06/2001 01/10/2001






Denmark04/04/1997 10/08/1999 01/12/1999
R.D.
T.

Estonia04/04/1997 08/02/2002 01/06/2002






Finland04/04/1997 30/11/2009 01/03/2010






France04/04/1997 13/12/2011 01/04/2012
R.


























Greece04/04/1997 06/10/1998 01/12/1999






Hungary07/05/1999 09/01/2002 01/05/2002







































Latvia04/04/1997 25/02/2010 01/06/2010

















Lithuania04/04/1997 17/10/2002 01/02/2003







04/04/1997





















































































Portugal04/04/1997 13/08/2001 01/12/2001

















Romania04/04/1997 24/04/2001 01/08/2001




























Slovak Republic04/04/1997 15/01/1998 01/12/1999






Slovenia04/04/1997 05/11/1998 01/12/1999






Spain04/04/1997 01/09/1999 01/01/2000









According to the Oviedo Convention, gene therapies must fullfill with the provisions of the Treaty and specially with those referred to scientif research. They are classified as such.

In addition, as provisions on human rights for any signatory country of the Convention, the Oviedo Convention provisions are granted the protection of the European Charter of Fundamental Rights in accordance with:

Article 3

Right to the integrity of the person

1.   Everyone has the right to respect for his or her physical and mental integrity.

2.   In the fields of medicine and biology, the following must be respected in particular:

(a)

the free and informed consent of the person concerned, according to the procedures laid down by law;

(b)

the prohibition of eugenic practices, in particular those aiming at the selection of persons;

(c)

the prohibition on making the human body and its parts as such a source of financial gain;

(d)

the prohibition of the reproductive cloning of human beings.


Article 35

Health care

Everyone has the right of access to preventive health care and the right to benefit from medical treatment under the conditions established by national laws and practices. A high level of human health protection shall be ensured in the definition and implementation of all the Union's policies and activities.

Article 41

Right to good administration

1.   Every person has the right to have his or her affairs handled impartially, fairly and within a reasonable time by the institutions, bodies, offices and agencies of the Union.

2.   This right includes:

(a)

the right of every person to be heard, before any individual measure which would affect him or her adversely is taken;

(b)

the right of every person to have access to his or her file, while respecting the legitimate interests of confidentiality and of professional and business secrecy;

(c)

the obligation of the administration to give reasons for its decisions.

3.   Every person has the right to have the Union make good any damage caused by its institutions or by its servants in the performance of their duties, in accordance with the general principles common to the laws of the Member States.

4.   Every person may write to the institutions of the Union in one of the languages of the Treaties and must have an answer in the same language.

Article 47

Right to an effective remedy and to a fair trial

Everyone whose rights and freedoms guaranteed by the law of the Union are violated has the right to an effective remedy before a tribunal in compliance with the conditions laid down in this Article.

Everyone is entitled to a fair and public hearing within a reasonable time by an independent and impartial tribunal previously established by law. Everyone shall have the possibility of being advised, defended and represented.

Legal aid shall be made available to those who lack sufficient resources in so far as such aid is necessary to ensure effective access to justice.

Article 51

Field of application

1.   The provisions of this Charter are addressed to the institutions, bodies, offices and agencies of the Union with due regard for the principle of subsidiarity and to the Member States only when they are implementing Union law. They shall therefore respect the rights, observe the principles and promote the application thereof in accordance with their respective powers and respecting the limits of the powers of the Union as conferred on it in the Treaties.

2.   The Charter does not extend the field of application of Union law beyond the powers of the Union or establish any new power or task for the Union, or modify powers and tasks as defined in the Treaties.

Article 53

Level of protection

Nothing in this Charter shall be interpreted as restricting or adversely affecting human rights and fundamental freedoms as recognised, in their respective fields of application, by Union law and international law and by international agreements to which the Union or all the Member States are party, including the European Convention for the Protection of Human Rights and Fundamental Freedoms, and by the Member States' constitutions.

Article 54

Prohibition of abuse of rights

Nothing in this Charter shall be interpreted as implying any right to engage in any activity or to perform any act aimed at the destruction of any of the rights and freedoms recognised in this Charter or at their limitation to a greater extent than is provided for herein.

