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Friday, March 05, 2021

WHO gets what role

India is playing for high stakes in a public health and innovation treaty. It musn’t blink

Written by Malini Aisola |
May 22, 2009 1:49:42 am

Today,at the World Health Organisation (WHO) headquarters in Geneva,a proposed treaty that would considerably benefit patients across the world is under threat. In spite of overwhelming recognition among member governments of the need for a treaty that will improve access to medicines and stimulate essential medical innovation,some governments are attempting to shut the WHO itself out of these discussions. The treaty would have significant implications for global pharmaceutical research and development and much time,effort and hope may be lost if the WHO — which is in a position to support the needs and advance the positions of developing countries — is not allowed to participate in bringing it to fruition.

This week,at the World Health Assembly (WHA),the annual governing meeting of the WHO,member-states are involved in deliberations about a biomedical R&D treaty. Extensive negotiations began in 2006,resulting in a Plan of Action document. This plan included key actions to improve access to essential medicines and enhance sustainable,needs-driven medical innovation,including an action to “encourage further exploratory discussions on the utility of possible instruments or mechanisms for essential health and biomedical R&D,including an essential health and biomedical R&D treaty.” One area in which this document is incomplete,and so far lacking agreement,is regarding the inclusion of the WHO itself as a stakeholder in advancing discussions on an R&D treaty.

Several governments are opposed to the exclusion. So are at least seven well-known NGOs that sent an open letter to the assembly expressing their grave concern at the exclusion of the WHO from the path forward. The letter pointed out that we are at a turning point,“more than seven years after the 2001 WTO Doha Declaration..,and in the middle of a number of public health crises”,as well as “facing our third recent alert for a new public health pandemic. There is a clear need for a discussion on what global norms for biomedical research and development are necessary.” Given that,the letter argued,“[It is unacceptable that there would be any opposition to the WHO having a role in taking forward discussions on what global norms should be contained in a proposal for a biomedical R&D treaty.”

There is wide support for such a treaty from many governments at the WHO,health experts,and public interest groups. The treaty proposal does not enjoy the same popularity with some industry groups seeking to retain their high profit margins.

A number of proposals have been made for what could be included under such a treaty. Recent proposals include: sustainable funding mechanisms for medical products that meet the health needs of developing countries,global norms to facilitate access to public research,measures for greater transparency in innovation,capacity building and technology transfer,measures to improve the delivery of health products and devices,and norms for the management of IPR in a manner that protects access to medicines.

WHO statistics indicate that developing countries like India bear a disproportionately high burden for communicable diseases such as AIDS and tuberculosis. Affordable access to essential medicines should be our policymakers’ highest priority. This cannot be achieved without discussions on new ways to create incentives for R&D that reward innovation based on health care outcomes and business models that de-link incentives from the cost of products. Establishing global norms for governmental contributions to the cost of medical innovation in keeping with levels of development,economic capacity and R&D contributions will make a giant difference to financing biomedical innovation.

Today,a draft resolution tabled by the governments of Canada,Chile,Iran,Japan,Libya,Norway and Switzerland with the support of the US is being discussed. If approved in its current form,it will exclude the WHO as a stakeholder in discussions on a treaty for biomedical R&D. This will be against the interests of Indian patients,generic manufacturers and small-scale innovators,and a bad outcome for innovation and access to medicines for citizens around the world.

India has just made an intervention “explicitly insisting on the inclusion of WHO” as a stakeholder on the R&D treaty. Following this,several developing countries,large and small,have also made statements aligned with the line that India laid out. India’s negotiators should continue to oppose this resolution,and ensure that reforming the current broken and expensive system of biomedical R&D remains a high priority for the WHO.

The writer works for a public health nonprofit in Washington,DC

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