For the past 8 months the Missing Medicines campaign has been calling on the UK government to support the establishment of a global R&D agreement to ensure we produce the medicines we all need at prices we can afford. Over 6,000 people have taken action and on Friday last week during the 69th World Health Assembly a resolution on R&D for global health was agreed.
Fortunately the text of the resolution looks really promising with some BIG WINS (Needs-based R&D) and some MEDIUM WINS (plans for a pooled fund) agreed upon. Unfortunately the establishment of a global R&D agreement was not discussed BUT there is still hope as the resolution has called for another open-ended meeting to discuss R&D reform ahead of next year’s WHA. Our mission now is to ensure that the idea of an R&D agreement doesn’t die.
You can read the full R&D resolution here and below is a brief summary of the main points:
BIG WIN! Prioritising health R&D according to need (not profit) was championed!
The WHO will set up an Expert Committee on Health R&D to provide technical advice on prioritization of health research and development for Type II and III diseases and specific research and development needs of developing countries in relation to Type I diseases as well as for potential areas where market failure exists based i.e in non-developing countries.
The Expert Committee on Health R&D will be facilitated in their role by the establishment of the Global Observatory on Health Research and Development. There was a lot of focus on how this will function to ensure that it is effective as it can be in collating data and providing information in such a way that it becomes easy to identify gaps in research.
MEDIUM WIN! Plans to establish sustainable financing!
Although no financial target was discussed the WHO secretariat have been tasked with presenting a proposal for a voluntary pooled fund which will be discussed at the next Executive Board Meeting and finalised at next year’s WHA. Member States have been asked to support its development and to ensure its sustainability.
BIG WIN! Supporting access to medicines!
On accessibility and alternative ways of funding R&D that doesn’t lead to high prices, the resolution states that the WHO must have a plan for how the Observatory, the Expert Advisory group and the pooled fund will be connected and based on the CEWG principles (affordability, effectiveness, efficiency, equity) and crucially delinkage.
Although there wasn’t much detail on how delinkage will be achieved, Jamie Love Director of Knowledge Ecology international is hopeful.
“Delinkage is moving forward, one step at a time, at the WHO… All delinkage efforts depend upon governments finding ways to fund R&D outside of the framework of high drug prices. We have asked countries to focus on the incentives that will be needed to induce countries to collaborate on funding R&D as a public good.”
BIG WIN! Ensuring affordability, effectiveness, efficiency, equity are applied to WHO’s other work.
On policy coherence the WHO secretariat have been asked to ensure that other initiatives on R&D such as the Research and Development Blueprint for Emerging Pathogens and the Global Action Plan on Antimicrobial Resistance apply the core principles of the CEWG (affordability, effectiveness, efficiency, equity) to their work.
MEDIUM WIN! Space for the R&D agreement to be discussed again in the future!
Although the R&D agreement wasn’t explicitly mentioned in the text, the door is not closed. The last paragraph of the resolution states that the WHO will hold another open-ended meeting of Member States in order to assess progress and continue discussions on the remaining issues in relation to monitoring, coordination and financing for health research and development.. taking into account relevant analyses and reports and to report back to the next WHA.
By this time next year the UN High Level Panel’s report will be out, and this is cited in the resolution as something that Member States have formerly acknowledged. It is also important that the resolution recognises the commitment within the SDGs towards health research and development and highlights the right to health as an attainable goal only if we can reform the way we do R&D.
So lots to celebrate! The next step is to see how the UK and other Member States implement the resolution in order for the words on the page to take effect. We need to maintain pressure on the UK government to make R&D reforms a priority and to ensure that they hold up the CEWG’s principles of affordability, effectiveness, efficiency, equity and delinkage across all their relevant portfolios.
We also need to ensure that the discussion around establishing a global R&D agreement doesn’t die. With the UN High Level Panel on Access to Medicines report due out this summer we are hopeful that the recommendations will call for an ambitious agreement which will help ensure the level of commitment required to make sure that the R&D model we have puts people over profit once and for all.
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