At WHO deliberations (26 November 2012 to 28 November 2012) on charting a path forward following the recommendations of the Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG), Bolivia, Colombia and Thailand reiterated their political commitment supporting a binding R&D treaty. The following non-governmental organizations made oral interventions in support of the R&D Treaty: the Council on Health Research for Development, Health Action International (on behalf of HAI, Knowledge Ecology International and Alianza LAC-Global), Médecins Sans Frontières and Oxfam. It should be noted that only the morning portion of the first day this “open-ended meeting on follow-up of the report of the Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG)” is open to observers.
While the Wellcome Trust did not attend this negotiation, they distributed a 6 page floor document. The Wellcome Trust criticized the CEWG’s advocacy of de-linkage noting that:
It is essential to engage with industry effectively. We are concerned that the report’s emphasis on the delinkage of R&D costs from the pricing of end-products may hamper this. The pharma industry are important partners and should be galvanised to develop business models that address the needs of the poorest consumers.
It is curious that de-linkage, an over-arching principle that guides the WHO global strategy on public health, innovation and intellectual property is questioned by this British philanthropy in contrast to the Council of the European Union conclusions (2010) which promoted the exploration of models that dissociated the costs of R&D from the prices of medicines.
While the Wellcome Trust is attached to traditional ways of funding R&D, it should be noted that the European Federation of Pharmaceutical Industries and Association and companies such as Novartis have embraced the de-linkage concept in certain contexts.
In the Novartis submission to the WHO Expert Working Group on R&D Financing for a Fund for R&D in Neglected Diseases (FRIND), Dr. Paul Herrling (former head of Corporate Research, Novartis) advocated a de-linkage approach in his submission:
FRIND would own the exclusive licenses for neglected disease indications of the funded compounds with an obligation that medicines developed will be made available at nonfor-profit prices.
The mission of the fund must include the obligation to make available the therapies it funds to poor patients in the developing world for free or at an affordable price, or at least at no profit (if a profit can be made, then the normal market mechanisms will be
With respect to the biomedical R&D treaty, the Wellcome Trust stated:
We seriously question the need for a new binding global instrument for R&D and inovation for health. We have real concerns that the time and resource required to develop such an instrument will detract from activities that are urgently needed to now to tackle the disease burden of LMICs. We note the difficulty of enforcing a legally binding convention of this type, and the complexity of developing an instrument that is relevant to all member states. We would urge that the focus should be on strengthening existing structures, rather than introducing new initiatives.
The position of the Wellcome Trust stands in marked contrast to the position over 80 global health researchers, institutions, and product development partnerships and public interest non-governmental organizations who have expressed support for the R&D convention including All India Drug Action Network, ACT Paris, BIO Ventures for Global Health, Health Action International, Médecins Sans Frontières- Access Campaign, Oxfam, Stop AIDS Campaign, KEI, The Thai Network of People living with HIV/AIDS (TNP+), Trans Atlantic Consumer Dialogue, the University of Cape Town, the Drugs for Neglected Diseases initiative, Universities Allied for Essential Medicines, COHRED, Berne Declaration, BUKO Pharma-Kampagne, Ministry of Health, Republic of Zambia, and People’s Health Movement.