A Call For Health Research, Innovation In The Post-2015 Era

In the post-2015 Development Agenda, United Nations members must explicitly support research and development, related policies and capacity building with special attention to the low and middle income countries, in order to advance global health targets, experts said at a recent event in Geneva.

Information about the post-2015 Development Agenda is available here.

A 22 May side event to the 67^th World Health Assembly featured a discussion on “The role of Research & Innovation to Achieve Health for All and Sustainable Development.” The event was co-organised by the Council of Health Research for Development (COHRED), Drugs for Neglected Diseases initiative (DNDi), Global Health Technologies Coalition (GHTC), Global Health Council (GHC), International AIDS Vaccines Initiatives (IAVI), and the delegations of Kenya, the Netherlands, Norway, Senegal, and the United Kingdom. The panel was moderated by Carel IJsselmuiden, executive director of COHRED.

The World Health Assembly convened from 19-24 May.

Kenya

Fred H.K. Segor, Kenya’s principal secretary of health, started by highlighting that, “R&D for new innovative health tools is essential because it makes progress for the MDGs,” adding that, “it enables more equitable and sustainable improvements towards outcomes.” In fact, he said, health healthy population is of paramount importance for economic development and according to a recent study “good health increases economic growth by more than 11 percent.”

Since 2000, Kenya has achieved numerous accomplishments in R&D, such as new drugs for preventing mother-to-child transmissions of HIV or for combatting malaria, he said.

In this regard, the government promotes strengthening R&D through investment and collaboration with all stakeholders in order to build capacity for the manufacture of health products, Segor said. Recently, new legislation on science, technology and innovation was enacted, allocating two percent of national GDP for national research funds. The government also supports a longstanding relationship with global health research organisations, as it does in the context of the HIV vaccine initiative.

However, Segor called for new partners and stakeholders to join their arms with governments to realise R&D. Governments need also to provide their populations with health technologies “that are cost-effective and sustainable and should be adaptable to each country’s health needs,” he said.

Global R&D therefore plays an important role to ensure continuous progress in health, and must be included as a central component in the post MDG framework, he concluded.

GAVI

Seth Berkley, CEO of the GAVI Alliance, recalled that since the World Development Report 1993, it has been found that “investing in health is a critical development measure,” and that at a certain level of income, the curve of life expectancy of a country changes mostly due to development of science and technology.

According to the new Gates Foundation-supported Lancet Commission on Investing in Health, he said, within one generation the world has the opportunity, using science and technology, to raise the level of health in poor and middle-income countries, which they called “the grand convergence.”

But, Berkley said, “We will not get there without better tools.” In fact, development of technology “is a critical global public good, which will give critical knowledge to help things to move forward,” he added.

With respect to GAVI, extraordinary advances in science and technology have been achieved and will continue to have new and powerful vaccines such as for flue, TB, malaria, and HIV, said Berkley.

However, this “scientific revolution has to extend across entirely the developing world,” he said. All recent discoveries in science have come from partnerships between scientists from developing as well as developed countries.

And “the only way” to bring about this scientific revolution, he said, is “to create a truly global scientific movement that include scientists from the North and South,” and provide financing to both institutions,

Meanwhile, at the GAVI replenishment launch on 20 May in Brussels, pharmaceutical company GlaxoSmithKline (GSK) announced a commitment to a five-year price freeze for GAVI graduating countries.

GSK

At the Geneva event, Jon Pender, vice president government affairs at GSK, evoked the progress made over the last 10 years in the health R&D area, especially for HIV, malaria, TB and NTDs.

At GSK, an open innovation approach for R&D has been adopted, in particular for NTDs. As a result, Pender said, they are more open with data, “we do not view as commercial assets at all.”

The outcomes of their activities are released in the public domain in order to enable the global scientific community to exploit them. With respect to the intellectual property and know-how, in the context of their pool for open innovation against NTDs, they are made freely available to the public.

He also mentioned a recently started open lab in Spain named “Tres Cantos Open Lab Foundation,” focusing on the diseases of the developing world, has been fundedby GSK and Wellcome Trust, an independent charity funding research. It welcomes scientists to work on their own projects and offers access to their expertise and technology. That enables the development of different methods to address NTDs. “Any IP they may have, belongs to them,” he said.

