WHO, WTO, WIPO Provide Policymakers Policy Options For Public Health

The launch of a study co-edited by the World Trade Organization, World Health Organization, and World Intellectual Property Organization on the intersection between public health, intellectual property and trade drew a full attendance from a wide array of stakeholders on 5 February.

The trilateral study, titled “Promoting Access to Medical Technologies and Innovation,” presents policy options involving health, trade and intellectual property, in a combination that some might have described as an oxymoron. Intellectual property and trade have, in certain circumstances, been presented as barriers to access to medicines, rather than enhancers.

The 250-page book, the result of three years of collaboration, is aimed at policymakers, international organisations, academics, researchers and non-governmental organisations.

WTO director general Pascal Lamy said the “report emphasises that innovation and access must be seen holistically.”

“Innovation without effective access offers scant public health benefit,” Lamy said, adding that development of new medicines and new medical technologies need to be encouraged.

“The study points out the importance of the patent system for the pharmaceutical sector, while also identifying alternative incentive mechanisms that seek to enable much-needed new products in neglected diseases,” he said.

In addition, it looks at “measures such as differential pricing as a practical way of reconciling innovation and access in medical technologies,” Lamy said, adding that the study was meant to enable “an overview of how diverse policy measures can fit together coherently.”

WHO in Favour of Public Interest

WHO Director General Margaret Chan called it “a big report with a noble ambition.” The ambition is to “help countries promote access to medical technologies and stimulate the development of new products, especially for diseases of the poor.” Every country in the world is worried about rising health care costs, she said.

In the past, trade rules and IP regime have been viewed by many people as barriers to the pursuit of public health goals, she said. Certain practices can make prices artificially high and delay the market entry of more affordable generic products, she added.

According to Chan, policy spheres in public health, intellectual property, and trade share much common ground and many social values, and all those policy spheres should operate in the public interest. International systems that govern IP rights and trade have health-specific provisions, she said, including numerous checks, balances, exemptions, exceptions and flexibilities.

The biggest achievement of the report, she said, is that it demystifies an intricate and extremely complex landscape of laws and policies and makes them accessible to the non-specialist. “It provides a comprehensive and coherent inventory of legal instruments and policy options that you as a sovereign state can draw on to craft measures that meet national public policy objectives.”

In a final comment, Chan said that an important flexibility in the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) gives least developed countries transition time, extended until 1 July 2013, before obliging them to implement provisions in the agreement. She called for a possible further extension of this transition.

“I respect the sovereignty and the multilateral systems in WTO and WIPO, but from a public health perspective an extension of this transition period is worth consideration,” she said.

WIPO Sees Innovation Opportunity

WIPO Director General Francis Gurry said the study represents “an expression of the basis of open innovation, namely as it is extremely unlikely that one institution has all the good ideas and all the knowledge, so the more we can collaborate, the better the result that will be produced.”

The study provides an opportunity to recognise the complexity and interconnectivity in most issues and in particular of the health issue, “which emphasises the advantages, if not the necessity, of cooperation,” he said.

There are few issues in the world perhaps as sensitive as IP and health, Gurry said. The mission of IP has evolved in the course of the last 10 or 15 years, he said. IP is mechanism that touches the whole process of the production, possession, and distribution of knowledge and culture, and within that whole process, “I believe the mission of IP is to find a balance or equilibrium point between all of those various interests and equities that surround that process,” he said. “The report demonstrates the multiplicity of interests that surround that process.”

In the health field, the interests are multiple and difficult to reconcile, according to Gurry. There are interests in encouraging innovation, interests in enabling intellectual assets to be diffused, and interests in enabling the social benefit of innovation to be enjoyed. Finding the point of equilibrium between these three sets of interests is an exceptionally difficult task, he said. “I don’t believe that there is any one balance for eternity here,” but a repeated process to find a balance, and “the report demonstrates there are multiple instruments of balance.”

The heads of the three international organisations were careful to underline the fact that the report is does not have a prescriptive function. “The function of the study is not to pronounce the final or authoritative word on the issues it addresses,” Lamy said. The study is meant to “provide a stronger shared platform of objective information to build the capacity of policymakers and to serve as the basis for informed policy discussions,” he said. “I commend the study to you as a practical resource, not as a doctrinal treatise.”

“We expect it will catalyse the cross-disciplinary dialogue, pooling of resources and coordination of technical assistance that has been the hallmark of our work on public health with our colleagues in the WHO and WIPO, ” Lamy said.

Members of the audience who took the floor lauded the initiative. Among them was Greg Perry, executive director of the Medicines Patent Pool, who said in a release, “This report adds further weight to the idea of public-health oriented licensing as a key win for all stakeholders in the public health arena: from pharmaceutical companies, to generic companies, to – most importantly – people living with HIV.”

“In light of it,” he said, “the Pool invites pharmaceutical companies holding key HIV medicines patents who have not yet licensed them to the MPP to do so.”