A draft resolution on the global financing and co-ordination of health research and development (R&D), adopted by member states of the World Health Orginization after three days of discussions in Geneva, is “a triumph of political foot-dragging and lack of leadership”, says activist group Médecins Sans Frontières (MSF).

To the disappointment of the activist community and developing-country negotiators, member states failed to endorse a binding global convention on health R&D in Geneva, as was recommended in last April’s report by the WHO’s Consultative Expert Working Group (CEWG) on Research and Development.

Instead – and reportedly in the face of firm resistance to a binding treaty from the US and the European Union – the member states agreed, among other proposals for adoption at the next World Health Assembly, to establish a Global Health R&D Observatory within the WHO’s Secretariat.

The observatory would “monitor and analyse relevant information on health R&D, building on national and regional observatories (or equivalent functions) and existing data collection mechanisms with a view to contributing to the identification of gaps and opportunities for health R&D and defining priorities in consultation with Member States”, the draft resolution noted. 

Process not progress

For MSF, this was a case of substituting “process for progress”.

Instead of “pushing forward with a real plan to address the continued lack of suitable and affordable vaccines, drugs and diagnostics that our teams in the field face, all countries have really pledged to do is to continue observing the situation”, argued Michelle Childs, director of policy advocacy for the MSF Access Campaign.

“After ten years of inter-governmental negotiations and several landmark expert reports with concrete proposals on how to fix a R&D system that fails to deliver, this is a triumph of political foot-dragging and lack of leadership,” Childs stated.

She claimed there was a “complete disconnect between the recognition of the scale and urgency of the problem, which is widely shared, and the fact there are proposals for transformative change that have been pushed back for another four years.”                     

Other commitments in the draft resolution included:

•    Strengthening health R&D capacities and increasing investments in health R&D for diseases that disproportionately affect developing countries.

•    Promoting capacity-building and technology transfer on mutually agreed terms,  health product manufacturing in developing countries, health R&D, and access to health products in developing countries through investments and sustainable collaborations.                                          

•    Continuing consultations at national, regional and global levels, including through the WHO’s governing bodies, on specific aspects related to the co-ordination, priority-setting and financing of health R&D.                       

•    Facilitating through regional consultations and broad engagement of relevant stakeholders “the implementation of a few health R&D demonstration projects” to address identified gaps that affect disproportionately developing countries.

Long-held concerns

The CEWG initiative arose from long-held concerns that the health R&D system as it stands is insufficiently oriented to the needs of developing countries.

This has prompted discussions on new financing and co-ordination mechanisms that might secure access to innovation at affordable prices, such as technology transfer, patent pools or ‘delinking’ prices from R&D costs.

The Consultative Expert Working Group on Research and Development: Financing and Coordination was set up by the World Health Assembly in 2010 to take forward the work of the WHO’s Expert Working Group on Research and Development: Coordination and Financing (EWG).

Underlying both these initiatives was a commitment outlined in the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property (GSPA-PHI).

This was to “examine current financing and coordination of research and development, as well as proposals for new and innovative sources of financing to stimulate research and development related to Type II and Type III diseases and the specific research and development needs of developing countries in relation to Type I diseases”.

The WHO defines Type II diseases as those found in both rich and poor countries, but with a much greater incidence in poor countries, such as HIV/AIDS and tuberculosis. Type III diseases, such as African sleeping sickness and river blindness, occur almost exclusively in poor countries.