At the end of a dramatic debate that began yesterday, the Executive Board (EB) of the World Health Organization (WHO) agreed to hold a special consultation on the report of the WHO Expert Working Group (EWG) on R&D Financing. A face-to-face meeting will be held on May 13, a few days before the 63rd WHA begins on 17 May. There will also be opportunities for web submissions on the EWG report. In addition, Dr. Margaret Chan, the Director General of the WHO, announced an investigation into the leaks of the draft EWG report and another EWG internal document to the IFPMA, at one point announcing dramatically that she was waiving diplomatic immunity for herself and her staff. Chan also told the EB that she had not yet evaluated the recommendations from EWG report, and would publish an analysis of the recommendations prior to the consultation.
During a highly polarized debate, a number of developing countries drew attention to the inefficiencies in the process that produced the EWG report, and the content of the report. Amongst the most charged came the call for an investigation into the leak of the report to the IFPMA, and the IFPMA’s apparent ease of access to experts shaping the reports recommendations. At one point the Chairman of the EWG, Sir George Alleyne, defended the process and lashed out at the Lancet, which wrote about the IFPMA leak, saying there was no proof of influence by the pharmaceutical industry. Sisule Musungu of IQSensato summed up the response of several NGOs when he wrote on Twitter, “If what is on wikileaks is not enough to cast serious doubt on the results of WHO’s work, then what [is]?”
In addition to complaints about the EWG process and the lack of opportunity to review the work, were detailed discussions of the content of the report itself. A number of governments criticized the EWG for failing to address proposals that de-linked R&D costs from prices, and noted the lack of concern in the report on issues of pricing and access, the management of intellectual property rights, technology transfer or capacity building for R&D in developing countries. Several countries discussed the Bangladesh, Barbados, Bolivia and Suriname proposals on prizes and the biomedical R&D treaty, which were rejected by the EWG. The concerns expressed by several developing countries were echoed by MSF and HAI, which both criticized the report in comments to the EB. The IFPMA uncharacteristically declined to speak during the period for NGO comments.
None of the higher income countries raised any questions of the pharmaceutical industry influence on the report, and none were keen on an EB consultation on the substance of the report. Canada sought a promise that the EWG report would go through to the WHA, regardless of what emerged during the review and consultation.
There were plenty of surprises during the meeting. During the debate on the EWG Report, Sir George Alleyne, the Chair of the EWG, said that he did not think that access to health products was part of the EWG terms of reference — repeating a comment he made earlier to NGOs attending the meeting.
In the beginning, Brazil made a point that they were concerned about the rejection of their proposal for taxing repatriated pharmaceutical industry profits to pay for R&D. Other than the discussion of the pharmaceutical profits tax, which was removed from the EWG following a covert lobbying effort by the IFPMA, there was very little discussion of the various tax proposals that were retained in the report, such as the Internet, banking or arms taxes.
After the EB adjourned for the day, there was considerable speculation about what might come out of a more extensive analysis of the report. One WHO staff member said, “wait till they start looking at the poor quality of the report itself, including the analysis and the writing.” Others saw the report as going nowhere, because many of the recommendations depend upon money, and the report focus on a global Internet, banking or arms sale tax seemed to lack support among the EWG’s most sympathetic allies — the high income countries with a domestic pharmaceutical R&D industry. But the EWG report does have some political allies — the support of the WHO DG and many high income countries. The discussion at the May WHA may be a heated one and quite important for the future of the innovation+access reform movement.
One unanswered question: what will be the position of the Obama Administration?
Other reports on the WHO investigation:
Kaitlin Mara, “Chan Launches Inquest On Leaked WHO Documents; Meetings Proposed On R&D Expert Report,” IP-Watch.Org, 20 January 2010.