Health R&D Still Underfunded – WHO Members Concerned, NGOs Call For More Ambition

Hopes of stimulating research and development for diseases affecting primarily poor countries and vulnerable populations, through a strategic work plan at the World Health Organization, are dimmed by the lack of funding. An R&D project on a single-dose malaria cure had to be cut short, while a global observatory for health research and development, recently launched, might be hampered in its progress, according to officials.

The World Health Assembly is taking place from 22-31 May.

WHO members noted a secretariat’s report [pdf] providing a follow-up of the report of the Consultative Expert Working Group on Research and Development (CEWG): Financing and Coordination information on 26 May.

They also noted the upcoming establishment of an expert committee on health research and development (R&D), which is expected to provide technical advice on the prioritisation of health R&D, and to explore the feasibility of a voluntary pooled fund to support R&D for Type III and Type II diseases (Type II have greater incidence on vulnerable populations in rich and poor countries, Type III are overwhelmingly incident in developing countries), and specific R&D needs of developing countries in relation to Type I diseases (incident in both rich and poor countries, with large numbers of vulnerable populations).

In 2013, the WHA agreed on a strategic work plan with several elements to help with the issue of the lack of R&D. Included in that strategy was a Global Observatory on Health Research and Development, which was launched in January.

Lack of Funds Hamper Further Progress, One Project Dropped

Countries in general underlined progress made on the Global Observatory and noted the lack of funding.

Marie-Paule Kieny, WHO assistant director-general for Health Systems and Innovation, remarked on the chronic under-funding of this “critically important” agenda.

“The CEWG strategy work plan has been on the agenda of the World Health Assembly for so long, but we do not all remember the scope of work decided by member states,” she said.

As part of the CEWG strategy work plan, six demonstration projects were selected and approved. The sixth project, the “demonstration of the potential of a single-dose malaria cure of artemether-lumefantrine through reformulation in a nano-based drug delivery system,” brought about by the Council for Science and Industrial Research in South Africa, fell through.

On demonstration projects, no new resources have been pledged beyond the US$11 million raised in the past three years, Kieny said, and therefore “we regretfully inform the proponents of the sixth project that they should not expect to receive more financial support before their project officially closes later this year, unfortunately unfinished.”

Global Observatory Focus, Access, Capacity Building

Germany said the observatory should be developed carefully, based on its financial capacity, considering the funding issues.

Russia suggested that the Global Observatory has a particular focus on R&D for new antimicrobial products, while Colombia said the observatory should focus on chronic illnesses.

Angola for the African region called for support of the principle of safe, accessible, affordable medicines and vaccines, and for the delinkage from the cost of R&D and volumes and prices.

The Maldives underlined the importance of creating and strengthening the research capacity of developing countries.

NGOs: Delinkage, CEWG Aspirations Diluted

Access to medicines for all means that the way innovation is financed has to be consistent with access to medicines, Knowledge Ecology International said in its statement. Delinkage, the KEI representative said, was a central proposal by the CEWG and the United Nations High-Level Panel on Access to Medicines, and should be on the agenda “every time public sector funding of R&D is discussed, and when R&D funding reforms are considered by the WHO.”

KEI called for a more “ambitious” Global Observatory, and suggested it collect and publish data on R&D investment flow, the cost associated with specific clinical trials, and the role of government in funding or subsidising drug development.

According to Medicus Mundi International, the WHO strategic work plan does not address the core aspirations of the CEWG process. In particular, the Medicus Mundi representative said in its statement that the aspiration to achieve a sustainable and novel model of incentivising, coordinating, financing and regulating R&D, independent of market incentives, and “designed to protect public health though a legally-binding R&D Convention.”

Such convention could delink the cost of R&D from the prices of medicines, which was one of the key recommendations of the CEWG report, the representative said.

Both KEI and Medicus Mundi called for an open-ended meeting in 2017 to continue discussions on remain issues raised by the CEWG report. Medicus Mundi remarked that medicines issues are not confined to low and middle-income countries, but are now global.

Médecins Sans Frontières (MSF – Doctors Without Borders) said in its statement that in its work they are often hindered in providing health care because medicines, vaccines, and diagnostics are too expensive, too difficult to use or do not exist.

“MSF believes a comprehensive reform of the way we prioritize, finance and conduct medical R&D is long overdue,” the representative said, adding that affordable access to medical innovation is a global issue.

The Global Observatory indicators, the representative said, do not include any of the core CEWG principles of affordability, effectiveness, efficiency, equity and the principle of delinkage. The observatory should monitor key indicators of transparency, including on the costs of clinical trials, drug prices, and access strategies for products in development, the representative added.

 

Image Credits: William New