Health R&D Experts Conclude Meeting With Few Details But Signal More Openness

An expert body under the World Health Organization tasked with finding innovative solutions for financing research for needed medicines concluded its second official meeting Wednesday, working on a process to analyse possible mechanisms. The WHO afterward appeared to address concerns – which included a civil society letter – by insisting there would be more transparency in the negotiating process, but did not provide assurance that potential conflicts of interest would be properly addressed.

At the 29 June to 1 July meeting, the WHO Expert Working Group on Research and Development Financing discussed different ways to finance and coordinate R&D efforts, according to an announcement posted on its website.

Many of the proposed ideas were submitted by governments and non-governmental organisations during a public hearing (IPW, WHO, 29 June 2009).

Others came from ongoing efforts in financing needed medicines, such as the Global Funding of Innovation for Neglected Diseases (G-FINDER) survey, which collects data on investment in R&D, and is run by the George Institute and funded by the Bill and Melinda Gates Foundation.

The body also “further elaborated a process for extended analysis of current R&D financing mechanisms which would include the submitted proposals and other key financing proposals in circulation,” says the announcement, available here. No further details were available on this process.

Seen as a critical part of a larger WHO strategy to address the connection between public health, innovation, and intellectual property, the expert working group has recently drawn criticism from key stakeholders, who are worried about the closed nature of the meetings. In particular the process for analysis – on which there have been few details circulated – has caused nine public health advocacy groups to write a letter calling for greater transparency and balance in the work.

“The mode for evaluating [R&D financing] proposals is highly secretive [and] there is little known about which consultants have been hired,” says the 30 June letter, available here.

The WHO announcement says the process for evaluating differing funding options will “envisage the opportunity for inputs from a wider interested public including member states, individuals, civil society groups, government institutions, academic and research institutions, the private sector and other interested parties.”

Updates on the progress of this effort are planned “from time to time,” the announcement adds, though it does not provide details on what the process will be.

The letter from the NGOs indicates this process may involve engaging the George Institute to “undertake a comparative review of alternative incentives, which will include the establishment of a stakeholder network.”

The network would involve nine representatives of the pharmaceutical industry, eight organisations funded by the Gates Foundation, seven developed country agencies, five developing country agencies, and one NGO “critical of the status quo,” adds the letter, citing a draft of this review not seen by Intellectual Property Watch.

Such a network would represent an “unacceptable lack of balance, have many conflicts of interest, lack legitimacy, and be highly unlikely to recommend anything that would represent significant changes,” the letter said.

Requests for more information from the WHO were not answered by press time.

Meanwhile, a statement on the working group process was circulated by Tido von Schoen-Angerer, the executive director of the Campaign for Access to Essential Medicines at Médecins Sans Frontières, which was not one of the signatories to the NGO letter.

“To date,” it says, the expert working group “has only heard directly from a limited set of stakeholders” and the recent proposal is “that an organisation (headed by a member of the [working group]) undertake a review of the submissions and other proposals for incentivising R&D, and in doing so involve a stakeholder network of handpicked groups.” Mary Moran, who directs the Health Policy Division of the George Institute, is one of the group’s experts.

These groups do not include enough end-users of medication nor adequate civil society representation, said Schoen-Angerer, calling for a more participatory process involving such stakeholders.

The working group, he concluded “must not only be fair and objective but must been seen to be so, by showing a commitment to transparency and the use of public procedures.”