TWN Info Service on Health Issues (Jan16/03)
28 January 2016
Third World Network

WHO: Executive Board to decide on agenda of open-ended meeting on R&D financing and coordination

Geneva, 28 January (K M Gopakumar) – The World Health Organization’s Executive Board (EB) is to take a decision on the agenda of the upcoming open-ended meeting on research and development (R&D) coordination and financing.

The 138th meeting of WHO EB is taking place at the WHO headquarters in Geneva on 25-30 January.  The open-ended meeting is to take place 7-9 March in Geneva.

There is no consensus regarding the agenda of the open-ended meeting. The informal consultations among the Member States and the WHO Secretariat prior to the EB led to an arrangement to amend the proposed agenda contained in the document titled “Follow-up of the report of the Consultative Expert Working Group on Research and Development: Financing and Coordination” (EB 138/39). The Secretariat is expected to circulate a new agenda during the discussion on the agenda item that is expected to come up for discussion during the evening session of 28 January.

Many developing country Member States do not agree with the proposed agenda. They point out that the proposed agenda does not address the mandate of the open- ended meeting as mentioned in World Health Assembly Resolution WHA 66.22.

The original mandate of WHA 66.22 is “to convene another Open-Ended meeting of Member States prior to the Sixty-ninth World Health Assembly in May 2016, in order to assess progress and continue discussions on the remaining issues in relation to monitoring, coordination and financing for health research and development, taking into account all relevant analyses and reports, including the analysis of the report of the Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG)”.

However, the proposed agenda does not state the second part on continued discussions on the remaining issues listed.

The Secretariat’s proposed agenda consists of mainly three sessions apart from the opening session.  The first session is the “presentation by the Secretariat on the progress in implementing resolution WHA 66.22”. The second session is on “Secretariat presentations on progress in the development of the global observatory on health research and development, in implementation of health research and development demonstration projects, and in exploring financing mechanism for contributions to health research and development”.  The third session is the Member States’ discussion.

The agenda does not include the focussed discussion on the remaining issues in relation to monitoring, coordination and financing for health research and development, taking into account all relevant analyses and reports, including the analysis of the report of CEWG.

In its report in 2012, the CEWG had recommended to start negotiations on a binding agreement on R&D that should take place under Article 19 of the WHO Constitution. According to Article 19 the World Health Assembly shall have the authority to adopt conventions or agreements with respect to any matter within the competence of the organization. There is concern that the proposed agenda, without any discussion on the remaining issues, would eliminate the possibility of discussion on the binding agreement on R&D.

The open-ended meeting held in 2012 decided to follow a piecemeal approach to the CEWG Report. The CEWG made recommendations on the following areas, viz. approaches to R&D, funding mechanisms, pooling resources, strengthening of R&D capacity and technology transfer and coordination. In order to implement these, it recommended a binding global instrument for R&D and innovation for health. Thus, a binding instrument would be the overarching instrument to contain these three pillars. However, the draft resolution only adopts one of its recommendations, i.e. the establishment of a global health observatory.

Third World Network learned that it was India and Thailand that had requested for an EB decision on the agenda of the open-ended meeting.

The Secretariat report shows that the first phase of the global observatory is expected to finish in January 2016. Regarding the funding of the six demonstration projects the report states: “After reviewing technical work plans and budgets for the first year, the Committee at its meeting in Geneva on 19 June 2015 recommended allocation of funding for three projects to date. Letters of agreement have been signed and money has been disbursed. The funding requirements from the other two selected projects have been received, and pledged contributions are awaited from some Member States before disbursements can be made”.

The report also shows a huge funding gap for financing of demonstration projects and the global observatory. “The estimated total financial requirement for implementation of these two activities for four years 2014–2017 is US$ 85 million. Member States were contacted to contribute to this voluntary fund and to date US$ 7.65 million have been contributed”. The estimated gap in funding is USD 875 million.

The 67th WHA (2014) took a decision to request the WHO Director-General, without prejudice to the future discussions on CEWG recommendations, “to further explore with the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, recognizing the following:

a) that the scope of the diseases should not be limited to type III diseases but should be in line with the mandate of the global strategy and plan of action on public health, innovation and intellectual property; (b) the need for a sustainable financial mechanism for health research and development; (c) the role of Member States in the governance of the coordination mechanism”.

[This is carried out according to Operational Paragraph 4.6 of WHA 66.22. It requested the WHO Directo-General to explore and evaluate existing mechanisms for contributions to health research and development and, if there is no suitable mechanism, to develop a proposal for effective mechanisms, including pooling resources and voluntary contributions, as well as a plan to monitor their effectiveness independently.]

The Secretariat document proposes that subject to the availability of new funding, the Special Programme can adapt the mechanisms it has in place to accommodate a new financial mechanism, certainly within the early start-up phase. However, this new financial mechanism is a voluntary fund. Many civil society observers point out that creating another voluntary mechanism goes against the spirit of the CEWG recommendations.

Many civil society organisations also want the open ended meeting to discuss the applications of principles recommended by CEWG on other R&D framework that WHO is developing in the context of emergency response and anti-microbial resistance.

The elements of the Objectives are as follows:

·         Implementing States' obligations and commitments arising under applicable international human rights instruments with provisions relevant to health;

·         Promoting R&D for developing new health technologies addressing the global challenges constituted by the health needs of developing countries by means which secure access and affordability through de-linking R&D costs and the prices of the products;

·         Securing sustainable funding to address identified R&D priorities in developing countries;

·         Improving the coordination of public and private R&D;

·         Enhancing the innovative capacity in developing countries and technology transfer to these countries;

·         Generating R&D outcomes as public goods, freely available for further research and production;

·         Improving priority-setting based on the public health needs of developing countries and decision-making relying on governance structures which are transparent and give developing countries a strong voice;

·         Core elements under the convention should focus on development of health technologies for Type II and Type III diseases as well as the specific needs of developing countries related to Type I diseases.