WHO Members Negotiate Resolution On Cancer; High Prices In Question

Cancer is spreading. According to the World Health Organization, the number of new cases of cancer is projected to increase to 21.6 million annually by 2030. The WHO Executive Board this week is considering a draft resolution for actions by the WHO member states and the secretariat. The resolution is being discussed and amended as issues such as the affordability and the accessibility of new cancer medicines, in particular in developing countries, are highlighted by many.

The WHO Executive Board (EB) is meeting from 23 January to 1 February.

WHO members have been discussing a draft resolution contained in a WHO report since last week, and have proposed a number of amendments, many of which are about access and affordability of cancer medicines and diagnostics.

In the face of a growing number of amendments, Board members decided to convene an informal drafting group alongside this evening’s formal session. The issue is expected to come back to the floor before the end of the Board meeting.

In the latest version [pdf] of the draft recommendations, amendments on accessibility and affordability were submitted by countries such as Colombia, Thailand, and Canada, as well as the European Union.

The European Union, for example, noted its concern about the increasing prices of cancer treatments, and added the fact that the access issue is not limited to developing countries.

According to the WHO report [pdf] considered by the EB today, in 2012, some 4.3 million premature deaths were cancer-related, 75 percent of which were in low and-middle income countries. The report provides a list of recommendations, such as improving access to timely cancer diagnostic and treatments, and strengthening health systems at the national and local levels “to ensure early diagnosis and accessible, affordable and high-quality care for all cancer patients.”

The report also underlined the significant economic impact of cancer, and said that in 2010, the total annual economic cost of cancer had been estimated at approximately US$ 1.16 trillion, “threatening health budgets and economics at all income levels…”

The resolution acknowledges “the limitations in access to medicines, technology and human resources for cancer care in low-and middle-income countries.” It calls for members to take actions such as accelerating the implementation of the WHO Framework Convention on Tobacco Control, ensure the highest possible coverage of vaccination against human papilloma virus (responsible for cervical cancer), and hepatitis B virus in line with the immunisation targets of the Global Vaccine Action Plan 2011-2020.

It also calls on members “to ensure the availability of the essential medicines and technologies to implement” evidence-based protocols for cancer management, “through appropriate financing arrangements, measures to overcome patent barriers, quality assurance mechanisms, more effective supply systems and measures to reduce prices.”

Novel Cancer Drugs and Diagnostics Too Expensive

Once more, in an international fora, the question of the high prices of novel medicines for cancer drugs and diagnostics was brought up. Congo for the Africa region underlined the lack of access to innovative cancer medicines in Africa, and the difficulties linked to the implementation of vaccination programmes against human papilloma virus and hepatitis B. The Congo delegate called for advocacy with the pharmaceutical industry to reduce prices.

Vietnam asked for support from the WHO to work on easier access to cancer medicines and technologies, underlining the need for accessibility and affordability, and to achieve a sustainable way to have sufficient vaccine coverage.

Colombia said that the draft resolution is an opportunity to guarantee effective responses to the growing threat of cancer but it is vital that the resolution reflects the need for equitable access to all medicines and technologies required for cancer prevention, control, and diagnostics, including for children and adolescents.

Thailand also highlighted the high prices of cancer treatments acting as a barrier to access for poor populations. The Thai delegate said cancer needs to be given much higher attention.

The Netherlands said although better medicines have been developed to treat cancer, their extremely high prices is a hindrance to widespread use. The delegate called for the need to approach access to medicines as a truly global problem. Canada called for increased equity.

India remarked the report notes that according to some estimates, “only 5% of global resources for cancer prevention and control are spent in low- and middle-income countries, despite the majority of preventable deaths occurring in these countries.” But India, noted, the report does not provide any reasoning for this inequitable situation.

India, contrary to most countries taking the floor today, said it is not in favour of the draft resolution covering human papilloma virus at this stage.

Brazil suggested elevating the profile of cancer within the WHO non-communicable diseases cluster. The delegate also underlined the high prices of cancer treatment, and called for a full discussion on innovation models, access and affordability.

WHO Concurs on High Prices

Oleg Chestnov, WHO assistant director general for Noncommunicable Diseases and Mental Health, reacted to WHO members’ suggestions on cancer prevention, diagnostics and treatment, saying the volume of information provided by members was huge and difficult to immediately translate into a strategy.

He added that being diagnosed with cancer is no longer automatically a death sentence, but a sentence nonetheless. It remains a death sentence for some and not for others, he said, underlining the issue of access to treatments. He asked what would be the best way to work with pharmaceutical companies.

“Look at the prices…. Where do they come from,” he asked, according to the interpretation in English. Some prices are “totally excessive,” he said, adding that the gap between affordable and not affordable is growing.

Many NGO Interventions

A long list of nongovernmental organisations made statements on this agenda item. All of the NGO statements can be found here, under Agenda item 10.5: https://extranet.who.int/nonstateactorsstatements/meetingoutline/7

 

Image Credits: Catherine Saez