WHO Report Details Accountability In Director Chan’s First Term

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World Health Organization Director General Margaret Chan was re-elected for another term at the annual May World Health Assembly. Now the WHO has issued a “report card” showing how she kept her promises during the first term. This includes a range of steps to ensure new drugs are affordable and accessible, even if intellectual property rights make them high-priced and hard to get.

The commitment the WHO took on was to: “Ensure that interventions, including new drugs, that arise from these initiatives are affordable and accessible to those in need.”

In response, it listed various activities and initiatives that member states have taken in the past couple of years, including adoption of the Global Strategy and Plan of Action for Public Health, Innovation and Intellectual Property.

“The Global Strategy set out the framework, and laid the groundwork, for multiple ways to improve access to essential products,” it said.

WHO specified the effectiveness of its work in helping developing countries use the built-in flexibilities in the World Trade Organization Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) for public health purposes.

“Moral pressure on industry, also using flexibilities in the TRIPS agreement, contributed to dramatic reductions in the price of antiretroviral therapy, with the annual costs of treatment dropping, within a decade, from $30,000 to $200,” it said.

The report also mentioned ways in which “WHO endorsement of new products can likewise stimulate dramatic price reductions for developing countries.”

And it mentioned several key vaccine-related initiatives, including one on meningitis that meant that “For once, the best technology that the world, working together, can offer was introduced in Africa.”

Other areas mentioned include financing of research and development of products for neglected diseases, affordable medicines against noncommunicable diseases (NCDs), and a framework to ensure fairness in fighting pandemic influenza.

“In May 2012, the World Health Assembly approved a way forward for exploring innovative ways of financing R&D to produce new products for neglected diseases of the poor,” it said.

On NCDs, it said: “The relentless rise of chronic noncommunicable diseases, especially in the developing world, is certain to create new challenges for access to affordable medicines. While many essential medicines for managing these chronic conditions are off-patent and available in low-cost generic form, the millions of people now affected, and the duration of needed treatment, take these products beyond the reach of health budgets in most developing countries.”

Additional areas of work described in the report are help to engender local R&D in developing countries such as in Africa, and WHO’s role and relationship with other organisations.

There is some mention of the inability to complete work due to funding shortages. Furthermore, one area of shortcoming was in the mandate to “integrate WHO activities across the health research spectrum to promote health and to prevent and control disease.”

“In May 2010, the Health Assembly approved a WHO strategy on research for health. However, this commitment has not been fully met,” it said. “In 2013, the World Health Report will be devoted to health research, with a particular focus on research that improves access to essential medicines and services and supports the goal of reaching universal health coverage.”

The WHO report is available here [pdf].

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

Creative Commons License"WHO Report Details Accountability In Director Chan’s First Term" by Intellectual Property Watch is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.


  1. Riaz K tayob says

    [A positive report? Is this not the same Chan who:
    1. facilitated the process on innovation for public health to be started upon the basis of a document that was a “helicopter drop” limiting the potential scope of action to a few diseases despite the WHOs own experts report that used economic categories;
    2. allowed IMPACT to conflate intellectual property rights with counterfeit medicines while nary offering a word about legal counterfeits like fatal Vioxx (the unmentionable if one gets a salary from WHO);
    3. left poor countries without access to vaccines during the “Swine Flu” pandemic while rich countries were complaining that the pre-purchase contracts for vaccines were triggered by a declaration of a pandemic that was only a pandemic because of the swingeing changes to the definition (form over substance), despite the fact that companies claims were made on vaccines sourced from poor countries subject to protections and benefit-sharing arrangements? Instead of sticking to its own guidelines in a show of “transparency” it removed the guidelines specifying benefit sharing so that US “research institutions” (aka proxies for private companies) could expropriate biodiversity from the poor countries and milk them for all it was worth (with the mainstream media pillorying and putting a frantic and desperate Indonesia on the stake for a right royal burning at the stake);
    4. Added insult to injury in coming along with the WTO’s Pascal Lamy of US and Mexican pig farmers saying it was safe to consume pork (when the virus was regarded as highly plastic – Evolution 101) while not taking even rhetorically a similar stance for poor countries access to medicines?
    5. Took up Intellectual Property Rights issues up into her direct control, and under that watch Pharmaceutical companies got to make privileged commentary on the outcome document of Innovation and Public Health? (At least when the likes of Aitken where in the play the game was tough but smart, not this amateurish “hard power” of eager to please bureaucrats: one needs to watch and see if a replacement of equal perspicacity is coming up the ranks… (a smart enemy is better than a stupid friend)
    6. Initiated processes to improve transparency and participation at WHO without changing designation of ‘official relations’ for civil society, keeping the WHO in archaic age when most UN bodies, even WIPO, have moved on… an arrangement that benefits corporate lobbies who have the wherewithal to help initiate changes in important designations like pandemics.
    7. under her watch lost “progressives” like German Valsquez (access to meds) and Kathy Holloway (rational use of medicines, that fig leaf over Adam’s navel given her recent filibustering) while those bureaucrats who allegedly maintained a “persona non grata” list of civil society people WHO officials could not speak to were promoted (one is reminded of two dialectical adages, cream floats to the top, but sh&t also floats!)
    8. talks about evidence based health policy but does in effect nothing about conflicts of interest (even in the mild form of disclosures even in academic journals) which even Harvard medical students have sought fit to take up with regards to their professors and their links to BigPharma.
    9. Waxes lyrical about being subordinate to the WTO and WIPO rules on intellectual property when poor countries have problems but is ever ready to come to defend developed countries like Australia in their trade mark disputes (a leader should be predictable and readable to breed stability imho, and perhaps Chan is). Moral pressure is one thing, but arguing that one is subordinate to WTO rules when countries have legal rights is sophistry…
    10. Is happy to push all sorts of new ideas from the World Bank and IMF on how developing countries should run their health system but stays mum on the highly inefficient US health system, which the UK is now seeking to copy… (health imperialism (abroad) = health tyranny @ home)
    11. Pushed the “Health Security” issue to the chagrin of many developing countries, while forgetting security of access to health care…
    12. Did not take an activist role in health worker migration and allowed the rich countries to bludgeon the African initiatives on this matter…
    What Chan has done is change the terms of the debate on a number of strategic issues. The first is the amount of WHOs budget that is controlled by member states (less than 20%). Second, at least opening more spaces for civil society participation – even though the rich “democratic” countries then take sessions into informal discussions where civil society is excluded… Third, by meeting with “radical” civil society like PHM (but of course, insisting allegedly on no discussion of intellectual property rights issues)… These are not easy changes, but it seems like some of Chan’s advisers are more servants to other forces than for health and her legacy…

    The choice essentially is whether Chan wants to go down as a well groomed bureaucrat or a leader in health. From the trajectory taken it seems like bureaucrat with tactically inept advisers is the preview for forthcoming WHO attractions… This is because the normal bureaucratic turf wars that characterise organisations seem to be missing at WHO… instead of trying to reclaim or retain turf and budget WHO just lets it slide… compounding its irrelevance to poor peoples’ needs…

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