MSF Observations on WHO Expert Working Group on R&D Financing

The WHO Expert Working Group (EWG) on R&D financing is holding its second of three proposed meetings in Geneva this week, when it will conduct its initial review of the various R&D financing proposals received. The EWG is one of the key outcomes of the World Health Organization’s Intergovernmental Working Group (IGWG) on Public Health, Innovation, and Intellectual Property, which resulted in the recently adopted global strategy and plan of action. The global strategy and plan of action seeks to secure an enhanced and sustainable basis for needs-driven, essential health research and development relevant to diseases that disproportionately affect developing countries. The EWG is a time-limited body that has the remit to “examine... proposals for new and innovative sources of funding to stimulate research and development related to Type II and Type III diseases and the specific research and development needs of developing countries in relation to Type I diseases”.

Médecins Sans Frontières has actively contributed to the discussions throughout the IGWG process, including as an invited expert at IGWG meetings. MSF has a strong commitment, both as a funder and user of medical technologies to support the EWG’s work. However, we are increasingly concerned about the lack of transparency and absence of clear procedures for the EWG in undertaking its functions. This is in stark contrast to the IGWG process and the transparent process followed by the Commission on Intellectual Property Rights, Innovation and Public Health in its proceedings, which balanced the need for both open and closed sessions.

This lack of transparency, and indeed basic information about how the EWG is undertaking its work, must be remedied if there is to be confidence in the outcomes of the EWG work and to ensure that it receives the necessary support it requires to carry out its work.

Procedures and practices adopted must be made public and be fair, transparent and contain provisions to address any conflicts of interest. The EWG must distinguish between the support it needs to undertake its core functions, and obtain input from stakeholders. If additional support is needed to undertake its core functions, this needs to be provided by independent sources.

There also needs to be clarity about the selection and involvement of stakeholders. The EWG needs to determine when and where it is appropriate to receive stakeholder input and how those stakeholders will be identified and participate. To date, the EWG has only heard directly from a limited set of stakeholders in its first meeting. It has recently been proposed that an organisation (headed by a member of the EWG) undertake a review of the submissions and other proposals for incentivising R&D, and in doing so involve a stakeholder network of handpicked groups. However, it lacks end-users and has very little civil society representation – but it does include the CEOs of several multinational pharmaceutical companies and their trade associations.

A more participatory process is needed to obtain balanced views from stakeholders, in particular including the views of developing countries and institutions, with all views reflected. The EWG could ask the WHO to hold a public hearing (or a series of hearings) with the key proponents, experts and other stakeholders. A similar process was successfully conducted by the Commission on Intellectual Property Rights, Innovation and Public Health.

Given the importance of the EWG’s work in fulfilling its mandate, it must not only be fair and objective but must been seen to be so, by showing a commitment to transparency and the use of public procedures.

Tido von Schoen-Angerer, MD
Executive Director, Campaign for Access to Essential Medicines
Médecins Sans Frontières (MSF)