WHO Asserts Global IP And Health Strategy Progressing But Offers Few Details

By Kaitlin Mara
Work is ongoing within the World Health Organization on a member-mandated global strategy on public health, innovation and intellectual property, a WHO official said Tuesday. But little information about that work has been forthcoming since the strategy was approved in May.

The “silence of the WHO doesn’t mean we haven’t been doing work,” said Malebona Precious Matsoso, who is director in PHI in the WHO Secretariat on Public Health, Innovation, and Intellectual Property, speaking at an informal seminar hosted by IQsensato on 23 September. “We are cautious; we cannot communicate things that have not been formally recognised.”

Intended to be an informal discussion between different interested stakeholders, all event participants spoke for themselves and not for their governments or institutions.

The event brought together speakers from the WHO, governments, and non-governmental organisations to discuss the global strategy, which puts into action years of work at the WHO on issues such as neglected, under-researched diseases disproportionately affecting the poor (IPW, WHO, May 2008).

One participant compared the strategy to the Development Agenda at the World Intellectual Property Organization, saying it would inform many different programmes at WHO. WIPO last year passed a 45-point plan – currently being implemented – for ensuring developing country needs are met through the organisation’s activities. [Correction: this comparison to the Development Agenda was incorrectly attributed to Matsoso in the original version].

But much work lies ahead on key decisions contained in the global strategy and plan of action. This includes assessing priority needs of developing countries in medical research and development, improving developing country capacity for R&D, and implementing alternative funding strategies to stimulate R&D.

Matsoso said that the WHO had “consciously identified those partners we think need to work with us” and that the organisation had had several meetings with different stakeholders.

She later explained that many of these stakeholders were researchers, often in developing countries, as well as public health associations, doctors and distributors of medicines. These are people, she said, whose day-to-day work will be affected by WHO decisions but who may not understand the implications of those decisions. They often “come back to us saying they need their own assemblies to assess” the document, she added.

Matsoso also said the WHO is working on a “matrix” detailing what activities mentioned in the global strategy already exist, what activities need scaling up, and what activities constitute new work, so that the organisation can decide out how to budget the programmes. “We’re hoping to finalise it soon and share it with you,” she said.

The global strategy [pdf] tasks WHO with creating and financing a “quick start programme” to “begin immediately to implement the elements of the global strategy and plan of action” falling under its responsibility.

“There’s no time to waste,” said Ambassador Tom Mboya Okeyo of Kenya, who was in the audience, “we have had many meetings, but for the billions suffering we need to move away from meetings” and “provide support for implementation.”

Keeping the ‘Secret’ in Secretariat

But there has been concern from many sources in Geneva about the international health agency’s tight-lipped policy on providing details or specifics on progress in the four months since the May World Health Assembly accepted the strategy.

Of particular concern to many civil society groups is the creation of an expert working group to “examine current financing and coordination of research and development, as well as proposals for new and innovative sources of financing to stimulate research and development.”

Nicoletta Dentico, an advisor to IQsensato, said it is “important to know the names of the people” in the working group, and how they “have been consulted, summoned, connected.”

The global strategy called the establishment of the working group “urgent” and Elil Renganathan, executive secretary of WHO’s Secretariat on Public Health Innovation and Intellectual Property, had expressed to Intellectual Property Watch in May the hope that the group would be operating within 2 to 3 months.

But the WHO has kept mum on the status of the working group. Matsoso was only able to say that it was a director general-level decision, and that WHO Director General Margaret Chan would “communicate in due course” information about the working group.

But the bulk of the strategy, she said, is a “member-state-driven process.”

Perspectives From Government and Civil Society

Also on hand at the meeting were representatives from several WHO member governments and civil society groups that work on public health.

Charles Clift of the UK Department for International Development (DFID), who headed the Commission on Intellectual Property Rights, Innovation and Public Health, which gave rise to the Intergovernmental Working Group on Public Health, Innovation, and Intellectual Property (IGWG) that led to the global strategy, said he had many concerns about the global strategy which were carried over from concerns about the IGWG.

Chief among them is that document contains “too many commitments, that are too weak and too vague,” Clift said. Progress indicators in the strategy are not measurable. There is a “missing middle column” in the plan of action, he said: there are actions to take on one side, and stakeholders on the other, but no detail on what needs to be done to meet objectives. A critical issue is finding new sustainable financing mechanisms, he said, which will be the responsibility of the expert working group and “one of the most important outcomes” of the process.

Peter Beyer from the Swiss Federal Institute of Intellectual Property (IPI) noted that “most of the work lies in front of us” and that it was now necessary for stakeholders to “analyse the recommendations addressed to them.” IPI had a “high-level meeting on the implementation of the WHO strategy and action plan” earlier on 23 September and plans to identify actions addressed to Switzerland.

Also contributing was Rodrigo Estrela from the Brazilian mission to the UN, who said the promise of a “more positive environment” for using flexibilities to rules on trade-related intellectual property and its strong declaratory statement as to the importance of WHO as a leader on health issues related to IP were notable achievements. In addition, Jeanne Tor de Tarlé of the French mission noted that an added value of the strategy is that it groups normally independent stakeholders and has them all work in the same direction.

Stephen Matlin from the Global Forum on Health Research noted that it takes time to build sustainable capacity for health research, and that WHO should work with the “many potential partners already working on aspects of the problem,” including those in policy capacity building, monitoring and resource tracking.

Chikosa Banda, a researcher at the University of Cambridge (UK), said during a public health study in Malawi he found people “are very suspicious of researchers and research,” and that research priorities are inevitably determined by those who fund the programmes, and thus address “what people elsewhere think are critical problems.” A key aspect of capacity building would be to get such nations to be able to address their own health concerns.

Jamie Love of Knowledge Ecology International said that there needs to be an instrument to deal with “global collective action problems” in research, and suggested that prizes could be used to reward those who give patents to patent pools, to incentivise volunteering.

Kaitlin Mara may be reached at kmara@ip-watch.ch.