3 Will the candidates commit to convening further discussions by member states on a global R&D agreement, based on the principles set out by the CEWG, to correct failures in the current
Trang 1no longer rely upon high prices and patent monopolies?
(3) Will the candidates commit
to convening further discussions
by member states on a global R&D agreement, based on the principles set out by the CEWG, to correct failures
in the current system that neglect pressing public health needs and result
in unaff ordable prices?
We look forward to reading the candidates’ ideas and plans for this pressing area of WHO’s future work
Signatories of this letter are: Richard Elliott (Canadian HIV/AIDS Legal Network); Yanni Natsis (European Public Health Alliance); Brook Baker (Health GAP); Brian Citro (University of Chicago Law School); Wame Mosime (International Treatment Preparedness Coalition);
Thirukumaran Balasubramaniam (Knowledge Ecology International); Françoise Sivignon (Médecins du Monde); Edward Low (Positive Malaysian Treatment Access & Advocacy Group);
Peter Maybarduk (Public Citizen); Mike Podmore (STOPAIDS); Lotti Rutter (Treatment Action Campaign); Mark Harrington (Treatment Action Group); Manon Ress (Union for Aff ordable Cancer Treatment); Merith Basey (Universities Allied for Essential Medicines); Jordan Jarvis (Young Professionals Chronic Disease Network);
Andrea Carolina Reyes Rojas (Alianza LAC - Global por el Acceso a Medicamentos);
Germán Holguín Zamorano ( Misión Salud);
Koen Block (European AIDS Treatment Group);
Diarmaid McDonald (Just Treatment);
John H Amuasi (African Research Network for Neglected Tropical Diseases) MJB and DG declare
no confl icts of interest JM is employed by Universities Allied for Essential Medicines, a non-governmental organisation that has advocated for some of the policies mentioned in this article TB is employed by Knowledge Ecology International, a non-governmental organisation that has advocated for some of the policies mentioned in this article.
© The Author(s) Published by Elsevier Ltd This is an Open Access article under the CC BY licence
Melissa J Barber, *Dzintars Gotham, Júlia Muntanyà,
Thirukumaran Balasubramaniam,
on behalf of 18 other signatories
dg1911@ic.ac.uk
London School of Hygiene & Tropical Medicine, London, UK (MJB); Imperial College London, London , UK (DG); UAEM Europe, Berlin, Germany (JM); and Knowledge Ecology International, Washington, DC, USA (TB)
1 World Health Organization Process to elect next Director-General of WHO begins http://
www.who.int/mediacentre/news/
releases/2016/election-process/en/ (accessed Sept 25, 2016).
Open letter to the
candidates for
Director-General of WHO: will you
support a
patient-centred R&D agreement?
Less than a year from now, a new
Director-General will be elected to
lead WHO.1 The next Director-General
should commit to developing a
global agreement on the research and
development (R&D) of medicines,
vaccines, and diagnostics of public
health importance This is critical in
order to address the dual challenges
posed by unaffordable medicine
prices and a lack of innovation in
neglected diseases, antimicrobials,
and other public health priorities
Discussions at WHO on how to
address failures of the current
monopoly-based R&D system have
been ongoing for over a decade, but
R&D policy change is yet to occur and
the will to address the root causes
of the access and innovation crisis is
still lacking
The imbalances in the current R&D
system were the subject of the 2012
report of WHO’s Consultative Expert
Working Group on Research and
recommended a global binding
agree-ment that provides a needs-driven
and evidence-based framework for
R&D, guided by the core principles
of affordability, effectiveness,
effi ciency, and equity, and grounded
in the concepts of delinkage and
knowledge-sharing approaches On
the basis of the report, the 69th World
Health Assembly passed resolution
WHA69.23 to request the
develop-ment of a plan for impledevelop-mentation
of a pooled fund for R&D.3 In a
recent report,4 the UN
Secretary-General’s High-Level Panel on Access
To Medicines restated the need for
negotiating a binding convention and
called on governments to take action
We would like to invite the
candidates to take a clear position
on the future of WHO’s work in supporting a patient-centred R&D system
Consider for example tuber culosis, the world’s leading infectious cause
of death: only two new drugs against tuberculosis have been brought to market in the last five decades In addition to the lack of investment in tuberculosis R&D, when innovation has occurred, only 2% of those in need
of these new treatments have received them The other 98% were unable
to access them due to exorbitant prices or the originator companies’
unwillingness to register them in high-burden countries.5,6
These gaps in innovation and access are seen across diseases A lack of public-health-driven priorities and incentives to develop much-needed new drugs such as antibiotics and vaccines is coupled with a tradition
of using patent monopolies to set prices beyond what even high-income health-care systems can bear, as currently seen in hepatitis C and cancer treatments
Committed leadership by the new Director-General will be instrumental
in following up on the CEWG’s recom-mendations and carrying through the WHO Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property
We therefore invite the candidates, the Executive Board, and Member States to consider the following points throughout the election process:
(1) What are the candidates’ visions for WHO’s work in supporting R&D,
in line with the WHO Constitutional principle that “[t]he extension to all peoples of the benefits of medical, psychological and related knowledge
is essential to the fullest attainment of health”?
(2) Do the candidates support WHO’s further exploration of
alter-native pharmaceutical R&D systems
based on the principle of progressive delinkage,7 wherein governments reform R&D incentives so that they
Lancet Glob Health 2016
Published Online
December 9, 2016 http://dx.doi.org/10.1016/ S2214-109X(16)30353-9
Trang 22 Consultative Expert Working Group on Research and Development: Financing and Coordination Research and development to meet health needs in developing countries:
strengthening global fi nancing and coordination http://www.who.int/phi/CEWG_
Report_5_April_2012.pdf (accessed Sept 25, 2016).
3 Sixty-Ninth World Health Assembly Follow-up
of the report of the Consultative Expert Working Group on Research and Development:
Financing and Coordination 2016 http://
apps.who.int/gb/ebwha/pdf_fi les/WHA69/
A69_R23-en.pdf (accessed Sept 25, 2016).
4 Report of the United Nations Secretary General’s High-Level Panel On Access To Medicines 2016 http://www.unsgaccessmeds.
org/s/UNSG-HLP-Report-FINAL-12-Sept-2016.
pdf (accessed Sept 25, 2016).
5 MSF Access Campaign First new TB drugs in half a century reach just 2% of people who need them 2015 http://www.msfaccess.org/
about-us/media-room/press-releases/fi rst- new-tb-drugs-half-century-reach-just-2-people-who-need-them (accessed Sept 25, 2016).
6 MSF Access Campaign DR-TB drugs under the microscope: sources and prices for drug-resistant tuberculosis medicines http://www.
msfaccess.org/sites/default/fi les/TB_report
DR-TB_DRUGS_UTM 4th_edition_2016.pdf (accessed Sept 25, 2016).
7 Love J, Rius J Contribution to the United Nations Secretary-General’s High Level Panel
On Access To Medicines: the need for global negotiations on agreements to fund R&D within the context of a progressive de-linking
of R&D costs from product prices 2016 http://
www.unsgaccessmeds.org/inbox/2016/2/29/
james-love (accessed Sept 25, 2016).