MSF at WHO's Open-Ended Meeting on CEWG - Agenda Item 5 (g-h): R&D Observatory, Coordination of Health R&D, Demonstration Projects
At the 68th World Health Assembly, resolution 66.22 requested the Director-General to convene an open-ended meeting of Member States prior to the 69th World Health Assembly, in order to assess progress and continue discussions of the Consultative Expert Working Group (CEWG) on the remaining issues in relation to monitoring, coordination and financing for health research and development. The three-day meeting takes place from 2nd to 4th May 2016 at WHO Headquarters.
Agenda Item 5 (g-h): R&D Observatory, Coordination of Health R&D, Demonstration Projects
Within a global pharmaceutical market exceeding one trillion dollars, the elements of the CEWG may seem small. But they are necessary first steps to address a series of systemic failures that MSF and others face within our current system of medical innovation. There is no coordination, no priority setting, and the current system ignores a range of priority health needs that have devastating impacts world-wide.
Some will state that a Coordination Mechanism under WHO will somehow hijack or undermine the decision-making of governments. We disagree. A coordination mechanism would instead enhance and improve the decision-making of governments and other R&D funders. WHO, as a Member State-led organisation, has the sole credibility and legitimacy to convene and encourage collaboration amongst governments and improve the quality of research and value for money.
Some will point to the lack of funding for demonstration projects as an indicator of failure. We disagree. More funding should be forthcoming for these collaborations, but a lack of funding for the selected projects actually strengthens the case for introducing these new components to ensure there is a strong institutional backbone – with Member State backing – for selected projects. Member States should be encouraged to consider mandatory funding, or at least sustainable funding mechanisms of a Fund.
Member States should remember that other demonstration projects, such as those on Ebola and AMR, have been successful. The Ebola outbreak demonstrated that governments and WHO can succeed to conduct R&D as the CEWG recommends when there is political will. WHO convened governments and projects were selected through a scientifically rigorous and evidenced-based process. In 2014, 165 million dollars was raised to finance Ebola R&D –double the current gap for the demonstration projects.
Overall, MSF recommends:
- A Coordination Mechanism is hosted by WHO and can convene a range of technical experts. It should seek to coordinate R&D, reconstitute the Advisory Committee on Health Research, and be based on a test and improve strategy, with evaluation and revision after two years.
- Provide sufficient, voluntary and regular funding towards an Observatory which should at least cover all areas for which there is market failure. Under no circumstances should the Observatory be limited to Type II and III diseases.
- View the demonstration projects in light of what improvements can be made, while not forgetting other examples of successful demonstration projects, and how those successes can inform the decisions that Member States can make.