E-drug: MSF letter to the WHO Executive Board
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To WHO Executive Board Members
Geneva, January 17th 2003
Dear Executive Board member,
M�decins Sans Fronti�res (MSF) would like to call to your attention the
following issues directly impacting access to essential medicines in
developing countries.
The crisis in research and development (R&D) for health tools directed at
neglected diseases
While today many pharmaceuticals and other health tools are available to
treat, cure or contribute to the control of a host of diseases, there is a
profound lack of effective, safe and affordable vaccines, drugs and
diagnostic tools directed at parasitic and infectious diseases. These
neglected diseases cause high mortality and morbidity among people in the
developing world - people who are largely poor and without substantial
purchasing power. A paucity of vaccines and diagnostics exist for these
diseases, and existing medicines are often not adapted to developing world
conditions, while inevitable drug resistance means that existing medicines
are less and less effective. Because of the lack of a viable market, and
because of the failure of public policy initiatives to address this market
failure, there is now a near complete lack of R&D directed at new or
adapted health tools for neglected diseases. For example, of the 1393 new
medicines marketed during the past 25 years, only 16 were for neglected
diseases. This represents a profound shortfall in effective, safe and
affordable essential medicines that are directed at neglected diseases, and
is the unacceptable reality today. Health R&D is increasingly market
driven, while needs-driven R&D activity is increasingly rare. Further, for
R&D directed at neglected diseases, the 10 / 90 Gap is widening. The
findings of the Drugs for Neglected Diseases Working Group and the views of
MSF are detailed in the report "Fatal Imbalance, The Crisis in Research and
Development for Drugs for neglected Diseases " available at
http://www.accessmed-msf.org/documents/fatal_imbalance_2001.pdf
MSF continues its strong collaborations with the WHO in a number of areas
germane to this crisis in R&D. For example, MSF has recently
partnered with WHO/TDR around a new not-for profit initiative to
develop drugs for
neglected diseases (DNDi). However, we believe that the WHO as the lead
health agency needs to take further urgent action to address R&D for
neglected diseases. The WHO needs to assess the deficit in R&D for
neglected diseases and its causes, and determine mechanisms to engage
effective needs-based R&D for these diseases. We therefore urge the
Executive Board to discuss the need for global measures to ensure R&D for
neglected diseases at the World Health Assembly (WHA) 2003.
Implementation of the Doha Declaration on TRIPS and Public Health
MSF is concerned that vital questions regarding access to medicines are
left in the hands of trade negotiators at the World Trade Organisation. The
implementation of the 2001 Doha Declaration on TRIPS and Public Health is
endangered by recent proposals by wealthy WTO members. MSF supports a
more active role played by WHO in the WTO TRIPS negotiations. WHO
should assist developing countries in their efforts to protect their
population by
ensuring that affordable medicines can be produced and exported to
countries that need them (the Paragraph 6 issue). This is increasingly
urgent as the deadline of the TRIPS implementation fast approaches. Unless
something is done soon, the source of affordable generic medicines will dry
up. However in view of the recently failed negotiations at the WTO we
recommend that the Executive Board proposes a broader discussion at
the WHA in May on how the availability of and access to affordable
medicines can be ensured in the future. This should include a
discussion on measures to
encourage technology transfer, local production and export of generic
medicines.
Pre-qualification of producers of low-cost medicines
MSF applauds WHO's work on the pre-qualification of medicines, including
life-saving products manufactured by generic producers. Pre-qualification
supports governments and NGOs in the procurement of affordable
medicines of assured quality. This information is also crucial for
recipients of Global
Fund money. We urge you to express support for WHO's work on
pre-qualification and to make additional technical and financial resources
available to enable the WHO to speed up and expand this work to include
other essential medicines.
We look forward to discussing the above issues with WHO Executive Board
members at your earliest convenience.
Sincerely,
Dr. Bernard P�coul
Director
Campaign for Access to Essential Medicines
M�decins Sans Fronti�res (MSF)
Rue du Lac, 12
CH 1211 Geneva 6
Switzerland