Three NGOs, Medicus Mundi International, HAI and MSF, each read statements during the EB discussions on the CEWG demonstration projects. The statements were limited to 300 words, and NGOs were required to provide the text 24 hours before the agenda item, and obtain WHO approval of the content. KEI worked with HAI on its statement, and the Peoples Health Movement worked with MMI on its statement. The text of the HAI and MMI statements follow:
Health Action International (HAI) statement to EB 134 On agenda item 9.3, follow up to CEWG on financing and coordination
Stichting Health Action International (HAI) is grateful for the opportunity to provide candid and constructive comments on WHO’s work on the R&D demonstration projects.
While the projects endorsed by the experts group last December address important health needs, and several propose good policies as regards the management of intellectual property rights and access to products, they collectively do not test the more transformative reforms that are needed to scale up access to medicine for all.
It may be that the CEWG demonstration projects will be a forgettable footnote in the effort to introduce larger reforms in the financing of R&D for new medicines, and that the discussions about the R&D Observatory and the R&D treaty will continue to advance this agenda.
Several of the demonstration projects that were endorsed during the country consultations proposed new incentive mechanisms, including open source development models that used medical innovation inducement prizes to delink R&D incentives from product prices. None of these projects were selected by the experts. The expert group generally endorsed more traditional grant proposals.
The reason why it is important for the WHO to consider new incentive mechanisms is because the current incentive mechanisms — the grant of product monopolies — lead to high prices, access barriers, and people dying for lack of access to expensive products.
HAI calls upon the EB, and the WHO, to make real progress on the implementation of delinkage of R&D costs from product prices, and this includes reforming the incentive system.
On the issue of the R&D demonstration projects, HAI asks the EB to consider all of the proposals for demonstration projects that were supported by the regional groups, together with the specific recommendations of the Experts Group, and propose the WHA reach a decision that includes at least one concrete test of new incentive mechanisms.
Medicus Mundi International, Statement to the 134th Session of the WHO Executive Board on agenda item 9.3 Follow-up of the report of the Consultative Expert Working Group on Research and Development: Financing and Coordination
Thank you, Chair, for the opportunity to address the EB on behalf of MMI and the PHM.
We congratulate WHO for providing leadership in relation to “Health R&D”. However, Document 134/26 clearly proposes a voluntary funding mechanism to pool funds. Such a mechanism is likely to be financially unstable and might face pressures from donors -whether countries or non-state entities- based on their individual interests. We therefore repeat previous calls for a global R&D treaty that is funded through mandatory contributions from countries and that incorporates the two most important principles enunciated in the CEWG report: open sharing of knowledge and de-linking the costs of R&D from the price of the final product. The proposal for the Global Health R&D Observatory seems to be structured as a top down process. The document doesn’t explain how the Observatory will engage with actors at the country level or how the Observatory will function in the context of other similar initiatives promoted by diverse organizations that may be driven by agendas different from the one of the WHO.
Regarding the demonstration projects, we have concerns about potential conflicts of interests for several experts on the project selection committee and on the criteria that have driven the whole process. We are surprised that the Category C criteria (whether the demonstration project would test a new approach to R&D) was not the starting point for the selection but it was examined after projects were selected for Criteria A and B.
Given these premises, it is unlikely that the demonstration projects could represent a useful contribution to addressing the current failure of global health R&D.
Fundamental changes in the landscape of innovative activity related to health products, require more decisive and bold measures in order to develop systems of innovation that privilege human lives over patents and profits.