Evaluation Starts On WHO Global Strategy For Public Health, Innovation, IPRs

This morning, World Health Organization Executive Board members took note of a report by the WHO secretariat on the evaluation of the organisation’s global strategy and plan of action on public health, innovation and intellectual property. An inception report by the evaluation team was provided to the WHO in December, which has not been shared to the member states, according to the secretariat, although its results are expected to be presented to them in March. In the meantime, key points have been provided.

The 138^th WHO Executive Board (EB) is meeting from 25-30 January.

WHO Executive Board Chair Precious Matsoso

The Global Strategy on Public Health, Innovation and Intellectual Property was agreed in 2008, with the final plan of action adopted the following year. The World Health Assembly (WHA) requested the WHO director general to conduct a programme review of the strategy in 2014, and produce recommendations at the WHA in 2015.

The stated aim of the strategy is “to promote new thinking on innovation and access to medicines and to secure an enhanced and sustainable basis for needs-driven essential health research and development relevant to diseases that disproportionately affect developing countries.”

According to the EB meeting document [pdf], in its report in 2015, the WHO proposed “an approach for undertaking the comprehensive evaluation and overall programme review separately…” An ad hoc evaluation management group was thus convened to assist in selecting the evaluation team, according to the document.

Six independent external experts, and two experts from the United Nations Evaluation Group, compose the ad hoc evaluation management group.

Prof. Rajae El Aouad Berrada, School of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco; Nadia Khelef, senior advisor for Global Affairs, Institute Pasteur, France; Prof. Bongani Mayosi, professor and head of Department of Medicine, Faculty of Health and Science, University of Cape Town, South Africa; Bernardo Hernández Prado, from Mexico, associate professor, Institute of Health Metrics and Evaluation, University of Washington; Viroj Tangcharoensathien, secretary-general of the International Health Policy Programme Foundation, Bangkok, Thailand; Professor Kathryn McPherson, chief executive at the Health Research Council of New Zealand.

An external independent evaluator was selected following an open tender, according to the WHO.

On 29 January, the EB considered a document [pdf] presenting the key points from the evaluation team’s draft inception report and initial comments by the ad hoc evaluation management group.

Members See Little Difference in High Prices of Drugs

Brazil asked that the inception report be shared with WHO member states, just not its key points. Egypt for EMRO asked for more information on the ad hoc evaluation management group, the selection of members and the choice of the independent evaluator. India also asked for the inception report.

Congo, speaking for the WHO Regional Office for Africa (AFRO), said very little progress seemed to have been achieved.

“Things seem very abstract,” the representative said, citing the high prices of drugs, such as cancer drugs. It is important, he said, that local generic manufacture of drug be supported.

The Dominican Republic said developing countries carry the highest disease burden and need to be able to use the most advanced technologies to tackle the problem, and solidarity between countries is needed to access those technologies and new drugs. A thorough evaluation is needed, the representative said, taking into account what is ethically right or wrong.

“We do not want to get into a situation where the goal is massive profit for some and massive problems for others,” he said through the translation. And WHO has a fundamental role to play in access to medicines, he added.

The Dominican Republic representative also said very little progress has been made since the initiative was set up 9 years ago. He said there is a lack of interest shown by developed regions. People concentrate on communicable diseases because they can travel between countries, however, non-communicable diseases do not travel and migrate, he said and so there is less focus on them but they still need to be treated.

“We don’t need an endless process of evaluation to do that because over the years, many years, you have a lot of evaluation but not an awful lot of results,” he said.

NGOs: Patent Pooling, Identity of Evaluator

The Medicines Patent Pool (MPP) said in its statement that the MPP is a concrete example of successful implementation of the GSPOA. Patent pooling “combined with push and pull mechanisms” can incentivise innovation and ensure affordable access to medicines, the representative said.

Medicus Mundi International, speaking for several non-governmental organisations, such as the People’s Health Movement and the Third World Network, in its statement, called for the WHO to disclose the identity of the independent evaluator.

Secretariat Responds

The WHO secretariat provided some responses to questions and in particular on the choice of the members of the evaluation group, and the independent evaluator.

According to Elil Renganathan, WHO director-general’s representative for evaluation and organizational learning, the evaluation group was set up according to the guidance of the WHA resolution and in collaboration with regional offices.

The request for proposal for the external independent evaluator was distributed widely, on various platforms, including the UN Global Marketplace, and a number of evaluation associations, the secretariat said.

Technical and financial merits of proposals were assessed by the evaluation group and bids went through a contract review committee, he said.

CAPRI, from Canada, an evaluation company that has worked for several UN agencies, was chosen unanimously, he said.

On disclosure of the inception report, he said the WHO “has a slight dilemma” as the evaluation is about evaluating member states, governments, and the WHO secretariat, he said, and many other partners, so “member states themselves are evaluees,” he added.

“To keep an evaluation like this as independent as possible we need to make sure we have not too much influence [of] member states on the evaluation per se,” he said, adding that the secretariat proposes to have regular briefings to member states.

Around the third week of February, the evaluation team is expected to come to Geneva, he said, and the WHO would like to have a session with member states and for member states to look at the inception report.

The WHO never makes inception reports public, he said. It is part of an agreement, a contract that the WHO has with the evaluator. So the inception report would be presented next month to member states by the evaluation team, he said.

Image Credits: WHO