Gates Foundation Echoes WHO Concern Over Medicines Access In Trade Deals

Melinda Gates of the Bill & Melinda Gates Foundation addressed the World Health Assembly today, highlighting a new initiative on newborns and stirring some discontent among activists. Alongside her at a press conference earlier in the day, a senior colleague signalled support for WHO Director General Margaret Chan’s strong concern yesterday about possible negative effects of free trade agreements on access to affordable medicines.

Speaking to journalists at the UN alongside Gates, Chris Elias, president of the Global Development Program at the Gates Foundation, answered a question about Chan’s comment (IPW, WHO, 19 May 2014).

Elias said he would not comment on specific trade agreements, but said: “a lot of our work in product development is aimed at developing safe, low-cost, affordable, high-quality medicines, vaccines, diagnostics to meet the needs of the poorest countries around the world. We work with a diverse set of pharmaceutical and biotechnology medical device companies to support the development of work in many ways that often involves what we call ‘global access agreements’, where, as part of our support for the research and development, we agree upfront to affordable pricing.”

“In many cases that involves technology transfer as well, and so it will be important, as Dr. Chan mentioned, that as international trade agreements are negotiated, that we pay attention to the importance of accessibility for affordable healthcare commodities for the poorest countries in the world,” he said.

Elias said he did not know the specifics of the Trans-Pacific Partnership agreement or the Transatlantic Trade and Investment Partnership (TTIP) well enough to know “what the issues are in terms of potential obstacles to access.

But, he said, “I would agree with Dr. Chan that it’s important that we pay attention to that, because some of the specific challenges we face in closing the gap in health between rich and poor countries [are] related to the accessibility and affordability of high-quality medicines.”

In her prepared remarks to the Assembly, Gates made a possible indirect reference to the Foundation’s focus on patent-related innovation.

“Since you first heard about our foundation, our core values haven’t changed – and they never will. We will always do this work because we despise inequity, and because we believe in the power of innovation to solve problems.”

Gates was an invited speaker at the Assembly along with Dr. Christine Kaseba-Sata, the first lady of Zambia, who is WHO Goodwill Ambassador against gender-based violence, another major theme of this year’s Assembly. A WHO press release is here.

Gates said in her prepared remarks that she “would like to talk about the issue I spend the majority of my time thinking about: the health of women and children.”

She introduced the newborn initiative to the UN journalists earlier in the day.

“Now that the deaths of under-5 mortality have come down so significantly, the glaring hole that is really pronounced now is newborn deaths,” she said. “2.9 million children still die within the first month of life, a million children die on their first day of life.” She highlighted the “Every Newborn Action Plan”, with five key interventions, which is to be considered by WHO member states tomorrow, she said.

Bill Gates addressed the WHA in 2005 and 2011, speaking on polio eradication and vaccines, respectively.

Major WHO Donor

The Gates is one of the largest donors to the WHO, if not the largest.

WHO priorities are set by WHO member states before funding is sought, a WHO source noted. Every two years, member states approve a two-year programme budget that details the organisation’s intended results and deliverables – and accompanying budgets – for the biennium,. the source said. “Once the priorities are set, WHO seeks funding, from member states and other funders, in support of these priorities.

In 2012-13, there were 494 contributors, both governments and other funders, providing funding in support of the 2012-13 programme budget. The Bill and Melinda Gates Foundation was one of the key non-member state contributors in 2012-13 , and their contribution was principally for the polio eradication initiative.

The Gates Foundation was WHO’s second-largest funder in 2012-13 after the US government, with total contributions of US$ 568,000, the source said. Of that amount, 67 percent was for the polio eradication initiative.

The Gates Foundation continues to be one of the largest international donor for health. “A significant part of the Gates Foundation’s expenditures is channelled through NGOs from partners and donor countries, international NGOs, universities and other teaching or research institutes, and multilateral agencies,” the source noted. The GAVI Alliance, UNICEF and WHO are the main institutions with which the foundation collaborates.

Protest Against Gates as Invited Speaker

A top issue at this Assembly is proposed new rules for WHO engagement with “non-state actors,” that is, industry, NGOs, foundations and academics. Civil society has been active at the event (which runs from 19-24 May) in calling for strong rules to prevent a private-sector takeover of the UN agency. Industry, meanwhile, says the new rules might unfairly disadvantage them in relation to other non-state actors.

The Peoples Health Movement is circulating a letter for signature that protests the repeat invitations to Gates Foundation leaders, as it says the foundation has investments in the food industry, including some that market unhealthy products (such as Coca Cola and McDonald’s), and in pharmaceutical companies. The letter calls for more transparency in the process.