A drafting group has embarked on the task of combining four different proposals on the table at the annual World Health Assembly aimed at financing research and development for neglected diseases mostly afflicting poorer populations.

The drafting group, established on 23 May in a larger committee of World Health Organization members, began work tonight and will continue on 24 May in a nine-hour marathon session starting at 1:00 in the afternoon.

The 65th World Health Assembly is taking place from 21-26 May.

The group decided tonight to create a single document with all of the elements of the four proposals, in order to begin narrowing and combining them, according to participants in the closed-door meeting. The new draft will be broken into three sections oriented around preamble, operational items, and other, possibly containing definitions, sources said.

The member governments are working to decide how to respond to a report of the Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG), which was established at the last WHA with the mission to come up with ideas. The problem it addresses is that under the current medical products R&D system, there normally must be a sufficient market to pay higher prices to recover the cost of the R&D, and this leaves diseases of poor populations without an incentive for R&D investment.

The group issued its report last month, available here.

It made several recommendations, including the negotiation of a binding convention on R&D for neglected diseases. So far nations are divided over whether a binding convention is needed.

Four proposals have emerged with variations on how to address the report recommendations. One is from Switzerland, one from Kenya, one from UNASUR (the Union of South American countries), and one from Australia, Canada, Japan, Morocco, and the United States.

There was no agreement tonight on whether to pursue a convention, but some delegates appeared optimistic that some sort of agreement would be reached this week on a way to carry forward the work of the working group.

The Kenyan proposal, A65/A/Conf.Paper No. 1, calls for the immediate convening of an intergovernmental negotiating body to negotiate the convention. It also calls for several steps to bring about the convention, as well as the implementation of the preceding WHO Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property.

The proposal of Switzerland, A/65/A/Conf. Paper No. 2, calls for consultations between the director general and member states on the feasibility of recommendations in the report, and would present a compilation of views expressed at the next World Health Assembly. It also would be discussed in regional groups.

The UNASUR proposal, A65/A/Conf. Paper No. 4, would convene a meeting of national health authorities, and initiate an open-ended, government-driven study of implementation of CEWG mechanisms. The meeting would reach consensus on principles, objectives and governance instruments that “could form part” of a binding agreement, and would submit a progress report to the next WHA. Regional offices would be involved.

The proposal by the United States and others, A65/A/Conf. Paper No. 5, calls for informal consultations between the director general and members on improving coordination and financing, including, but not limited to, the possible methods recommended by the CEWG. It also calls for the issue to be discussed by regional committees, and would compile the views in a document to be presented at the next WHA.

One developing country source predicted after tonight’s meeting that during this week’s Assembly, there would not be in-depth discussion on substance of the proposals but rather mainly a focus on procedure.

“Today was just collecting statements,” the official said. “There is no agreement on anything yet.”

Sources said the possibility was raised to narrow the types of diseases that would be under consideration going forward, but this was not agreed.

Another source said some delegations may be looking to revive some ideas that were dropped by the CEWG. The group began with over 100 proposals and narrowed them down (IPW, WHO, 22 May 2012).