[Ip-health] intervention of DNDi's Director Bernard Pecoul at the WHO IGWG

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STATEMENT BY DR. BERNARD PECOUL

EXECUTIVE DIRECTOR, DRUGS FOR NEGLECTED DISEASES INITIATIVE (DNDi)

WHO  IGWG   -- Geneva, 5th December 2006





Dear Chairman, distinguished delegates,



In order to put in place a global action plan aimed to overcome today's fat=
al imbalance in health R&D and to improve the access situation of the milli=
on patients suffering from diseases which disproportionately affect develop=
ing countries, I should like to highlight five points that I believe are es=
sential  :



1.      setting up an agenda with clear R&D priorities. While we discuss, w=
e should all be aware that we are still a long way behind reaching this goa=
l. It should be clear to all of us, for example, that in order to control H=
IV/Aids we need much more than condoms and antiretrovirals. Vaccines are re=
quired, urgently.  We urgently need new diagnostics and innovative drugs to=
 stop TB.  Medical doctors are still condemned to use health tools that wer=
e discovered more than forty years ago. In the meantime, tuberculosis is ma=
king a comeback. We also need new tools to diagnose patients if we are to e=
liminate sleeping sickness, to mention one of the diseases that DNDi is dir=
ectly involved in. We are still using dangerous and toxic drugs like melars=
oprol, which has frequent and severe adverse reactions, while the only avai=
lable alternative is a sophisticated drug that is impossible to use in cont=
exts where sleeping sickness prevails. WHO, with approval from Member State=
s, is in a key - and today I should say even in a unique - position to defi=
ne such a priority agenda for essential health R&D, taking into account spe=
cific needs linked to difficult settings;



2.      stimulating R&D. Redirecting today's scientific knowledge to patien=
ts' needs entails a significant shift in the way essential innovation is va=
lued, funded, and made accessible.  Too many barriers are still hindering t=
he innovation cycle. It is necessary to overcome them. It is necessary to m=
ake more efforts in the field of basic research, but then it is crucial to =
translate this basic knowledge into candidate drugs. Emphasis must be place=
d on translational research. At the same time, we need to increase clinical=
 trails capacity in developing countries; technology transfer initiatives m=
ust be at the heart of such endeavour, together with capacity utilization a=
nd strengthening in disease endemic countries. I am convinced that governme=
nts' determination is this direction would sharply increase the availabilit=
y and affordability of drugs, vaccines and diagnostic tools;



3.      Access is a key factor; we need to create a more favourable environ=
ment for needs-driven R&D. This requires certain conditions that do not exi=
st yet today. I am referring in particular to the issue of access to knowle=
dge existing already in compound libraries. Potential drugs are certainly l=
anguishing in many chemical libraries , and tapping such dormant science is=
 vital if we are serious about developing essential innovation. We also nee=
d to facilitate the regulatory process. In this field, too, a more structur=
al linkage is required between unmet public needs and lifesaving health too=
ls. The risk and benefit of each drug or vaccine will have to be assessed i=
n relation to the needs of patients, the severity of the disease, and the e=
xistence of alternative treatment options. Yet again, transfer of technolog=
y here is the way forward, as provided also in the TRIPs Agreement. This pr=
ovision needs to be credibly implemented.



4.     It will take a multiplicity of actors to implement such an ambition =
plan as the one which is discussed these days in the Intergovernmental Work=
ing Group made up of WHO Member States. PDPs are always mentioned as the ne=
w actor that is effectively changing the R&D landscape, and our role can su=
rely be very important to catalyse scientific competence, bridge research p=
latforms and maintain focused R&D goals. However, it would be totally irrea=
listic to think that PDPs could represent the solution to the problem. Toda=
y, their work depends largely on philanthropic funding and their success is=
 still to be proven. However, even if PDPs were entirely successful they wo=
uld not provide, alone, the solution to the existing R&D gaps. It is necess=
ary to promote partnerships with public research institutes, governments, a=
cademia, and of course with pharmaceutical companies, including large compa=
nies, biotech companies, and generic producers from developing countries.



5.      Sustainable funding is urgently needed. Global health has to become=
 a strategic sector for governments, and new sources of funding, with a sus=
tainable public commitment, have to be found and promptly implemented. Such=
 an important plan for essential health R&D cannot rest on the goodwill of =
philanthropists. It cannot depend on humanitarian motivations. It requires =
firm political will.



     There are no easy recipes for the global strategy and the plan of acti=
on that the IGWG is asked to prepare in less than two years. A daunting  an=
d challenging task. But if we are to be successful in this breakthrough ini=
tiative undertaken by WHO, which we support wholeheartedly, these are in my=
 view the essential ingredients in the process ahead.



Thank you, Mr Chairman.