On 1 September 2023, Csaba Kőrösi, President of the 77th United Nations General Assembly, circulated three draft texts of political declarations related to the following processes:
Embedded into these three texts is the concept of delinkage. As described in a 2016 Unitaid discussion paper, An economic perspective on delinking the cost of R&D from the price of medicines:
The term “delinkage” is used for a set of options that aspire to change fundamentally the paradigm for financing innovation. The term can best be understood as partly technical − the separation of R&D costs from product prices – and partly polemical− a demand that the R&D system be reformed to accommodate universal access to knowledge goods, to induce openness and sharing of knowledge in general, and to make investments in R&D more cost-effective and responsive to the needs of patients and society.
The delinkage concept is reflected in the three HLM texts: 1) pandemic prevention, preparedness and response, 2) universal health coverage, and 3) tuberculosis.
In the PPPR text, delinkage is contained in paragraph 13:
13. Recognize further the important role played by the private sector in research and development of innovative medicines, encourage the use, where appropriate, of alternative financing mechanisms for research and development as a driver of innovation for new medicines and new uses for
medicines and continue to support voluntary initiatives and incentive mechanisms that separate the cost of investment in research and development from the price and volume of sales, facilitate equitable and affordable access to new tools and other results to be gained through research and
development;
In the universal health coverage political declaration, the delinkage concept is embedded in paragraph 76:
76. Recognize the important role played by the private sector in research and development of innovative medicines and continue to support voluntary initiatives and incentive mechanisms that separate the cost of investment in research and development from the price and volume of sales, facilitate equitable and affordable access to new tools and other results to be gained through research and development;
In the tuberculosis political declaration, the delinkage concept is contained in paragraph 75:
75. Continue to support existing initiatives and incentive mechanisms that separate the cost of investment in research and development from the price and volume of sales, to facilitate equitable and affordable access to new tools and other results to be gained through research and development;
The high-level meetings of the 78th session of the UN General Assembly are expected to adopt these declarations in New York next week, further sealing the concept of delinkage into the architecture of global health governance.