EB136: WHO Evaluation of the global strategy and plan of action on public health, innovation and intellectual property

The World Health Organization (WHO) convenes its 136th Executive Board in Geneva from 26 January 2015 to 3 February 2015. Among the topics up for discussion at EB136 is the proposed evaluation of WHO"s global strategy and plan of action on public health, innovation and intellectual property (document EB136/31). The mandate for this overall program review of the global strategy and plan of action emanates from WHA62.16, paragraph 6, which requests the WHO

to conduct an overall programme review of the global strategy and plan of action in 2014 on its achievement, remaining challenges and recommendations on the way forward to the Assembly in 2015 through the Executive Board.

The evaluation of WHO's implementation of the global strategy and plan of action on public health, innovation and intellectual property was first broached at WHO EB in May 2013 . During this Executive Board, the WHO secretariat circulated document EB/133/7, Suggested approach for the evaluation of the implementation of the global strategy and plan of action on public health, innovation and intellectual property. This 2012 document by the Secretariat proposed the following approach for the evaluation:

12. The evaluation would be conducted by an external independent evaluator, selected by the Secretariat through an open tender.

13. The evaluator would be an independent external organization or team with an appropriate knowledge of the subject of the evaluation and skill mix, as well as relevant experience in performing evaluations involving innovation strategies in public health and access to medical products and technologies.

14. The evaluator would develop the evaluation methodology, conduct the analysis and deliver a report of the findings, including recommendations.

15. The Secretariat would provide the necessary support to the evaluator during the evaluation exercise (finalization of methodology, identification of partners, facilitation of contacts, identification of relevant documentation and data).

During EB133 discussions on public health, innovation and intellectual property in May 2013, the WHO secretariat provided the following insight into WHO's evaluation of the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property (GSPOA). It is telling that the WHO secretariat refers to the GSPOA in the past tense noting that it "was a medium-term strategic plan for 2008–2015" but noting that "some activities would continue after 2015" including WHA66.22 which requested WHO to report to the Health Assembly on health research and development demonstration projects in 2015, and to convene an open-ended meeting of Member States prior to the World Health Assembly in May 2016." If the GSPOA is indeed a "medium-term strategic plan for 2008-2015", this poses an interesting quandary, what next? Perhaps one possibility would be for WHA68 in May 2015 to extend the mandate of WHO's Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property.

In terms of developing the evaluation methodology for assessing how the GSPOA has been implemented, Dr. Kieny intimated that the Secretariat would prefer to use "a consultancy with appropriate knowledge and experience" stressing the need to "ensure independence and use of appropriate methodology".

Dr KIENY (Assistant Director-General), thanking speakers for their useful suggestions, recalled that the global strategy and plan of action on public health, innovation and intellectual property was a medium-term strategic plan for 2008–2015. Monitoring and evaluation were built into the strategy as part of element 8 (establishing monitoring and reporting systems) and the indicators to measure performance had been adopted in resolution WHA62.16. Implementation had begun in 2008, and the Secretariat had provided progress reports in 2010 and 2012. However, some activities would continue after 2015, and she drew attention in that regard to resolution WHA66.22 on follow up of the report of the Consultative Expert Working Group on Research and Development: Financing and Coordination, which requested the Director-General, inter alia, to report to the Health Assembly on health research and development demonstration projects in 2015, and to convene an open-ended meeting of Member States prior to the World Health Assembly in May 2016.

It had not been possible in the progress report to provide more detail on the evaluation methodology, and further information would be made available on the WHO website. The Secretariat was planning to review five to seven countries in detail, element by element, since the allocated resources were not sufficient for a detailed case study of all countries. Efforts would be made to build on the PAHO Regional Platform on Access and Innovation for Health Technologies and other platforms in different regions; the Secretariat was also building a global platform. Although the global health research and development observatory that the Director-General had been requested to establish in resolution WHA66.22 would be useful for the purposes of reporting, it would not be fully operational by the 2015 deadline.

The evaluation was complex and in order to ensure independence and the use of appropriate methodology, the Secretariat would prefer to use a consultancy firm with appropriate knowledge and experience. The details of the evaluation and all the results would be provided to Member States.

The DIRECTOR-GENERAL said that the current workplan finished in 2015 and consisted of eight elements that were all being implemented at different rates, and efforts would be needed to achieve coherence and ensure a comprehensive evaluation using the indicators agreed in resolutions already adopted. Given its technical nature, the evaluation exercise should be conducted by experts in order to ensure that the correct methodology was being used. However, the evaluation methodology and terms of reference must not be affected by conflicts of interest or vested interest. As part of the culture of evaluation being developed under WHO reform, the Evaluation Monitoring Group, which comprised Officers of the Executive Board, had already provided Member State oversight of the second-stage evaluation. If the Board was agreeable, she would request that Group to provide Member oversight and ensure transparency concerning the evaluation exercise.

In terms of the timeline for the independent evaluation of the GSPOA, EB/136/31 proposes the following. The WHO secretariat proposes that the "evaluation management group" be established in January 2015, with the terms of reference and request for proposals for potential members of the team finalized in March 2015. The selection of the evaluation team and the finalization of contracts will be done in June 2015. Although this is an independent evaluation, it is unclear from EB/136/31 as to whether the EB will have any oversight of the work of the evaluation management group of the global strategy and plan of action on public health, innovation and intellectual property.

4. In order to facilitate the process leading to the presentation of the evaluation report, the
Secretariat proposes the following timeline, which is in line with the WHO evaluation policy:

(a) January 2015: Establish the evaluation management group.

(b) March 2015: Finalize and approve the terms of reference for the evaluation, and request proposals for potential members of the evaluation team.

(c) June 2015: Select the members of the evaluation team and finalize the contracts.

(d) August 2015: Issue an inception report, which presents the plan of action, the timeline and the terms of reference.

(e) September 2015 to September 2016: Facilitate the evaluation exercise and monitor the
outputs.

(f) January 2016 and May 2016: Report to the Executive Board and the World Health Assembly on the progress of the evaluation.

(g) October 2016: Review and finalize the evaluation report.

(h) January 2017 and May 2017: Submit the report to the Executive Board and the World Health Assembly.