World Health Assembly Creates New Initiative For R&D Financing

World Health Organization members today took an important step closer to finding new ways to finance research and development into diseases afflicting developing countries.

Innovation is critical to meeting the health needs of underserved people in developing countries, but research and development is expensive and the prices of medicine is as a result often high. Today the annual World Health Assembly decided on a new initiative aimed at addressing the need for creative financing mechanisms to meet the needs for effective drugs at a low cost.

A new consultative expert working group on research and development financing and coordination was created to take up the work of a previous expert working group. The previous group was dogged by concerns about lack of transparency, and its final report did not meet the expectations of many member states. It is hoped that the new group will provide concrete, actionable solutions for financing much-needed new treatments for diseases affecting the poor, and that member states will have more participation in its process than they did with the last.

Member states will nominate the experts, consult with regional groups to ensure balanced representation, and then submit names to the Executive Board meeting, which advises the WHO’s decision-making World Health Assembly, in January 2011. The WHA met this week from 17-21 May. The final report of the new group is scheduled to be submitted to the WHA in May 2012 through the January 2012 Executive Board.

This is a “good indication for countries of the developing world,” as they are the ones who suffer the consequences of not having medicines, or of having weaker control systems, David Chiriboga, Ecuador’s minister of public health, told Intellectual Property Watch. Ecuador is currently speaking on behalf of the Union of South American Nations (UNASUR), which was a leading voice in this week’s negotiations, and which had provided initial resolutions on two critical issues: the working group, and falsified medicines (IPW, Public Health, 18 May 2010).

This decision represents an “important political statement: ‘wait a minute, you need to listen to us’,” Chiriboga added. “In short, [this is] a victory for the developing world in general,” he said to the negotiating committee.

This was a victory at the end, agreed Maria Luisa Escorel of the Brazilian delegation, highlighting new transparency on the first group’s methods and sources, the ability of member states to participate in the process as key aspects of the agreement. She praised the strong participation of UNASUR, which she said was the beginning of something that will continue.

Stephen Muleshe of the Kenyan Ministry of Medical Services said it was “an agenda for the third world,” to help “us to get medicines to our people.” He added the hope that the new group would come up with good recommendations, implementable by member states. This would be much more helpful than a menu of options, he said.

“We were happy with the original” report, said a delegate from a developed country, adding that it had had a menu of a lot of ideas and left it up to member states to take forward the recommendations, or to take forward recommendations not in the report. But ultimately the developed countries “could support” a new group taking forward various propositions from the first group, or looking at new ones, the delegate said.

That experts will be approved by the Executive Board is unprecedented for expert groups, the delegate added, but said that as this particular group is unique it was okay.

As a part of the new process, full information about the methodology, advisors and sources of the previous group will be publicised online by the end of June. Transparent management of the new group is a critical part of its terms of reference, which also place government in charge of nominating experts.

And the new group will look not only to deepen the work done by the first but will also explore proposals that were not looked at by the first group. Issues needing further exploration include the de-linking of the costs of research and development and the price of health products, which was a critical matter for developing countries.

The full text of the final resolution is available here [pdf].

During the resolution’s adoption the line “observe the scientific integrity and be free from conflicts of interest in its work (or undertaking)” was added to the working group’s terms of reference at the suggestion of Thailand, and footnotes on regional economic integration organisations were changed to reflect standard WHO language.

What really aided the movement of negotiations, said Chiriboga, was a lot of support from all developing countries in spite of sometimes differing perspectives.

What comes next is also critically important, said Muleshe. The group will need to come up with recommendations that states will be expected to implement. The global strategy and plan of action on public health, innovation and intellectual property was an expensive venture and it is up to all governments to put research and development as a top priority, he said. A critical next phase is understanding the current research capacity of developing countries, he added.

Also, this is only one part of the global strategy, said Escorel. It will be essential to make sure its other parts, especially those on access to medicines, will be addressed in the future work of the WHO.

“The issue of intellectual property is critical for 4.8 billion people who live in developing countries… poverty affects their access to health products to fight disease,” said the WHO in a press release on the close of the WHA, adding the global strategy “was designed to promote new thinking in innovation and access to medicines, which would encourage needs-driven research rather than purely market-driven research.”

WHO Director General Margaret Chan hailed the spirit of collaboration and consensus building in a closing speech, referring to R&D financing and “substandard, spurious, falsely-labelled, counterfeit medical products,” where agreement was also reached this week (IPW, WHO, 21 May 2010).

“Thank you for finding a way forward” on these issues, she said.