[Ip-health] IGWG should strengthen WHO's role on public health, say NGOs

[Sangeeta]

IGWG should strengthen WHO's role on public health, say NGOs

(Published in SUNS #6360 dated 7 November 2007, reproduced here with
permission)

 Geneva, 6 Nov (Kanaga Raja) -- One important outcome of the
Intergovernmental Working Group on Public Health, Innovation and
Intellectual Property Rights (IGWG) should be to strengthen the role of the
World Health Organization in the areas of intellectual property rights,
access and innovation from a public-health perspective.

This message was delivered by several non-governmental organizations at a
media briefing on Monday, just as the IGWG began its week-long session (5-10
November) aimed at coming up with a plan of action to ensure that new
medical products are developed, and existing ones are made affordable.

The NGOs also said that the IGWG negotiations have the potential to change
the way medical research is conducted and ensure that urgently needed drugs
are developed and made accessible.

The IGWG represents the first chance for countries to begin building a
system for medical innovation and access to medicines that prioritizes
diseases that disproportionately affect developing countries, develops
needed health tools and makes them affordable, according to the NGOs.

The NGOs - the international medical humanitarian organization Medecins Sans
Fronteires (MSF), Knowledge Ecology International (KEI) and Third World
Network - were joined at the media briefing by Dr A. E. O Ogwell, the
representative from Kenya and a member of the IGWG bureau.

At the briefing, Dr Ogwell said that the IGWG process was an important one
for Africa. In the African region, there are people suffering from a wide
range of diseases for which health products are available but poor people
cannot access these products as they are too expensive.

There is also another group of people that is suffering from diseases that
do not have proper, or even any, health products available on the market.
This is because the research that is going on in the different types of
diseases do not cover these groups of neglected diseases.

As for Africa's expectations from the IGWG negotiations, Dr Ogwell said: "We
want to see the world coming together to provide solutions. We don't want
people to just talk and go away with very lofty statements that are very
nice for a political engagement but totally useless when it comes to
addressing patients' problems."

"We want to see real solutions coming out of the process... we want to see
solutions that we can be able to utilize today, tomorrow; not solutions that
we will be able to utilize years from now," he added.

"We want to finish the whole negotiations this time. We are very hesitant to
support a process that will be a lengthened negotiation. We want it to end
quickly so that we can be able to do some good work to respond to the
problems that we are having and that have resulted in the process (IGWG)
beginning," he said.

Asked about the August 2003 decision at the WTO on compulsory licensing and
the importation of generic medicines, Dr Ogwell said that those agreements
were made without a proper health background and proper public health input,
so much so that "we don't believe they were made to be implemented because
every time a developing country tries to implement them, there is a lot of
resistance from other countries, and that resistance is what has slowed down
the ability of developing countries, especially from Africa, to be able to
utilize the flexibilities in those agreements."

"How we are going to approach this particular round of negotiations (at the
IGWG) is that we are basing most of the decisions on public health and it is
not a trade matter. If we base the principles on public health, it will be
slightly easier to be able to implement them."

Michel Lotrowska of MSF said that there is a real opportunity to
re-conciliate access to medicines and innovation in one same space where you
don't have them as antagonists. Innovation and access are important issues,
and a trade-off between one and the other is not the best solution.

The MSF representative said that more sustainable funding was needed, as
well as a framework to try to define what is the R&D agenda.

Noting that the IGWG is the place for this discussion, he stressed that the
role of the WHO should be reinforced. "What we see is that the WHO has a
role to play when access and innovation is at stake... When public health is
at stake, the WHO should be present."

Sangeeta Shashikant of Third World Network said that one of the most
important outcomes of the IGWG should be a strengthened role of the WHO in
relation to intellectual property rights, access and innovation issues, from
a public health perspective.

The IGWG process is for governments to give WHO direction as to the role
that it should play and the activities that it should undertake to promote
access to medicines and R&D in diseases that affect developing countries.

"We think that governments at this IGWG should reaffirm and strengthen the
WHO's mandate and capacity for it to undertake and expand its work in areas
of IP, access and innovation issues," she said, adding that this should be a
priority outcome of the IGWG.

On strengthening the WHO's capacity, she said that it is important for the
UN health agency to have the correct pro-public health orientation, and thus
have relevant departments staffed with personnel that have a public-health
orientation, and have adequate resources to do this work.

Since the WHO is the primary institution on public health, "we would like to
see it take a lead on public health issues from a public health perspective,
especially where there are tensions between trade/commercial and public
health interests."

One area that may emerge during the IGWG negotiations is the WHO's role with
regard to IP issues. Shashikant said that some claim that the WHO should not
have a mandate and expertise in this area.

However, she added, in many countries, it is the Ministries of Health that
take the lead in relation to IP issues, and where it becomes a problem for
health.

For example, in countries that issued compulsory licences, it is the
Ministries of Health that took the lead. Noting that the WHO represents the
Ministries of Health of countries, she said that it is difficult to
understand the argument that WHO should not have a mandate in this area.

In fact, the mandate of WHO should be strengthened in this area and it
should play a more proactive role to help countries understand and build
capacity on how to use TRIPS flexibilities as well as to create awareness of
the negative impacts that TRIPS-plus provisions can have on access to
medicines.

Previously, she said, WHO played a pioneering role in this area with its
various publications that came out prior to the adoption of the Doha
Declaration on TRIPS and Public Health which has benefited many countries.
"We want to see WHO play a stronger role to help developing countries."

In the area of R&D, WHO should help create a better understanding of the
public health needs of developing countries - for example, where treatments
exist but are not affordable because of the high prices, where treatments
exist but are inadequate for use in developing countries, and areas where
treatments do not exist at all.

The WHO should also create a mechanism on prioritizing R&D and establish a
mechanism to deal with the prioritized R&D, said the representative from
TWN. Models for R&D should de-link the cost of R&D from the price of
medicines so that the treatment is affordable to countries.

She cited one model where there is an increase in public funding in R&D of
diseases that affect developing countries. As the R&D is publicly funded,
the product developed should not be patented and companies should be allowed
to produce these products with certain conditions as to the price.

One of these models has been used by the Drugs for Neglected Diseases
Initiative (DNDi), she noted.

James Love of Knowledge Ecology International said that "This is an
unprecedented opportunity to change the paradigm. The IGWG has been asked to
de-link the cost of R&D from the price of medicines. This is enormously
important."

"We need new mechanisms and institutional responses to move toward a
paradigm of innovation plus access, rather than a set of poorly functioning
trade-offs."

The NGOs also noted that the UN talks risk being derailed by opposition from
some governments.

Although the meeting is based on a World Health Assembly resolution which
puts intellectual property on the agenda, the US and the European Union
countries are questioning an expanded role for the WHO regarding
intellectual property and health, the NGOs said.

"As a medical organization, we need medical innovation to happen. But we
also need to ensure that new and existing medicines are made affordable for
all those that need them," said MSF's Lotrowska.

"Innovation is meaningless if newly developed products remain out of reach,"
he added. +