KEI Statement on WHA resolution on Consultative Expert Working Group on Research and Development: Financing and Coordination
KEI Statement on World Health Assembly resolution on Consultative Expert Working Group on Research and Development: Financing and Coordination
A number of developing countries worked together to push the World Health Assembly to create a member state process to consider the implementation of the CEWG. The most important CEWG recommendations are to begin work on a new WHO Convention on R&D financing, and to de-link R&D costs from drug prices.
During the past week, the US and several European countries tried to slow down, marginalize and block progress on the CEWG. The US role was the most visible and aggressive, and indeed, often shocking in terms of the tone and tactics employed. The extreme negativity of the US position has raised concerns about the future prospects of reaching an agreement on the financing of R&D.
Not entirely obvious were the role of pharmaceutical companies and the Gates Foundation. The pharmaceutical industry had a highly coordinated strategy of only saying things in public that were seen as neutral or positive about the R&D treaty proposal, and the IFPMA statement today at the WHA on the adoption of the resolution was well received by health NGOs. On the other hand, privately some pharma companies lobbied delegates to block any mention of a convention or any other binding instrument, and one complained bitterly of the notion that new products should be seen as "global public goods." There was a report that the pharmaceutical industry had met with the Danish government before the meeting to lobby against the R&D Convention. The Danes currently hold the EU presidency.
For the USA, several departments and agencies (DHHS, State, USPTO and USTR) worked closely together to try to block the core CEWG recommendations, and pushed a number of standard PhRMA talking points, such as advocating extended market exclusivity and subsidies of drug product prices as a better approach than "de-linkage" or products as public goods. Given the extensive and aggressive nature of the US government in the WHA negotiations, as well as in the related WIPO negotiations on patents and health, many assume that the Obama White House has taken a direct interest in the global health issues, and that this is connected to Obama's efforts (and struggles) to raise corporate money for his reelection campaign.
The ties between Obama's fund-raising efforts and the Obama positions on global health issues was earlier acknowledged by White House staffers, in connection with White House decision to block references to the Doha Declaration in a UN resolution on non-communicable diseases. Health groups hope that the Obama Administration will change and become less controlled by big pharma after the election, since Obama will never run for another elected office. But, once bought, some politicians stay bought.
The role of the Gates Foundation on the CEWG is less clear, in part because much of what the Gates Foundation does is deliberately done behind the scenes, or through surrogates. Despite the fact that the CEWG was trying to raise billions of dollars in new R&D funding for Type II and III diseases, the only Gates funded PDP to support the initiative was the MSF affiliated DNDi. Apparently the Gates Foundation declined multiple requests to meet with key advocates of the treaty proposal before the WHA. It was also revealing that none of the extensive network of Gates funded journalists covered the R&D treaty negotiations.
Among the developing countries, the Union of South America Nations (UNASUR) played a very important role, with Brazil, Argentina and Bolivia as the most effective advocates. During the negotiations on the text, the strongest advocate from Asia was Bangladesh, led by Faiyaz Murshid Kazi, one of the most respected and talented negotiators from the Geneva missions. Dr Viroj Tangcharoensathien of Thailand chaired the drafting group, often relying upon his extraordinary wit, humor and charm to relax tensions and focus delegates on "delivery of the baby." India was not as active as people had expected, and China, now the second largest economy in the World, sent mixed messages. From the African region, Kenya tabled an ambitious and timely resolution advocated effectively in public forums by Ambassador H.E. Dr. Tom Mboya Okeyo. Malebona Precious Matsoso of South Africa was quite supportive. For many developing countries, it was difficult to monitor or participate in the extended negotiations, due in part to the many competing demands on their time with the entire WHA agenda, as well as the concurrent WIPO discussions on patents and health.
The South Centre was quite important, with Carlos Correa and German Velasquez both serving on national delegations and participating in the resolution drafting group. The United States blocked the CEWG Chair and Vice Chair from attending the drafting sessions, but Chair John-Arne Røttingen (Norway) and Vice Chair Claudia Inês Chamas (Brazil) monitored the proceedings and met with negotiators during the week. A number of NGOs were in Geneva to work on the CEWG resolution negotiations, including MSF, HAI, TWN, the People's Health Movement, UAEM and KEI.
While the press coverage of the meeting was limited, stories by Zach Carter in the Huffington Post and Agathe Duparc in Le Monde during the negotiations seemed have to have had an impact on the positions of the US and French delegations.
Now KEI and others will begin to focus on the next negotiation, which will probably happen after the US election in early November. Among those preparations will be analysis of the substantive approaches, such as the current limits on the types of R&D to be addressed.