The World Health Assembly (WHA) has just adopted a new resolution on the “Establishment of a Consultative Expert Working Group on Research and Development: Finance and Coordination.” The resolution is just over 4 pages. It represents a dramatic response to the earlier WHO Expert Working Group (EWG), by
- calling for a more member state driven role in establishing the membership of the group,
- focusing extensively by the need to deepen the analysis,
- recognizing the need to further explore and where appropriate, promote a range of incentive schemes ….. addressing where appropriate, the de-linkage of the costs of R&D and the price of health products, for example through the award of prizes.
- calling on upon the new group to “further explore the six proposals that did not meet the criteria applied by the EWG” in Appendix 2 of the EWG Report,
- creating new mandates for regional analysis and consultations, and
- “to put particular emphasis on the transparent management of potential conflicts of interest.”
The resolution was a major victory for developing countries and those promoting transformative reforms in the way that research and development and access to medicine is managed. In 2009, the 62nd WHA decided to eliminate the WHO as a stakeholder in the biomedical R&D discussions, and the EWG rejected both the biomedical R&D treaty and the use of prizes to reward product development. The EWG did not mention the concept of de-linking R&D costs from product prices — the new resolution highlights this for the new consultative group mandate. The EWG met only with the pharmaceutical industry and a handful of groups funded by the Bill and Melinda Gates Foundation, ignored obvious conflicts of interest, and gave the industry the opportunity review drafts and amend the language of the report. The new mandate focuses on the need for transparency and to better manage conflicts of interest.
Today the World Health Assembly has put the reform process back on track. We now have a brand new opportunity and a fresh and strong mandate to de-link R&D cost from product prices. This is one of the most important steps yet in remaking the R&D system so it works for everyone. The R&D treaty is now going to be reviewed, by a fresh set of eyes, with much strong member country support.
Among the many countries that demonstrated leadership on this issue were 2 regional blocs: 1) UNASUR, the group of 12 South American countries and 2) SEARO, the WHO region that includes India and Thailand. Ecuador, president pro tempore, of UNASUR, Bolivia, Bangladesh, Brazil, Thailand and India emerged as powerful voices of the developing world. Switzerland played a very constructive and important role, and the European Union and the United States both showed sufficient flexibility to advance this important reform agenda. David Hohman of the US and Norway were said to have played a particularly constructive role at the end.
A number of NGOs played an important role this negotiation, including for example MSF, Health Action International, TWN, Oxfam, and the People’s Health Movement. KEI’s Thiru Balasubramaniam, Malini Aisola and Judit Rius each contributed much in this debate.