Therefore, :

1) EU's mRNA vaccines authorizations were subject -as gene therapies- not only to any of the EU provisions mentioned in the letter of Marcel de Graaff to EMA,  but to the CFREU and to the Oviedo Convention in the member states that ratified such Treaty for the protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine 

2) Even in those EU member states  that did not ratify the Oviedo Convention, mRna vaccines authorizations and mRna vaccines inoculations were subject to articles 3, 35 and 41of the CFREU

Those articles must be interpreted according to the EMA practice and its guidelines. In accordance with the "Reflection paper on classification of advanced therapy medicinal products", in particular:

2.1.1. Gene therapy medicinal product
 

Gene therapy medicinal product means a biological medicinal product which has the following characteristics:

(a) it contains an active substance which contains or consists of a recombinant nucleic acid used in or administered to human beings with a view to regulating, repairing, replacing, adding or deleting a genetic sequence;
(b) its therapeutic, prophylactic or diagnostic effect relates directly to the recombinant nucleic acid sequence it contains, or to the product of genetic expression of this sequence.


Gene therapy medicinal products shall not include vaccines against infectious diseases.

It should be noted that in order to be considered a gene therapy medicinal product, both the characteristics (a) and (b) have to be fulfilled.

(...)

 The legislation provides that “Gene therapy medicinal products shall not include vaccines against infectious diseases”. For classification purposes, vaccines are expected to have prophylactic mode of action, i.e. prevention of an infectious disease in humans. If a product is intended to treat pathologies caused by the infection (e.g. malignancies), it is classified as a GTMP. Live recombinant viral vectors (delivering genes encoding specific antigen sequences into human somatic cells) could fulfil the definition of Gene Therapy Medicinal Products (GTMP) when administered for example in oncology, but similar products would not be classified GTMPs when intended as prophylactic against infectious disease. In order to enable the classification of borderline products (treatment of infections or premalignancies) the therapeutic indication and target population should be clearly defined."

The Covid-19 vaccines were not expected to to have prophylactic mode of action, i.e. prevention of an infectious disease in humans.

In any case, EMA practice on Advanced Therapy Medicinal Products could not exception -in any EU member State obliged by the Oviedo Convention-  any legal consequence flowing from the Oviedo Convention an Explanatory Report on it:

"Human genome


71. Genetic science has undergone dramatic changes in recent years. In human medicine, apart from the pharmaceutical field, there are other areas in which, it can be applied, namely: genetic testing, gene therapy and the scientific elucidation of disease causes and mechanisms.


72. Genetic testing consists of medical examinations aimed at detecting or ruling out the presence of hereditary illnesses or predisposition to such illnesses in a person by directly or indirectly analysing their genetic heritage (chromosomes, genes).

73. The aim of gene therapy is to correct changes to the human genetic heritage which may result in hereditary diseases. The difference between gene therapy and the analysis of the genome lies in the fact that the latter does not modify the genetic heritage but simply studies its structure and its relationship with the symptoms of the illness. In theory, there are two distinct forms of gene therapy. Somatic gene therapy aims to correct the genetic defects in the somatic cells and to produce an effect restricted to the person treated. Were it possible to undertake gene therapy on germ cells, the disease of the person who has provided the cells would not be cured, as the correction would be carried out on the cells whose sole function is to transmit genetic information to future generations.

Article 13 – Interventions on the human genome


89. The progress of science, in particular in knowledge of the human genome and its application, has raised very positive perspectives, but also questions and even great fears.


Whilst developments in this field may lead to great benefit for humanity, misuse of these developments may endanger not only the individual but the species itself. The ultimate fear is of intentional modification of the human genome so as to produce individuals or entire groups endowed with particular characteristics and required qualities. In Article 13, the Convention provides the answer to these fears in several ways.


90. In every case, any intervention which aims to modify the human genome must be carried out for preventive, diagnostic or therapeutic purposes. Interventions aimed at modifying genetic characteristics not related to a disease or to an ailment are prohibited. As long as somatic cell gene therapy is currently at the research stage, its application can be allowed only if it complies with the standards of protection provided for in Article 15 and the following Articles.

Article 15 – General rule


95. Freedom of scientific research in the field of biology and medicine is justified not only by humanity's right to knowledge, but also by the considerable progress its results may bring in terms of the health and well-being of patients.


96. Nevertheless, such freedom is not absolute. In medical research it is limited by the fundamental rights of individuals expressed, in particular, by the provisions of the Convention and by other legal provisions which protect the human being. In this connection, it should be pointed out that the first Article of the Convention specifies that its aim is to protect the dignity and identity of human being and guarantee to everyone, without discrimination, respect for their integrity as well as for other rights and fundamental freedoms. Any research will therefore have to observe these principles.