On the post-2015 agenda, Pender said he is concerned, as “there are 16 focus areas. Health is just one of the 16.”

“It is a real challenge to make sure that health gets its fair part of this cake.” However, “our advantage” to ensure this happens, he said,is that “health supports many other focus areas, in a way the other focus areas do not.”

A difference from the last MDGs, Pender observed, is the emphasis on non-communicable diseases (NCDs, such as cancer) and the building of the concept of universal health coverage.

While universal health coverage will be achieved by each government and health system in different ways and from different starting points, eight principles should be pursued, he said: equitable access, efficiency, quality, inclusiveness, availability, adaptability, choice and innovation.

Given the growing challenges of NCDs in Africa with its particular variants, GSKhasalso put forward the creation an open lab including African scientists that will focus on innovative ways to address this major danger of the next decade, he said.

Other Efforts

Mandiaye Loume, first technical counsellor to the Senegal Minister of Health and Social Action, explained that in Senegal they have a high rate of morbidity related to HIV, malaria, tuberculosis (TB) and neglected tropical diseases (NTDs).

Despite a dedicated department for R&D set up in the higher education ministry, the results remain slow, he said. But Loume believes that “R&D can bring a real asset in the fight against these diseases,” and urged WHO to take it into account.

Osman Sankoh, executive director of INDEPTH Network, a network of health and demographic surveillance systems, emphasised the lack of health data in low and middle income countries (LMICs), which makes it much more difficult for policymakers to meet the needs of their populations. Experience has shown that “policymakers who are guided by ex-post evidence are in a better position to design more effective strategies for their people,” he said.

Presently, INDEPTH Network and several other research organisations across the South are trying to address this gap of reliable data and the lack of human capacity to use them.

With regard to MDGs beyond 2015, “reliable health population data will be an essential good for delimiting the new goals and for measuring progresses of our steps,” Sankoh said.

In fact, universal health coverage will only be achieved “if it is backed up by comprehensivehealth information systems that account for everyone’s birth, life course and death,” he said.

Along with the other panellists, Sankoh recalled that this “post-MDG process should be a new opportunity for global health to really become global,” by including collaborations across the South and the North.

In addition to save lives, a strong international commitment to invest in R&D in LMICs will also save a huge amount of money, he said.

The ‘Black Hole’ of R&D

Robert Terry, manager of knowledge management at WHO, explained how it is difficult to be informed at the global level about research projects which are taking place across the world – notably, who, where and how. There is what he called “a black hole” in R&D.

One way to address this data gap is “to think outside the box” or “how can we do more with what we have,” he said. The Global Health Observatory being developed by WHO, for instance, could try to make available much more data for each country on the internet.

“We need to be much more clever at reducing the transaction cost of the access to data” he said. Principles such as open data, open access, or open innovation will have to be followed, he said, because “we can’t solve problems by using the same kind of thinking we used when we created them.”

Christine Sow, executive director of the Global Health Council, highlighted how over the past decade there has been a shift around the idea of making R&D more applicable, more operationally oriented through various ways, such as North-South collaboration or public private partnerships with a practical focus.

However, health remains a multisectoral issue, which needs multisectoral approaches, and, as she explained, “research and innovation in other areas can have a great effect on the success of health intervention.”

While, governments play a role at the frontline in terms of funding for R&D against their priority diseases and making the results of this R&D available to the public, the private sector is a critical actor too, “because it brings know-how into processing, which are not necessarily available in other areas,” she said.

With respect to North-South collaboration in R&D, “it is also around working in low resources settings either in the South or in the North” she said. Currently, there is an incredible potential for some of the work going on in this area in the South, “which will have a great application globally and not just in the global South,” she said.

Sow concluded that “R&D and innovation is truly multisectoral and must remain so.” None of these sectors cannot withdraw from that partnership. “All of them play a role, and all must continue to play a role,” she said.

Joséphine De Ruyck is an intern at Intellectual Property Watch. She is currently finishing an LLM degree in intellectual property rights and ICT law at University of Leuven in Belgium. She holds a Master’s Degree in Law with honours from University of Louvain and an LLM degree from Queen Mary University of London. She has a strong interest in several intellectual property issues, especially access to health, climate change and new challenges facing copyright law.