[Ip-health] Bridges Weekly: Participants satisfied with progress in WHO talks on bolstering medical innovation

[Judit Rius Sanjuan]

BRIDGES Weekly Trade News Digest - Vol. 11, Number 39 14 November 2007

PARTICIPANTS SATISFIED WITH PROGRESS IN WHO TALKS ON BOLSTERING MEDICAL
INNOVATION

Members of the World Health Organisation (WHO) on 10 November ended a
week of talks without coming up with a draft plan to promote medical
innovation, instead noting that they had made meaningful progress and
that the negotiations would resume next year.

The WHO Intergovernmental Working Group (IGWG) on Public Health,
Innovation and Intellectual Property is charged with developing a global
strategy and plan of action on vital health research specific to the
public health needs of developing countries in time for the May 2008
World Health Assembly. The recent session of the committee had in theory
been expected to complete a draft strategy and action plan. The IGWG is
now set to pursue further work in January 2008, and meet again from 28
April to 3 May.

Ahmed Ogwell, head of international relations at the Kenyan health
ministry and vice-chair of the IGWG, stated that participants -
governments, the drug industry, and civil society groups - were on "the
path to results." Building trust and consensus had proved slower than
expected, he allowed, but nevertheless, they were moving.

"I've been very much impressed by the level of engagement, the
participation of all delegates=85 by the passion... and the spirit of
friendship," WHO Director General Margaret Chan told delegates at the
session's close, describing the meeting as "historic." The "spirit of
compromise=85 moves us forwards," she added.

Chan reiterated her commitment to "moving the organisation forward in
the areas" of intellectual property rights, innovation, and public
health. "We are gearing ourselves up to do more," she stated. "I will
need your specific guidance from the strategies and plan of action."
Sources say that the WHO Secretariat is preparing to scale up technical
cooperation efforts, and is working on a comprehensive plan to better
address existing mandates on issues such as incentives for medical
innovation, technology transfer, and access to health products.

Inching towards consensus

The principal basis for negotiations last week was a draft strategy and
global plan of action that the WHO Secretariat had issued on 31 July,
incorporating comments made by countries and regional groups after the
IGWG's first meeting. The global strategy text outlined its context,
aim, and focus, and outlined ideas for dealing with issues such as
prioritising research and development needs, building and improving
innovative capacity, transfer of technology, and intellectual property
rights.

During the first day of the meeting, a paper produced by 14 Latin
American countries at one of a worldwide series of regional conferences
on the IGWG process - the so-called 'Rio text' -- was incorporated into
the working draft (see BRIDGES Weekly, 7 November 2007,
http://www.ictsd.org/weekly/07-11-07/story2.htm). This document was more
emphatic than the Secretariat's text about the need to explore new ways
of de-linking research and development (R&D) costs from drug prices, as
well as on the use of flexibilities in trade rules to promote public health=
.

To negotiate the text, members split into parallel drafting groups open
only to government representatives and appointed experts. These meetings
ran late into the evenings. One of the crucial issues they dealt with
was a section comprised of eleven principles outlined in the Rio text
addressing issues including the right to health, the relationship
between intellectual property and access to medicines, and innovative
capacity in developing countries. During the talks last week, members
reached consensus on several of them, but have yet to resolve two
remaining principles. For instance, officials could not agree on whether
to include the Rio document's assertion that "the right to health takes
precedence over commercial interests," or an alternative phrase,
reportedly advanced by the EU, specifying that "the objectives of public
health and the interests of trade should be appropriately balanced and
coordinated." There is also not consensus on a proposed principle
stating that "the right of everyone to the enjoyment of the highest
attainable standard of physical and mental health is recognised as a
fundamental human right in the international human rights instruments."

Much of the discussion focused on the issue of intellectual property
rights. Ultimately, the working draft included a section on "Application
and Management of intellectual property to contribute to innovation and
promote public health" as 'Element 5'. Agreed text in this section
states that "there is a crucial need to strengthen innovative capacity
as well as capacity to manage and apply intellectual property in
developing countries including =85 the use to the full of the provisions
in the [WTO] TRIPS Agreement." One proposed section of text that is
still placed within square brackets signifying disagreement calls for
the creation of "user friendly global databases on the status of
health-related patents." Central to this discussion is how the WHO and
the World Intellectual Property Organization should work together to
manage such databases, and how the information they contain might be used.

Another outstanding issue is whether the global strategy should focus on
the fourteen diseases outlined in a footnote in the WHO Secretariat's
July draft, including HIV/AIDS, Tuberculosis, Chagas disease, diabetes,
and cancer (see BRIDGES Weekly, 5 September 2007,
http://www.ictsd.org/weekly/07-09-05/story4.htm). Several governments --
including that of Brazil and several African nations -- expressed
interest in a broader focus, which would allow for adjustments to meet
countries' respective health needs. Members agreed to revisit this issue
at a later time.

Optimism in spite of slow progress

Though participants were overwhelmingly positive about the meeting,
progress was slow, with one observer likening the focus on virtually
every word and comma to the caution that marks formal treaty
negotiations. Such slow progress was attributed to external pressures,
divisions within regional groupings, and disagreements both among
governments and within them (such as between trade and health
ministries). For instance, several initial supporters of the Rio text,
including Mexico, Costa Rica, and Peru, went on to distance themselves
from it during the course of the meeting. Additionally, progress was
slowed by long discussions over procedural questions, such as those
relating to the framework for negotiations, fair representation for
smaller delegations, the number and scope of drafting groups, and the
transparency of the working group.

A few onlookers questioned whether WHO members actually made much
progress towards developing a concrete global strategy and plan of
action that goes beyond current agreements. Others suggested that it was
too soon to say, and the overall assessment was uniformly positive.

"We didn't finish the global strategy and plan of action," said Syed Ali
Asad Gillani (Pakistan), "but significant progress has been made."

One EU official expressed satisfaction with the commitment shown by all
participants. Although slightly disappointed that the work could not be
finished, the source suggested that they were on the "right course" to
do so in the next meeting.

"What is most encouraging is that governments have decided that business
as usual won't do anymore," said Michel Lotrowska of Medecins sans
Frontieres' Access to Essential Medicines Campaign. "They are open to
exploring entirely new ways of financing essential health research, in
such a way that the fruits of innovation are accessible to those who
need it the most."

Acknowledging the slow progress, Guy Willis of the International
Federation of Pharmaceutical Manufacturers called the IGWG's subject
matter "fiendishly complex," suggesting that it is "important to take
the time to get it right."

IGWG Chair Peter Oldham (Canada) closed the second session by likening
the process to a mountain ascent. While the pinnacle was not reached on
this attempt he concluded that "You and I and the Secretariat, have
gotten us to a high base camp preparing to attack the summit=85 gird up
your loins, let us go up together."

In preparation for the resumption of the committee's work, the WHO
Secretariat is until 31 January accepting comments from members on parts
of the text that have not yet been the subject of negotiation. It is
planning to issue documents in March on the comments received and the
inter-sessional work.

ICTSD reporting.

--
Judit Rius Sanjuan
Attorney
judit.rius@keionline.org

Knowledge Ecology International (KEI)
www.keionline.org / www.cptech.org
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