MSF's Letter to the 63rd WHA Delegates

Each World Health Assembly delegate received a packet in advance of the 2010 WHA. Included were this letter along with three briefing documents covering: infant and young child nutrition; public health, innovation, and intellectual property; and counterfeit medicinal products.

Dear World Health Assembly delegate,

On the eve of the 63rd World Health Assembly (WHA), on behalf of Médecins Sans Frontières (MSF), I would like to share our perspective on key issues related to access to medicines and medical innovation that will be discussed at the WHA.

For this purpose, we have included three briefing documents on issues up for discussion at the World Health Assembly.

Under the agenda item on infant and young child nutrition, MSF urges Member States to support the development of an Implementation Plan to reduce malnutrition, prioritising treatment and early interventions to protect children from acute malnutrition. High-burden countries should develop national plans and donor countries commit to providing the technical support and sustainable financial resources to overcome this scourge.

As regards discussions on public health, innovation and intellectual property, MSF calls on Member States to support innovative financing mechanisms capable of bringing sustainable resources to medical R&D, particularly those that allow the delinking of the cost of research from the price of the product and that overcome the flaws of the current system for drug development.

Concerning the discussion on counterfeit medical products, MSF warns against the possible negative impact on access to legitimate quality generic medicines that an excessively broad interpretation of ‘counterfeit medicines’ can have, and asks Member States to push WHO to adopt a new approach to the problem, driven by public health, guiding countries in the fight against poor quality and fake medicines, distancing itself from intellectual property enforcement agendas, and speaking out against risks to access to medicines when these occur.

In addition, we would like to take this opportunity to share the following concerns:

In relation to the discussion on tuberculosis control and scaling up diagnosis and treatment of multidrug-resistant TB (MDR-TB), MSF is alarmed about the extremely slow progress achieved, as still fewer than three per cent of those with MDR-TB are receiving appropriate treatment. MSF calls on high-burden countries to prioritise scale up efforts and for WHO and other agencies to facilitate these initiatives through support mechanisms, such as increasing availability of quality-assured second-line drugs and improved assistance for programme implementation. Member States and drug developers are urged to test new TB drugs for MDR-TB and to fund currently-proposed clinical trials for MDR-TB. Member States also need to commit urgent funds to reach the US$16.2 billion needed by 2015 in accordance with the Global Plan to Stop TB.

This year, Resolution EB124.R7, Chagas Disease: Control and Elimination, presents an opportunity for the estimated eight to 15 million people infected with Chagas disease. However, the recommendations fail to address key issues. Based on its experience treating patients with Chagas disease, MSF believes that a clear commitment to patient needs and their lack of access to diagnosis and treatment is needed. We urge Member States to emphasize the importance of integrating diagnosis and treatment of Chagas disease at the primary health care level, for patients - children and adults - in both the acute and chronic phase of the disease; to reinforce supply chains of existing treatments within endemic and non-endemic countries in order to scale up access; and to promote further and increase research and development for better drugs, diagnostic tools and a test of cure in order to control Chagas disease, including identifying additional sources of funding.

Concerning the provisional agenda item on monitoring of the achievement of the health-related Millennium Development Goals (MDGs), MSF is deeply concerned that health-related MDGs may not be achieved due to major gaps in many areas including universal access to HIV and MDR-TB treatment, acute childhood malnutrition and vaccination, a situation that is exacerbated by uncertain funding. MSF urges Member States to commit to adequately funding activities to achieve health-related MDGs, ahead of the forthcoming MDG plenary and Global Fund replenishment conferences. We also call on Member States to support a financial transaction tax that could raise additional funding needed to achieve health-related MDGs and to request WHO to play a leading role in ensuring that health needs are addressed in ongoing discussions on innovative finance mechanisms, such as financial transaction taxes.

We remain at your disposal for any further information or for meetings with your delegation before and during the WHA in Geneva in May.

Yours sincerely,

Tido von Schoen-Angerer, MD
Executive Director
Médecins Sans Frontières International   

Michelle Childs
Director of Policy Advocacy
Médecins Sans Frontières International

UPDATE: To learn more about the outcomes of EWG discussions, read "New direction: WHO's work on the financing of medical research and development is given a fresh start" (16 June 2010)