SEARO RC70: India calls on WHO to take the lead in negotiations of the R&D treaty (General Programme of Work debate)

As noted in an earlier piece, on 25 August 2017 the WHO published a draft concept note to provide a road map to "underpin WHO's General Programme of of Work from 2019-2023... and serve as the strategic basis for resource mobilization" for the Organization (WHO draft concept note on strategic priorities for 2019-2023 charts a new vision for the organization, 29 August 2017, KEI). The WHO concept note on the General Programme of Work (GPW) will be discussed at all meetings of the WHO Regional Committees. The WHO has proposed presenting the draft GPW during an additional session of the WHO Executive Board scheduled for 22-23 November 2017.

During the 70th Session (6-10 September 2017) of the WHO Regional Committee for South-East Asia (SEARO), the General Progamme of Work (GPW) was presented to the region. The WHO's strategic priorities include: 1) Preventing, detecting, and responding to epidemics, 2) Providing health services in emergencies and strengthen health systems, 3) Helping countries to achieve universal health coverage, 4) Leading on health related SDGs including women, children and adolescents; climate and environmental change; communicable and noncommunicable diseases, and 5) Providing the world’s platform for collective decision-making in health.

While India expressed agreement with Dr. Tedros's vision and the five priorities outlined in the concept note, the delegation stressed that universal health coverage was not possible without affordable access to medicines and health technologies. India highlighted the role that trade barriers place in impeding access to medicines and called upon the WHO to place issues related to innovation and access at the ""center stage" of the General Programme of Work.

Although India lauded the WHO's proposal to align its work towards the achievement and realization of the Sustainable Development Goals, India's urged WHO to "not only set priorities but also focus on the means and resources needed to achieving them... with the principle of de-linkage intact."

In relation to priority 5 of the General Programme of Work (GPW), providing the world’s platform for collective decision-making in health, India requested "the WHO to take a lead in negotiations of the R & D treaty under [a] WHO framework which incidentally is an unfinished agenda of the CEWG recommendations and workplan."

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Finally, India noted the scheduling conflict of the proposed special session of the WHO Executive Board from 22-23 November 2017 with the Government of India's (in coordination with WHO SEARO) First World Conference on Access to Medical Products and International Laws for Trade and Health which will be convened from 21-23 November 2017 in New Delhi. India requested that the WHO Secretariat reschedule the special session of the Executive Board for December 2017.

The full text of the intervention is reproduced below.

70th Session of the WHO Regional Committee for South-East Asia
Maldives (6 – 10 September 2017)

INDIA
Agenda 7.4 – Draft Concept Note on the Thirteenth WHO General Programme of Work

Mr. Chairman,

We thank the WHO headquarters and SEARO for sharing the Draft Concept Note on the Thirteenth WHO General Programme of Work 2019-23 proposed to be launched in 2018 to provide the strategic vision for the next five years. This is the first time that the new WHO DG has shared his vision with the Member States on the strategy to move forward over the next five years. We agree with his vision and the five priorities suggested in the Concept Note.

We take note of the statement in the Concept Note that only 60% of the people in the world have access to health care without financial hardship. An affordable access to healthcare is not possible without affordable access to medicines and medical technologies. When we talk of the issue of access to medicine and medical technologies, we must also consider the barriers to access including the price and trade barriers and the issues relating to research and development for new medicines. We would prefer if this issue finds centre stage in the strategy under the 13th General Programme of Work and is given due attention and priority. We also believe that the strategic priorities of universal health coverage, achieving health related SDGs and effectively tackling the challenges of communicable and non communicable diseases cannot be met unless a holistic healthcare model encompassing the traditional system of medicines and traditional medical knowledge is made an integral part of WHO’s strategy.

We have carefully gone through the Concept Note and its focus on what the WHO proposes to do differently. We are in agreement with WHO in setting up a measurable results framework and its contribution to outcomes and impact. However, we believe that such exercise has to have a focus on WHO’s results separately from the results of Member States.

We are in complete agreement with the proposal of aligning with and driving progress towards the Sustainable Development Goals. However, we would urge WHO to not only set priorities but also focus on the means and resources needed to achieving them. The R & D efforts on new medicines must focus on diseases of the developing countries, with the principle of de-linkage intact. We have taken note of the fact that achieving the SDG health targets would require substantial new investment to the extent of 58$ per person by 2030. However, we need to remain alive to the issue of sustainable funding of the new investments and the ways of raising them across the globe. We cannot achieve SDGs without helping the countries in need of resources. The WHO and the World need to not only talk of SDGs, their targets and priorities, but also to find ways and means and resources for the countries in need to be able to achieve those goals. We believe, therefore, that the general programme of work should also identify the cost to countries for the required interventions to meet SDG 2030 targets, and suggest means of funding them. Of course, the World cannot remain oblivious to the limitations on availability of domestic resources for the poor and developing countries.

We are happy to note that WHO’s role has been identified in the Concept Note, as a platform on which the public health convention, regulations or frameworks could be negotiated and implemented. We would like the WHO to take a lead in negotiations of the R & D treaty under WHO framework which incidentally is an unfinished agenda of the CEWG recommendations and workplan.

We welcome that the WHO is prepared to place countries at the centre of its work and will increase the level of autonomy at country level. We would be interested in seeing how it evolves into practice.

We are in agreement with the suggested action points on delivery strategy, i.e. through putting countries at the centre, getting value for money for the Member States, promoting workforce of excellence, re-engineering Data Architecture, fostering Innovation, promoting policy coherence, strengthening health diplomacy, resource mobilization and communications, strengthening and expending partnership and developing a fit-for-purpose administration and management. We would like to suggest, however, that WHO should walk the extra mile in ensuring that it steers clear of conflict of interest while strengthening and expanding partnerships, particularly with NGOs, private sector entities and philanthropic foundations.

The concept note says that the proposed goal is to have the GPW 13 approved by the World Health Assembly in May 2018. At the same time, it says that the consultation on GPW must be robust. This gives us a very tight timeline. The proposed November 2017 Special Session and the January 2018 session of the EB are not far off. I do not know how we can have a robust process of consultation in this tight timeline. However, to help matters, we would urge RD, SEARO to organize a special regional briefing session before the EB Session in January 2018, so that an informed view could be taken by Member States in the Region in the process of development of the 13th GPW.

Ministry of Health & Family welfare, Government of India, in coordination with WHO SEARO is organizing the “First World Conference on Access to Medical Products and International Laws for Trade and Health” from 21-23 November 2017 at New Delhi, India. As such, we would suggest that the proposed Special Session of the EB is not organized around these dates, if possible, and preferably organized in December 2017.

Thank you for your attention.