Stiglitz Backs Proposal for Binding R&D Global Health Agreement
A proposal for a binding agreement for research and development (R&D) to address diseases that disproportionately affect developing countries needs strong backing from the international health community, Nobel Laureate Joseph Stiglitz said at a seminar held in Geneva, Switzerland last week. The proposal is being featured in a new World Health Organization (WHO) report that will be reviewed during the annual meeting of the organisation's decision-making body later this month.
The report was prepared by the WHO's Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG).
The working group was established by the World Health Assembly in 2010, in the context of the implementation of the global strategy and plan of action on public health, innovation, and intellectual property (GSPA-PHI). The CEWG was given the mandate of examining current and proposed financing of R&D focused on diseases that disproportionately affect poor countries, along with diseases that occur in both developed and developing countries.
"Market forces will not lead to efficient technologies and affordable medicines" against diseases that disproportionately affect developing countries, CEWG Chair John-Arne Røttingen explained at the seminar, held at the Graduate Institute of International and Development Studies.
The report suggests that all countries should aim to achieve specified levels of public funding on health R&D relevant to the needs of developing countries, and that a financing system be established under the convention based on contributions by governments.
Such a convention, the CEWG argues, should focus on the development of health technologies for diseases that occur almost exclusively in poor countries - such as HIV/AIDS, malaria, and African sleeping sickness - as well as the specific needs of developing countries regarding more globally widespread illnesses, such as cancer and diabetes.
It also advocates for the de-linking of research costs from final drug prices through upfront public financing. Pharmaceutical companies have traditionally argued that significant R&D expenditures are needed to develop new drugs. In addition, the exclusive protection afforded by patents to pharmaceutical products is an important market mechanism that allows for the channelling of resources for future R&D on innovative products.
However, as acknowledged by the 2001 Doha Declaration on TRIPS and Public Health, while intellectual property protection is important for the development of new medicines, its effects on prices is also an important consideration as it can make products less affordable for poor countries.
According to the CEWG report, an R&D convention should not serve as "a replacement for the existing intellectual property rights system," but should instead act as a supplementary instrument in areas "where the current system does not function."
"Living in a profit-driven system means that research goes where the money is," Stiglitz - who previously held the role of World Bank Chief Economist - said.
He also stressed the need for shaping a well-designed IP regime, given that "intellectual property does not lead to efficient allocation of resources" when it comes to R&D and "patents can be an impediment to innovation."
Suerie Moon - Research Director and Co-Chair of the Forum on Global Governance for Health at the Harvard Global Health Institute, and a commentator at the event - argued that the implementation of the right to health is primarily a responsibility of governments and invited them to support a binding approach for an R&D treaty at the WHO. "Soft norms have not been enough," Moon said.
Concluding such a convention could be a valuable opportunity for the WHO to reaffirm the organisation's role in global norm-setting, she added, given that recent discussions on WHO reform have identified this area as one where the organisation has a unique role to play.
Kenyan Ambassador to the United Nations Tom Mboya Okeyo echoed this sentiment, noting that "what is needed is not the setting up of more Working Groups but to develop further the negotiated global strategy on Public Health Innovation and Intellectual Property into a Research and Development Convention within the context of WHO reform."
James Love, director of Knowledge Ecology International, said that the WHO should consider broadening the scope of the proposed R&D treaty in order to address global health needs involving high-income countries.
For instance, he suggested, such a treaty could include funding more R&D for new antibiotic drugs or products for influenza pandemics, or to fund independent clinical trials to test products.
The CEWG report will be discussed at the upcoming World Health Assembly on 21-26 May. The organisation's Executive Board will follow on 28-29 May.