Article 16 – Protection of persons undergoing research


97. This Article lays down the conditions for all research on human beings. These conditions were largely inspired by Recommendation No. R (90) 3 of the Committee of Ministers to member States on medical research on the human being.


98. The first condition is that there must be no alternative of comparable effectiveness to research on humans. Consequently, research will not be allowed if comparable results can be obtained by other means. Invasive methods will not be authorised if other less invasive or non-invasive methods can be used with comparable effect.


99. The second condition is that the risks which may be incurred by that person are not disproportionate to the potential benefits of the research

100. The third condition is the need for an independent examination of the scientific merit as well as of the ethical, including legal, social and economic acceptability of the research project. The examination of the latter aspects have to be carried out by independent multi- disciplinary ethics committees.


101. Paragraph iv underlines the obligation to inform the person in advance of their legal rights and guarantees, for example their right to freely withdraw their consent at any time.


102. Paragraph v reinforces conditions set forth in Article 5 concerning consent. In the sphere of research, implicit consent is insufficient. For this reason the Article requires not only the person's free and informed consent, but their express, specific and written consent. Thewords "specific consent" are to be understood here as meaning consent which is given to one particular intervention carried out in the framework of research.

The Additional Protocol to the Oviedo Convention (not signed, however, by Spain and other EU member States that ratified the Convention)  contains also these important provisions:

Article 1 – Object and purpose
 

Parties to this Protocol shall protect the dignity and identity of all human beings and guarantee everyone, without discrimination, respect for their integrity and other rights and fundamental freedoms with regard to any research involving interventions on human beings in the field of biomedicine.

Article 2 – Scope


1 This Protocol covers
the full range of research activities in the health field involving interventions on human beings.


2 This Protocol does not apply to research on embryos in vitro. It does apply to research on foetuses and embryos in vivo.


3 For the purposes of this Protocol, the term “intervention” includes:


i a physical intervention, and
ii any other intervention in so far as it involves a risk to the psychological health of the person concerned.

Article 3 – Primacy of the human being


The interests and welfare of the human being participating in research shall prevail over the sole interest of society or science.


Article 4 – General rule


Research shall be carried out freely, subject to the provisions of this Protocol and the other legal provisions ensuring the protection of the human being.


Article 5 – Absence of alternatives


Research on human beings may only be undertaken if there is no alternative of comparable effectiveness.


Article 6 – Risks and benefits


1 Research shall not involve risks and burdens to the human being disproportionate to its potential benefits

In addition, where the research does not have the potential to produce results of direct benefit to the health of the research participant, such research may only be undertaken if the research entails no more than acceptable risk and acceptable burden for the research participant. This shall be without prejudice to the provision contained in Article 15 paragraph 2, sub-paragraph ii for the protection of persons not able to consent to research.


 Research in States not parties to this Protocol


Article 29 – Research in States not parties to this Protocol


Sponsors or researchers within the jurisdiction of a Party to this Protocol that plan to undertake or direct a research project in a State not party to this Protocol shall ensure that, without prejudice to the provisions applicable in that State, the research project complies with the principles on which the provisions of this Protocol are based. Where necessary, the Party shall take appropriate measures to that end.

Conclusions:

1) European Union law in this field was subject in any member State to the CFREU  and additionally to the Oviedo Convention provisions in those member States that ratified such Convention. European Union law could not replace the Oviedo Convention requirements in the EU member States which were parties to it

As a consequence of it,  it could be argued that, even if valid on grounds of EU law, mRNA vaccines authorizations were in contradiction with the Oviedo Convention provisions in the EU member States that signed such Convention

2) National and international law (treaty conventions) on health care and related human rights may be legally opposed to EU law in accordance with articles 35 and 53 of the CFREU

3) European Union and member States health authorities should have considered in advance any legal requirements and consequences arising from the different legal status of the EU member States being a party of the Oviedo Convention

4) EU member States being a party of the Oviedo Convention could not disregard any legal obligation flowing from such Convention.Their citizens are entitled to the human rights provided for in it, in addition to the human rights provided in the CFREU.

The above considerations and conclusions reinforce, in our opinion, the serious concerns and petitions contained in the letter of the MEP to EMA

 

EL SENADOR RENNICK (AUS) Y EL MEP DE GRAAF SOBRE TERAPIAS GÉNICAS Y VACUNAS COVID-19 (UE Y ESPAÑA)

 

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