MSF intervention at WHO R&D demonstration projects meeting
Intervention by Mr Rohit Malpani, Médecins Sans Frontières International
5 December 2013 — Médecins Sans Frontières field teams bear witness to the fact that the current innovation model is failing our patients every single day. As a medical, humanitarian organisation providing medical care in over 65 countries around the world, we thank WHO and its Member States for allowing us to provide input into this important process.
MSF welcomed the analysis and recommendations of the Consultative Expert Working Group on R&D Financing and Coordination, and the decision by Member States to set up R&D demonstration projects.
The Decisions Point adopted at the 66th WHA specifies that demonstration projects should in particular ‘utilize collaborative approaches, including open knowledge approaches for R&D coordination; promote the delinkage of the cost of R&D from product price; and propose and foster financing mechanisms including innovative, sustainable and pooled funding.’
Most importantly, the demonstration projects should be used to demonstrate new models of R&D that are guided by principles ensuring innovation with access, as outlined in the CEWG report. This is not about funding individual R&D projects - we already have governments, grant-making organisations and product development partnerships for that. This is about testing approaches that could demonstrate new ways of conducting R&D in a manner that supports innovation with access for the many patients neglected and underserved by the current innovation system.
Although we are of course disappointed that the proposals submitted by MSF have not been shortlisted, this is not our primary concern. What we want to see are good, strong proposals that fulfil the recommendations of the CEWG and satisfy urgent, unmet medical needs.
We are very concerned by the criteria for the selection of projects which was introduced only a few weeks ago and that was used in the Expert meeting. The criteria are incomplete and strike the wrong balance. The considerations at the core of the CEWG approaches - delinkage and open collaboration – were only used as third-level criteria, when they should have been the first. In addition, in places the criteria were unhelpful. For example, rather than clearly emphasising open collaborative approaches, the criteria weaken this to ‘collaborative/partnership approaches’. A partnership can be narrow and exclusive, and do nothing to address the need for broad openness that seeks to attract as many players as possible to neglected R&D.
Moreover, proposals were marked favourably for having concretely identified potential partners to develop as well as to produce the technology. We are concerned that such criteria may actually have actively driven the selection of projects away from proposals that seek to demonstrate new ‘delinkage’ models of innovation. Delinkage is not best served by identifying a single production partner, but rather identifying a range of potential sources of production. Delinked models require openness and to a certain extent, it requires unpredictability as to partners that can ultimately develop and manufacture technologies.
We would like to remind the WHO and its Member States of the critical importance of the outcomes of this process. Member States must ensure the core of the CEWG principles and the commitments made by Member States in the Global Strategy and Plan of Action are brought back to the centre of the decision to select demonstration projects. Any deviation from the principles of the CEWG and the objective of ‘demonstrating’ alternative R&D models, rather than funding existing approaches or individual research projects, would undermine a long process to find real and ambitions solutions that deliver for neglected patients.