By William New
The World Health Organization Executive Board recently addressed several key issues pertaining to intellectual property rights and access to knowledge. This included extensive discussion of pandemic influenza policies, the management of IP and health, and an appeal by WHO Director General Margaret Chan for governments to trust her office’s proposal to require pre-approval of hundreds of publications through the WHO executive office.

The Executive Board set the pace for the annual World Health Assembly in May. The board met from 21 to 26 January. The last meeting of the board was in May 2007, at the time of the assembly.

At the meeting, WHO members took note (without changes) of a secretariat report on a high-profile working group on public health, innovation and intellectual property (IGWG) that is mandated to prepare a draft global strategy and plan of action by the May assembly. The strategy and plan will target “an enhanced and sustainable basis for needs-driven, essential health research and development relevant to diseases that disproportionately affect developing countries,” the WHO said.

The group has been working slowly since 2006, and has come up with a draft strategy and plan, but the latest draft shows many aspects still not agreed. At the executive board meeting, some members raised concern about the slow pace, according to participants.

The second IGWG working group meeting, held 5-10 November (IPW, WHO, 10 November 2007), was suspended and will be resumed on 28 April to 3 May in order to finalise the draft global strategy and plan of action. The full working group will be preceded by a meeting of the “subgroup of drafting group B” from 17-19 March, which will focus on a matrix for the draft plan of action. Comments on the draft submitted by a 31 January deadline will be made available in March, according to the WHO.

Pandemic Influenza Preparedness

The Executive Board also took note of a report on the mandate from the May 2007 Health Assembly to take a variety of steps to resolve concerns related to the fair and equitable access to vaccines for pandemic influenza, such as an avian flu outbreak among humans. A key element of the discussion is whether patents are interfering with development of and access to needed treatments by developing countries.

Some progress was made at the 20-23 November meeting of the intergovernmental working group on the issue (IPW, WHO, 14 December 2007).

But big gaps in views exist and there does not appear to be an action for the May assembly to take, as an “open-ended working group” is expected to be held in August, and the next intergovernmental working group meeting is not scheduled until November 2008, a year after the last one.

Publication Policy Under Scrutiny

The WHO issues some 400 publications per year, some 75 percent by the headquarters and the rest by regional offices, it said. Chan is considered the organisation’s editor-in-chief, and her office came under pressure in the past year particularly from officials from the United States who expressed displeasure with the publication of documents bearing the WHO logo that were critical of the country’s policies.

Costs of publications rose from $117 million in 1998-1999 to $347.6 million in 2004-2005 (nearly 13 percent of the organisation’s total budget), the WHO said.

Chan released a new WHO publishing policy in the face of concerns about political pressure, and at the board meeting heard comments and scepticism about the plan. But in the end, she dismissed concerns and, in a personal appeal, urged members to “give me a chance to manage this organisation. Don’t micromanage me. I’ll do my job.”

Chan vowed: “Not during my time will we compromise editorial independence” and quality.

Brazil called for full transparency of the process, and raised concern that the publication policy would be subject to “political pressure” to block publications that are critical of certain governments or practices, to which Chan replied, “Don’t worry, I can stand the pressure.”

She acknowledged that mistakes were made in the past, though she did not offer specifics. She said some publications may have gone out without proper clearance in the interest of speed, and that money had been offered by outside sources to the secretariat in the past to pay for publications. “We must be courageous enough to say no” to money, she said, adding that this requires showing “financial and managerial discipline.”

But the concern among non-governmental groups and developing countries is that publications critical of the United States led to a call for a review of the publication policy (IPW, WHO, 28 September 2006). At the recent board meeting, the United States expressed interest in greater executive office control over publications.

Publications on IP Issues Blocked?

There also have been indications of the WHO executive office withholding publication of any material related to sensitive intellectual property issues, despite no formal statement of such a policy.

On executive clearance, the proposed policy from the executive office states: “The final text of all publications will be cleared by the relevant assistant director-general or regional director before publication. Publications that describe the workings of a particular government or national health service or that have policy implications for the organisation or address controversial health-related issues will require additional clearance by the director-general’s office.”

David Heymann, the assistant director-general for health security and environment – and an American – defended the proposal, arguing that it is “not ad hoc,” but rather part of a continuous process of updating the publication policy, and that it is in response to criticisms.

The plan will be further discussed at a WHO retreat in March, Chan said, after which the secretariat will come back to members once there is “internal agreement.” She also noted that this is not the first revision of WHO publication policy.

The proposed new publishing policy would ensure that publications are “relevant,” in line with WHO corporate policies, “based on sound evidence,” and are “authoritative, credible, reliable and impartial.” It also aims to increase the cost-efficiency, accessibility and availability, and multilingualism of publications. And it would call for greater protection of its intellectual property rights related to publications.

A “master list” of publications would be prepared at the start of each biennium. Some publications, such as World Health Report, will be cleared as much as two years ahead, Chan said. Staff members would also have to clear any outside publishing.

Several nations, such as China and Chile called for better access to publications, lower cost production (such as reducing paper editions), and more translations. African countries raised concern about the executive office spending too much time screening publications. “We don’t want them to spend all their time looking at publications,” a Liberian official told the board.

Denmark suggested executive clearance on “sensitive” issues, and added that “technical issues” can be sensitive as well.

But the United Kingdom said it is “very important” that the WHO be able to use references to models or ideas that may not be comfortable to some members.

William New may be reached at wnew@ip-watch.ch.