E-DRUG: Technical implementation options for CEWG recommendations
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[E-druggers may wonder what this CEWG is doing here: the upcoming Consultative Expert Working Group (CEWG) meeting in WHO 26-28 November will however be important for the future R&D for new essential medicines. WB]
Dear E-drug colleagues,
In October 2012, the International Health Policy Programme, Ministry of Health, Thailand, and the Forum on Global Governance for Health of the Harvard Global Health Institute jointly organized a multi-stakeholder technical meeting at the Rockefeller Foundation Bellagio Center to explore implementation options recommended by the WHO Consultative Expert Working Group on Research & Development: Financing and Coordination (CEWG), which issued its report in April of this year.
The meeting report is now available here:
http://globalhealth.harvard.edu/sites/globalhealth.harvard.edu/files/Meeting%20Report%20FINAL.pdf
[the executive summary is copied below; WB]
We hope this report may be of use in the weeks leading up to the Intergovernmental Meeting to be held in Geneva, 26-28 November 2012, to follow up on the CEWG's recommendation to implement a global framework for R&D through a binding convention.
Best wishes,
Suerie
Suerie Moon, MPA, PhD
Research Director and Co-Chair, Forum on Global Governance for Health,
Harvard Global Health Institute and Harvard School of Public Health
104 Mount Auburn Street, 3rd Floor, Cambridge, MA 02138, USA
smoon@hsph.harvard.edu
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EXECUTIVE SUMMARY
Existing market mechanisms and public policies do not drive adequate research and development (R&D) efforts into many urgently-needed health technologies.3 Examples include diseases that predominantly affect the poor (�neglected diseases�), rare diseases, diseases involving high scientific uncertainty or risk, and antibiotics. Also missing are policies to ensure that the end products of such research are affordable for all, particularly for populations in developing countries. While the past decade has produced a wealth of initiatives and policy experiments to address this gap, efforts remain ad hoc, fragmented, and insufficient overall. To craft a system that is greater than the sum of its parts, the concerted effort of governments is needed to establish a more coherent global framework to generate R&D as a global public good, with contributions from all and benefits for all.
In April 2012, the WHO Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG) delivered its report, concluding with a package of recommendations constituting a global framework for health needs-driven R&D to be implemented through a convention.4
At the 65th WHA in 2012, Member States welcomed the report analysis, and called for an intergovernmental meeting to consider how to move forward in the three interlinked areas of coordination, financing, and monitoring.5 To facilitate further discussions, in October 2012 the International Health Policy Programme, Ministry of Public Health, Thailand, and the Forum on Global Governance for Health, Harvard Global Health Institute, USA, jointly organized an experts� meeting at the Rockefeller Foundation Bellagio Center to explore technical implementation options for the CEWG report recommendations.
Figure 1 offers a summary of key issues discussed at the Bellagio meeting. It begins at the top with an articulation of the Goal. It then illustrates what a Member State-driven system to achieve that goal might look like, beginning with the mobilization of financing for both national R&D efforts and an international Pooled Fund, and Monitoring and Coordination functions. The question of how to mobilize resources, through more voluntary or more obligatory methods, remains open. Once mobilized, these financial resources would support the performance of three integral functions: Monitoring to generate evidence to inform decision-making and to ensure the accountability of the overall system; Coordination to enhance synergies and efficiencies, including through priority-setting; and Financing R&D efforts, including by building national capacities. It should be noted that these three functions are fundamentally interrelated � the system will not work with just one. The Figure then lists some options for the �forms� that could be taken for global level functions � in particular, the organization (unified model) or set of organizations (network model) that could carry out these functions. Some functions would fit most naturally under the umbrella of WHO, given its mandate, governance structure and role as an arena for intergovernmental negotiations, while other functions might be better carried out by adjusting the mandates of existing organizations or creating a new one. The Figure then lists the seven core principles that should undergird a global framework, and principles for governance and accountability of the monitoring, coordinating and pooled financing functions. At the bottom of the figure is the still-open question of what vehicle can and should be used to implement this framework, including the options of a legally-binding convention or other non-legal and/or non-binding instruments.
Member States will gather 26-28 November 2012 in Geneva for an intergovernmental meeting to discuss next steps. After a multi-year process of debate, negotiation, research and analysis, it is now up to governments collectively to address current system failures and establish an effective, sustainable global framework that will deliver both innovation and access to health technologies for all.