# E-DRUG: HAI Revised Drug Strategy Watch **URL:** \ **Category:** e-drug\ **Created:** [August 17, 1998, 8:23am UTC](https://talk.edrugplus.org/t/e-drug-hai-revised-drug-strategy-watch/3280 "1998-08-17T08:23:11Z")\ **Posts on this page:** 1\ **Page:** 1
**Author:** ![hai1](https://avatars.discourse-cdn.com/v4/letter/h/e9c0ed/32.png) [@hai1](https://talk.edrugplus.org/u/hai1)\ **Post date:** [August 17, 1998, 8:23am UTC](https://talk.edrugplus.org/t/e-drug-hai-revised-drug-strategy-watch/3280/1 "1998-08-17T08:23:11Z")
E-drug: HAI Revised Drug Strategy Watch ------------------------------------------------------------ This is a year of major changes at the WHO, and a key question for Health Action International (HAI)\* is what these changes might mean and should mean concerning WHO's revised drug strategy (RDS) and the future and role of the Action Programme on Essential Drugs (DAP). One of HAI's main activities has always been to advocate for a strong and effective RDS, which is the World Health Assembly document that guides WHO policies on drugs. To implement the RDS, DAP has been an important force in promoting essential drugs concepts, rational drug use and advising countries on national drug polices. HAI has been a strong supporter of and counterpart to DAP in the promotion of essential drugs and rational drug use, especially in the global South. HAI believes there is reason to be concerned about the future direction of WHO policies on drugs and about the future role of DAP that require monitoring and advocacy within the NGO community and among individuals working on health and medicines. The following are some examples of trends this year that bear out this concern: --In May at the World Health Assembly, countries sympathetic to the high-profit, free-trade wishes of transnational pharmaceutical companies, such as the United States and other powerful governments in the global North, engineered the defeat of the resolution on the RDS, which contained a clear position that public health interests should be paramount in pharmaceutical and health policies. The resolution also contained many other objectives and mandates concerning rational drug use, drug promotion and other key issues of access to medicines that became hostage to the disagreements over the language on trade issues. �In response to the disagreements over the resolution, the assembly voted to send the resolution back to the WHO Executive Board (EB). WHO subsequently announced a two-tiered approach to working on the resolution: (1) the EB will establish an ad hoc working group on the RDS that is open to all member states that will meet in Geneva that will discuss and present a draft resolution to the EB for consideration and (2) the EB will establish a subgroup comprised of the chairman of drafting group established at the assembly and two member states from each region, of which at least one must be a member of the EB. According to the decision, "This group will assist the WHO in its contacts with relevant interested partners." It appears that the real negotiations on the RDS will take place in this subgroup. It is also where the EB has ensured that the member states, many in the global South, that called for the stronger commitments to public health in trade issues, for example, will be effectively neutralised by the tight requirements of the subgroup membership. It is important to note that NGOs will not likely be considered "interested partners" because they have never had any formal rights or processes for inputs into drafting committees. --In July, Brundtland appointed Dr. Michael Scholtz, a former executive in marketing at a transnational pharmaceutical company to head up the new management cluster for Health Technology and Drugs. This means he will be in charge of DAP and be responsible for the implementation of the RDS. It remains to be seen if Dr. Scholtz has the necessary commitment to meeting the needs of poorer countries and the hundreds of millions of people worldwide who do not have access to essential and affordable drugs. �In her speech to the assembly, Dr. Brundtland promised to create "a WHO-industry roundtable" to have a "dialogue on key issues facing us." WHO has announced that the first meeting of this roundtable will be in October. Revised Drug Strategy Watch HAI agrees with other commentators who have pointed out the need to monitor WHO closely. In particular HAI will focus on the cluster on Health Technology and Drugs. HAI believes that an integrated strategy will be needed to address the concerns outlined above: �Activities concerning the EB process to redraft the RDS. The first opportunity for NGO inputs should be at the regional committee meetings that will be scheduled to discuss the RDS and to name members to the EB subgroup (Europe region: 14-18 September in Copenhagen; other regions have not yet posted meeting dates on the WHO website). HAI encourages people and NGOs to make