Chan’s Last Speech To WHA Opening: Affordable Medicines, Innovation, Listen To Civil Society, Partner With Industry

In her final opening speech to the annual World Health Assembly, Director General Margaret Chan today underlined progress made and left to make, and highlighted access to medicines as the most contentious issue of her decade of service. She stressed the importance of innovation, and investment in health, acknowledged the necessity of partners such as the private sector and civil society, and encouraged scientific evidence in decision making. And she focussed strongly on global security and health emergencies.

The 70^th World Health Assembly (WHA) is taking place from 22–31 May. Her full prepared remarks are available here.

Chan, who will be leaving the World Health Organization in a few weeks after two mandates, was first appointed by the WHA on 9 November 2006, and was re-appointed for a second five-year term in May 2012.

Prior to becoming WHO director general, Chan was WHO assistant director general for communicable diseases, and representative of the WHO director general for pandemic influenza.

Chan’s speech today spanned many different areas of WHO, as does a recently issued Report, tracking how public health evolved during the ten years of her administration. While it tells of successes, the report “makes no effort to promote my administration,” she said.

She said WHO did not lose its relevance in the last 10 years, despite some criticism, arguing that “the facts tell a different story.”

Access to Medicines, Affordability

“The most contentious issue was access to medicines, especially when intellectual property and the patent system were perceived as barriers to both affordable prices and the development of new products for diseases of the poor,” she said.

She also noted that “it took nearly a decade, 10 years, to get the prices for antiretroviral treatments for HIV down.” In contrast, she said, “prices for the new drugs that cure hepatitis C plummeted within two years.”

“The negotiations that led to the establishment of the Pandemic Influenza Preparedness Framework were tense, to say the least,  but ultimately successful, as were those that led to the Global Strategy and Plan of Action on Public Health, Innovation, and Intellectual Property,” thanks to team work, Chan said.

She underlined new global antibiotic research and development partnership launched last year by the WHO and the Drugs for Neglected Diseases initiative (DNDi), aimed at promoting access and ensuring affordable prices for new antibiotics for treating sepsis and sexually transmitted infections, in particular gonorrhoea. The “needs-driven R&D initiative” is a partnership with two distinctive features, she said: “it aims to ensure that prices are affordable, and it does so by delinking the costs of R&D from new product prices.”

She also noted the launch earlier this month of an important pilot project for prequalifying biosimilar medicines, “a step towards making expensive cancer treatments more widely available.”

WHO is also working with partners on a model for the fair pricing of pharmaceuticals. “The rationale is obvious: universal health coverage depends on affordable medicines,” she said.

No country can devise a way to treat all diseases that affect people, she added.

Ebola, Epidemics

WHO was too slow to recognise that the Ebola virus “during its first appearance in West Africa would behave very differently than during past outbreaks in central Africa,” Chan said.

“But WHO made quick course corrections, brought the three outbreaks under control, through team work and partnerships, and gave the world its first Ebola vaccine that confers substantial protection,” she said. “This happened on my watch, and I am personally accountable.”

Chan mentioned the research and development (R&D) blueprint to facilitate R&D for new medical products. “By setting up collaborative models, standardised protocols for clinical trials and pathways for accelerated regulatory approval in advance, the blueprint cut the time needed to develop and manufacture candidate products from years to months,” she said.

The expert consultations that designed the blueprint led to the establishment of the Coalition for Epidemic Preparedness Innovations, announced in January 2017, she said, indicating that initial funding is nearly US$500 million.

“The Coalition is building a new system to develop affordable vaccines for priority pathogens, identified by WHO, as a head-start for responding to the next inevitable [Ebola] outbreak,” she said.

Advice for the Future, Innovation, Partners

Chan advised member states to push for innovation. “Meeting the ambitious health targets in the sustainable development goals depends on innovation,” she said.

She also said health systems with international health regulations core capacities must be strengthened.

The multiple determinants of health demand engagement with non-health sectors, communities, and partners, including civil society organization, she said.

She mentioned the global partners meeting on neglected tropical diseases, which took place last month, during which industry celebrated progress towards the elimination of those diseases.

“This is one of the most effective global partnerships, also with industry, in the modern history of public health,” she said, underlining the medication donated by the pharmaceutical industry.

But Chan also underlined the role of civil society. “Listen to civil society,” she said. “Civil society organisations are society’s conscience. They are best placed to hold governments and businesses, like the tobacco, food, and alcohol industries accountable.”

 

Image Credits: Catherine Saez