The World Health Organisation Executive Board agreed Friday to submit a heavily bracketed draft resolution on the need to develop safe and affordable medicines for diseases primarily affecting the world’s poorest people to the World Health Assembly for consideration.

The resolution was submitted to the board by Brazil and Kenya with the original headline “Global framework on essential health research and development.” But after two working sessions during the board meeting, one on Thursday and another on Friday, the added brackets (which signify lack of agreement), deletions (strike-throughs) and underlines watered down the original content of the draft.

A draft in English, incorporating all the changes, was circulated toward the end of the board meeting on Friday evening, and the board decided to provide the assembly the draft with all the remarks, plus some minor amendments.

The original draft resolution requested the director general to establish a working group of interested member states to “consider proposals to establish a global framework for supporting needs-driven research, consistent with appropriate public interest issues.”

But parts of the headline were put in brackets indicating that the term “global framework” was not acceptable to everyone. One developed country source said that this term had been one of the major issues many developed countries and the industry had taken issue with in the draft resolution because it was seen as too far-reaching.

The draft also contains references to rights of smaller economies under World Trade Organization agreements, including in bilateral free trade negotiations.

The working group that met on Friday had also agreed that the board would merely submit the draft resolution to the assembly without any form of recommendation, the source said.

The chairman of the working group said that the group had “examined carefully all paragraphs and agreed on some, and put some in brackets.” The group recommended “that the text be submitted to the 59th WHA (22-27 May 2006) for their consideration.” The chair also said that the attitude of the group, which had met for “four hours, thirty minutes and 55 seconds,” had been positive and all participants had been devoted.

A Brazilian delegate told Intellectual Property Watch that there were “a lot of brackets” but that the “main idea had been saved” and the draft resolution would go forward.

A Kenyan delegate said in an interview that one “cannot be happy with 50 percent brackets,” but added that Kenya is still content with the board formally submitting it to the assembly, as opposed to Brazil and Kenya doing it on their own initiative. That would have meant that all the amendments the two working groups had made to the draft would be dropped and it would have gone “back to scratch,” the delegate said. He noted that the decision of the board to submit the draft would “close the chapter” until the May assembly.

A spokesperson for the WHO secretariat also clarified that the resolution would not be on the agenda of a focus group representing the board that will meet in Geneva at the end of April to review the upcoming report of the WHO Commission on Intellectual Property Rights, Innovation and Public Health (CIPIH) (IPW, UN, 27 January 2006). The CIPIH is referred to in the draft R&D resolution.

It could be possible, however, that the secretariat will submit a resolution to the assembly based on the report alongside the R&D resolution, but that would be done by the secretariat and not the focus group, the spokesperson said. Whether this will happen, however, is still not clear.

Mixed Reaction to Outcome

Eric Noehrenberg of the International Federation of Pharmaceutical Manufacturers and Associations told Intellectual Property Watch that it would have been better to wait to have the discussion of intellectual property rights, innovation and health, which had been a bit premature, until after the CIPIH report had been published. But, he said, as it had been very important for some member countries to discuss the draft resolution right away, one had had to “respect their wishes.”

Noehrenberg said that “more is bracketed than not” in the draft, and that it was important to note the distinction between the board recommending the draft to the assembly, or merely submitting it.

He also said that the amount of effort expended by the working group and certain board members showed the complexity of the issue. He added that the draft could form the basis for discussion at the next meeting, but the full discussion should be taken after the CIPIH report had been published.

“Today, the WHO took an important step forward in addressing the issues of setting priorities,” said James Love of Consumer Project on Technology. “The resolution recognises the importance of both public and private sector investments in R&D, and also the need to address areas of priority and public interest, including attention to diseases that primarily concern patients living in poverty.”

But Love took issue with the brackets. “We are of course disappointed that the document is highly bracketed, reflecting a divergence of views on key issues. For this to move forward, there will have to be a more positive engagement from developed countries,” Love said, adding that Brazil, Kenya, South Africa and Thailand had played a particular important role in moving the resolution forward.