interventions with their respective government representatives and to make direct inputs into the process to the maximum extent possible. HAI will be providing information and analysis to HAI members via HAI News and special mailings and to other interested NGOs and individuals via electronic mail lists and website postings. �WHO-NGO interactions. At the assembly, Dr. Brundtland also stated that she will "convene a conference with the NGO community to draw up new guidelines for our cooperation to establish new mechanisms for interaction with civil society in member states." HAI understands that WHO is planning to announce a consultation with NGOs, possibly in November. This meeting will be a crucial test for NGOs to prove that they are prepared to meet Dr. Brundtland's call for more productive interactions with civil society. Currently, WHO-NGO information sharing and participation in policy and program is worked out by individual programs and organisational units. There is no overall WHO policy on NGO relationships. HAI proposes that the NGO community should work for an overall policy that is inclusive, substantive and that recognises the need for and value of having a diverse representation of NGOs in WHO-NGO dialogues. Specifically, HAI proposes the following: (1) NGOs should have formal processes for making inputs into drafting processes; (2) WHO should ensure that NGOs in the global South have direct and adequate representation; (3) NGOs should be recognised by WHO automatically if an NGO is recognised by the member state in which it is legally established; (4) WHO-NGO mechanisms need to recognise and support the flexible, independent and distinct characteristics of the NGO sector and not invoke mechanisms that seek to create one NGO consensus position or voice on international health matters; and (5) WHO consultation mechanisms must recognise that pharmaceutical companies enjoy and disproportionate advantage in access to WHO and have extremely disproportionate resources available to influence WHO in comparison to NGOs, and that mechanisms must seek to redress that imbalance in substantive ways. �The future of DAP. HAI understands that the mandate for the new Heath Technology and Drugs cluster is currently under review. HAI notes the substantive and positive contributions DAP has made to many member states, especially in the global South, over the past years and that HAI feels that it is important to monitor management decisions concerning DAP and work to ensure that its policy and country program work is not weakened or restricted in any way. �Developing monitoring criteria. Mark Raijmakers suggested in an E-Drug posting that the "contents and acceptance of the revised drug strategy for the next WHA in May 1999 are criteria [for judging] the management by Scholtz. The criterion should be that Scholtz will have to find a balance between industry's and consumers' interests and concerns in the new revised drug strategy to be proposed." HAI supports this suggestion, which can be further developed in the coming months. �Ongoing monitoring criteria. HAI has ongoing monitoring, for example of WHO policy and program commitments to promote the marketing of effective, necessary and affordable medicines in all countries, of commitments to guidelines and advice concerning the ethical promotion of drugs, which WHO should strengthen and expand, and of DAP's ability to address health and trade issues, which should be supported and expanded. Additional criteria for monitoring the RDS and the future of DAP. These can and should be developed, especially ones that promote the sharing of information from local and national levels. HAI would welcome dialogue about developing additional criteria that could be finalised at the November WHO-NGO meeting. HAI welcomes comments and suggestions about the RDS Watch and looks forward to being able to work with interested individuals and NGOs to ensure its success. For further information, please contact: Health Action International Europe (HAI-Europe) Jacob van Lennepkade 334 T, 1053 NJ Amsterdam, Netherlands tel: +31 20 6833684, fax: +31 20 6855002 email: hai@hai.antenna.nl \*For readers not familiar with HAI, it is an informal network of some 150 consumer, health, and other public interest groups involved in health and pharmaceutical issues in 70 countries around the world. HAI actively promotes a more rational use of drugs. It believes that all drugs marketed should meet real medicinal needs, have therapeutic advantages, be acceptably safe, and offer value for money. HAI has regional offices located in Amsterdam (HAI-Europe), Lima (HAI-Latin America), Penang (HAI-Asia and Pacific) and it will be establishing a regional office for HAI Africa in 1999. -- Send mail for the `E-Drug' conference to `e-drug@usa.healthnet.org'. Mail administrative requests to `majordomo@usa.healthnet.org'. For additional assistance, send mail to: `owner-e-drug@usa.healthnet.org'.