The in­no­va­tion WHO needs

The strat­egy to push public health, in­no­va­tion and in­tel­lec­tual prop­erty is a tough chal­lenge be­cause of fund­ing con­straints

Down to Earth - - COLUMN - DOWN TO EARTH

SAGO, the World Health Or­ga­ni­za­tion IX YEARS (who) adopted a Strat­egy and Plan of Ac­tion on Public Health, In­no­va­tion and In­tel­lec­tual Prop­erty (IP), or gspa as it is known, to “foster in­no­va­tion and im­prove ac­cess for peo­ple in de­vel­op­ing coun­tries”. At its ex­ec­u­tive board meet­ing that ended on Fe­bru­ary 3, the board rec­om­mended ex­ten­sion of gspa un­til 2022. This fol­lowed the pro­posal moved by Ar­gentina,Brazil,Ecuador,In­dia and South Africa that the World Health As­sem­bly ex­tend gspa that ex­pires in 2015.

The ques­tion is whether this strat­egy has worked at all. But first, some­thing about gspa which has eight el­e­ments, most of which are about pri­ori­tis­ing re­search and devel­op­ment needs and pro­mot­ing in­no­va­tive ca­pac­ity along with trans­fer of tech­nol­ogy. Un­der­ly­ing this is the man­age­ment of IP to push in­no­va­tion in a way that it pro­motes public health by de­vel­op­ing new health­care prod­ucts. The stark re­al­ity driv­ing gspa was the fact that of the 4.8 bil­lion peo­ple living in de­vel­op­ing coun­tries, 43 per cent live on less than US $2 daily. Since it was im­prac­ti­cal to ex­pect purely mar­ket-driven re­search to tar­get dis­eases which dis­pro­por­tion­ately af­fect th­ese peo­ple,it was de­cided that who should be the lynch­pin of the strat­egy by me­di­at­ing the re­la­tion­ship be­tween public health,in­no­va­tion and IP.

But six years down the line,it is am­ply clear that who and de­vel­op­ing coun­tries have not made much progress on gspa. This fail­ure came through most dramatically dur­ing the re­cent Ebola virus cri­sis, com­pelling who direc­tor-gen­eral Mar­garet Chan to make some un­char­ac­ter­is­ti­cally scathing ob­ser­va­tions. At a Novem­ber meet­ing in Africa on steps to tackle the spread of the virus, which has been characterised as the most wor­ry­ing global public health emer­gency, Chan passed se­vere stric­tures on the phar­ma­ceu­ti­cal in­dus­try. She said the rea­son why clin­i­cians were “empty-handed” was be­cause “a profit-driven in­dus­try does not in­vest in prod­ucts for mar­kets that can­not pay”, and that cri­sis un­der­lined a long-stand­ing who com­plaint about the lack of in­vest­ment in drug r&d and the poor fo­cus on health­care sys­tems of de­vel­op­ing na­tions.

But here comes the rub.While coun­tries such as In­dia, Brazil and South Africa would like to pur­sue the line that the Doha Dec­la­ra­tion of World Trade Or­ga­ni­za­tion on Trade-Re­lated As­pects of In­tel­lec­tual Prop­erty Rights (trips) “does not and should not pre­vent mem­bers from tak­ing mea­sures to pro­tect public health”, this does not find gen­eral ac­cep­tance within who. Nor do is­sues such as their em­pha­sis on who tak­ing a “lead­er­ship role”on the re­search agenda.

Re­ports from Geneva on the board meet­ing spoke of the (usual) fric­tion on the is­sue of coun­tries us­ing trips flex­i­bil­i­ties. Brazil had pro­posed the in­clu­sion of this cru­cial safe­guard dur­ing the meet­ings which kicked off on Jan­uary 26, ac­cord­ing to sources, but was ap­par­ently pre­vented by de­vel­oped coun­tries. The con­sen­sus was that the ref­er­ence to gspa was ad­e­quate since it talks of trips flex­i­bil­i­ties.

Ac­cord­ing to a state­ment is­sued by the hu­man­i­tar­ian agency Médecins Sans Fron­tières, which has also sought ex­ten­sion of gspa to 2022, there are ur­gent and com­pelling rea­sons for do­ing so. For one, it cites the in­creas­ing fail­ures of the cur­rent sys­tem of r&d, whether with re­spect to Ebola, an­tibi­otic re­sis­tance or a range of ne­glected dis­eases. In­stead of con­sid­er­ing new r&d ap­proaches, “some gov­ern­ments, pushed by multi­na­tional phar­ma­ceu­ti­cal com­pa­nies, are in­stead seek­ing to in­crease IP pro­tec­tion world­wide, which will only deepen the chal­lenges,”it warns.

But what can who do given its de­pen­dence on vol­un­tary dona­tions? Since most dona­tions are for spe­cific projects, there are lim­i­ta­tions on what the UN agency can do when it has lit­tle con­trol over the bud­get. With such con­straints an ex­tended gspa may not make much head­way.


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