E-DRUG: MSF submission to WHO intergovernmental working group
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Please find below the summary of MSF's contribution to the
intergovernmental working group on public health, innovation and
intellectual property.
The full text can be downloaded from
http://www.accessmed-msf.org
or viewed with all other contributions on
http://www.who.int/public_hearing_phi/en/
Thanks
James
James ARKINSTALL
MSF
<James.ARKINSTALL@paris.msf.org>
Towards a health needs driven framework for R&D and access to medicines
The Commission on Intellectual Property, Innovation and Public Health
(CIPIH) report concludes that making the medical research and development
(R&D) system prevailingly dependent on patents and other forms of
intellectual property (IP) protection carries significant consequences for
the setting of R&D priorities, with a detrimental effect for diseases that
disproportionately affect developing countries.
One crucial consequence is the absence of financial incentives to drive R&D
when the client population has insufficient purchasing power. This applies
to neglected diseases - recent research shows how these still only account
for 1% of the new chemical entities reaching the market. But more common
diseases are also affected: the lack of reliable medical tools to address
the escalating tuberculosis epidemic or paediatric HIV/AIDS are clear
illustrations of how the system is fundamentally flawed.
Financing R&D through IP also severely impacts access to medicines.
Competition between manufacturers, which IP protection is designed
specifically to prevent, is the only way to bring prices of medicines down
to a sustainable level that patients or ministries of health can afford.
But today, five years after the Doha Declaration promised to re-establish
the balance between IP and public health, the cost of treating patients in
developing countries is once again increasing.
Arguably the CIPIH report's most important contribution is its
consideration of the entire innovation cycle including discovery,
development, but also delivery. In other words, one must also examine how
those in need can access an innovation, once it has been developed.
The Intergovernmental Working Group (IGWG) must follow the CIPIH's lead,
and address problems related to both innovation and access. Economic
mechanisms alone will not succeed: government action is needed to ensure
that innovation is steered to meet real health needs, and that access to
these innovations is secured. The Group must pay considerable attention to
neglected diseases, but not limit itself to them, for the problem is wider
in scope. Nor must it content itself with calling for new financial
mechanisms. What is needed is a concerted effort towards a framework to
promote innovation and access, for diseases that disproportionately affect
developing countries.
Such a plan must include: priority setting of R&D, so that innovation
responds to health needs; new mechanisms for financing R&D that don’t come
at the expense of high drug prices; active promotion of mechanisms that
facilitate access to medicines, such as compulsory licences; and review of
failed mechanisms such as the August 30th Decision.
In recent years, WHO's relative silence on these questions has left the
field open to other agencies like WTO and WIPO that cannot give proper
consideration to health issues. This must change: the IGWG process must now
examine them with the prioritisation of health above other concerns. WHO
and the Group must not squander this opportunity.