Governments to develop global research strategy by 2008

WHO members are now required to seek new incentives for R&D for the poorest, with results in two years

SUMMARY: At the last World Health Assembly, Kenya and Brazil pressed for member to agree a "framework" for global health research for resource-poor countries and communities. The word frightened some states, but they agreed to look for new incentives in addition to intellectual property.

>by Robert Walgate

Well it’s only an agreement to talk towards a global research strategy and new incentives – but in diplomacy that can be a long step forward. With low-income countries on one side, and rich countries stoutly defending the rights of their pharmaceutical industry to intellectual property and high prices on the other, it didn’t seem likely that even that agreement would be reached, but it was.

This conclusion and several others were reached by combining two previous draft resolutions: one based on a recommendation at the January Executive Board by Brazil and Kenya that there be a global framework on essential health research and development; and another based on the recommendations in a report from the Commission on Intellectual Property Rights, Innovation and Public Health (CIPIH).

All sides warmly commended Gaudenz Silberschmidt of the Swiss Federal Office of Public Health, who chaired the negotiations, on his success. Speaking to RealHealthNews after the decision, he said the discussions had been difficult “but there was a surprisingly positive mood”.

There was agreement that the new working group would “look for the low-hanging fruit, to be harvested within a year”, including a special focus on essential health research; and to conclude that work within two years, he said. Furthermore there was agreement “not to decide now what was in or out, but to give the mandate to look at the whole range of recommendations from the Commission” [the CIPIH].

Silberschmidt’s negotiating trick appeared to have been to agree at the outset that the WHA would not be creating a “framework” – as requested by Brazil and Kenya - but rather a global strategy and plan of action. This meant “a moral commitment that provides a framework”.

Asked what the difference was, Silberschmidt told RealHealthNews that “with the memory of the Framework Convention on Tobacco Control, those not wanting a binding commitment didn’t want this to be the first step”.

“So who is battling with whom here?” RealHealthNews asked. “I must pay tribute to the Commission, which showed that it’s not a simple good-guy bad-guy issue; it’s not a simple quick-fix issue; but that it’s a real challenge from discovery, through development to delivery; to get improvements to the chain of the innovation cycle. And that is beginning to be understood – that we shouldn’t be fighting on a single issue, be it research, or intellectual property (IP), or access, or whatever.”

It’s now a question not whether IP is needed or not, but what other incentives are needed in addition to IP, to get new treatments to people where paying markets are poor, Silberschmidt believes. “We shouldn’t listen to the fringes of whether IP is good or bad – I don’t want to go back to that deadlock… the more time we lose discussing that the less time we have to discuss real implementation of what’s needed” he said.

“I hope for a Global Strategy and Plan of Action with real, concrete steps forward” said Silberschmidt. But that progress will come in small steps and details, not in headlines, he believes.

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