WHO Negotiations To Address Medical R&D Global Gaps Head Deep Into Night

Negotiations on the follow-up of the report of the expert group on research and development for neglected diseases tonight were continuing in a late-night session at the World Health Organization. At press time, member states were discussing options to address the research coordination, financing, and monitoring of medical R&D expenditures for the health needs of developing countries.

The open-ended meeting of governments addressing the report of the Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG) convening 26-28 November has been extended through a night session as member states continue to debate the modalities of how to address inequities in the current medical research landscape.

As of press time, it appeared that proposals to address the coordination, financing, and monitoring of medical R&D expenditures were advancing, but not as part of an overarching framework. However, member states in favour of a binding convention continued to push for the inclusion of language, which would allow for the possibility of an R&D treaty going forward.

The latest draft resolution [pdf] circulated at the start of the 26 November afternoon session (though still with a 9:00 time on it), did not include the possibility of a binding convention on medical research and development. Rather it endorses a “strategic work plan to improve monitoring, coordination, and ensure sustainable financing for health R&D, as an initial step towards the development of effective, safe, quality, suitable and affordable health products that existing market mechanisms and current public policies fail to deliver.”

A copy of the draft meeting report [pdf] notes agreement on “a phased approach by endorsing a strategic work plan which encompasses monitoring, coordination, prioritization and financing.”

Countries including Bolivia, Thailand and Colombia have expressed strong support for a medical R&D treaty. Laurent Gaberell, from the Bolivian delegation, said, “We are getting what we want, but more slowly than what we want.”

“Ultimately this could really have a big potential, Gaberell explained in a video interview by Knowledge Ecology International (KEI). “If we get countries to sit together and pool resources to finance some R&D project that could ultimately really make a difference for developing countries that could show the world that there is not only one model for R&D, the IP model, the private commercial model, but also that governments sitting together and public funding can also deliver and make a difference.”

Agreement seemed to have been reached on a monitoring proposal or a “Global Health Observatory,” which was also one of the recommendations included in the CEWG report.

According to the meeting report draft, “Members States agreed in principle that a Global Health Observatory should be set up in WHO. The Secretariat was requested to develop, for consideration by the World Health Assembly, a proposal on how such an Observatory could be set up, including the scope of the Observatory, its relationship with mechanisms at regional and national levels, as well management, timeframe and financial implications of such an Observatory.”

As member states continued to hammer out a resolution into the early morning of 29 November, many delegates described the negotiations this week as particularly challenging.

Tough Negotiations

Several member states have described this week’s negotiations as particularly challenging. Germán Velásquez, a special adviser for health and development at the South Centre, is negotiating with the Bolivian delegation, and called it very difficult.

“I have been following this issue over the last 10, almost 15 years and this has been one of the most difficult meetings that we have had because of all the issues in intellectual property and access to medicines that we discussing, or trying to discuss today,” Velásquez said in a video interview.

Additionally, he described a close collaboration between the Union of South American Nations (UNASUR), India, China, Iran, and Egypt, saying that the countries worked together “in a very consistent way.”

A delegate from a high-income country expressed frustration leaving the meeting before negotiations had been concluded. “We just spent a half an hour negotiating whether or not we should include reference to CEWG. At this rate, this meeting is going to run all night. As the chair said, it’s not good for your spiritual health,” he said.

Others, though, were positive on the evolution of the discussions. “Considering how polarized the positions are, we have made a lot of progress. In May, ‘instrument’ was a bad word. It is still, but less so. At least the idea is still on the table,” said a delegate from an African country.

This meeting was mandated by the 65th World Health Assembly last May, with the objective to examine the CEWG report, the feasibility of its recommendations, and to develop proposals or options related to research coordination, financing, and the monitoring of R&D expenditures.

The general meeting documents are available here. Viroj Tangcharoensathien of Thailand is chairing the meeting and will hold an open briefing session on the outcomes on 29 November.

Outside Views

The mobilization around these negotiations has been significant. Due to the strong interest, member states opened the first morning session to non-governmental organisations (NGOs) in official relationship with the WHO, other NGOs, intergovernmental organisations, The Wellcome Trust, the Bill & Melinda Gates Foundation, and the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA).

Over 60 NGOs submitted an open letter [pdf] supporting a global R&D convention. On behalf of Knowledge Ecology International and Alianza LAC-Global, Health Action International delivered a shortened version of the letter in an oral intervention. Several other NGOs also spoke out in favour of an R&D treaty including Médecins Sans Frontières (MSF, Doctors Without Borders), the South Centre, the Council on Health Research for Development, and Oxfam.

The IFPMA also made a statement [pdf], welcoming the “[CEWG] conclusion that new models would be supplementary instruments to address challenges that cannot be fully tackled trough the current innovation paradigm.”

While the Wellcome Trust was not present during the opening session, the London-based global charitable foundation circulated a statement critical of an R&D treaty: “We seriously question the need for a new binding global instrument for R&D and innovation for health. We have real concerns that the time and resource required to develop such an instrument will detract from activities that are urgently needed now to tackle the disease burden of LMICs [Low and Middle Income Countries].”