News link 100

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries

 

News Link 100

Open letter from Civil Society groups to Minister Rob Davies and the Newly Appointed Cabinet on the Urgent Need to Finalise and Adopt South Africa’s National IP Policy

Eliminating inequality and the threat of climate change key to new UN development goals

UN Advisor Denounces Junk Food As ‘Culprit’ In Rising NCDs, Calls For Change

Chile, China and Morocco join others in moving closer to eradicating hunger

Small Farmers’ Rights Sidelined In Uganda’s Plant Breeding Regulation

NGOs blame Berlin for feeding big business land grabs

How can food security interventions be more sustainable?

How to feed a hungry planet

UN urges G77+China to unite on combating poverty, climate change

Not Just ‘Women’s Issues’: Including Women in the Growth Agenda

5 Practical Actions to Help Free Imprisoned Sudanese Mother

A Call to Prioritize Gender in Development

Donors Should Put Evidence Before Politics and Diplomacy

Sustainable development: Show, don’t tell

Toilets for all: a big challenge for India’s government

Partnership commerciale tra Usa e Ue: L’Italia avrà un ruolo fondamentale

Partire è un poco morire. Malattie infettive nelle popolazioni immigrate nell’Unione Europea

Sud Africa. I progressi e le sfide

Ospedali for profit in Africa. Il caso Lesotho

Come s’insegna Medicina nell’Università Fluminense, Rio de Janeiro-Brasil

 

 

 

 

 

 

 

News Link 99

 

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries

 

News Link 99

Commission rejects call to respect right to life in development aid 

Council for Trade-Related Aspects of Intellectual Property Rights – Non-violation complaints under the TRIPS Agreement – Communication from the United States

TRIPS Council Debates Non-Violations, Innovation, Green Tech Transfer 

Development Progress LAUNCH: Pathways to Progress in Health 

UN group chairs unveil zero draft for sustainable development goals 

The Brussels G7 Summit Declaration 

Oxfam on G7 summit: Stronger steer needed on energy security, climate change and the global economy 

Shared Responsibilities for Health: A Coherent Global Framework for Health Financing  

Growing concerns over medicines agency’s proposed rules for transparency  

Africa and the New European Parliament: How Much Change Can We Expect? 

Civil society leaders to meet in advance of US-Africa summit   

A healthier South Africa through continued ANC dominance?   

Vaccines Europe: Call for Action 

Access To Vaccines, Patents Growing Concerns, Panellists Say 

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Kellogg & General Mills: Feed people, fight climate change! 

Change the way the food companies that make your favorite brands do business  

Sustainable Energy Supply Models Discussed At UNESCO Conference 

Q&A: Developing World Leads in Advancement of Climate Change Laws

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African Intellectual Property Organization (OAPI) Becomes Second Intergovernmental Organization to Join UPOV     

How to Beat Malaria, Once and for All 

Fight the Fakes Campaign: Partners  

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Mind the gaps – the epidemiology of poor-quality anti-malarials in the malarious world – analysis of the WorldWide Antimalarial Resistance Network database  

Quality of Antimalarial Drugs and Antibiotics in Papua New Guinea: A Survey of the Health Facility Supply Chain 

A Tiered Analytical Approach for Investigating Poor Quality Emergency Contraceptives

Measuring Wealth to Track Sustainability

New CONCORD president: Show development’s ‘positive impact’

No excuses in Chagas diagnosis  

Fear and ignorance aid spread of Ebola

How ‘rogue’ is China’s aid?  

 

 

 

 

News Link 98

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries

 

News Link 98

The human embryo is “One of Us”: help us to protect and respect its dignity and integrity   

Petition To Save Meriam Ibrahim Yehya 

Making fair choices on the path to universal health coverage

What is the Open Policy Network? 

Open A.I.R. Project Publications 

The Open African Innovation Research and Training (Open A.I.R.) Project 

Commodities for better health in Africa – time to invest locally

Innovation & IP – Collaborative Dynamics in Africa 

Knowledge & Innovation in Africa – Scenarios for the Future 

BRICS and global health 

BRICS cooperation in strategic health projects

BRICS seek value for money as health-care costs rise 

The BRICS countries: a new force in global health? 

Relative health performance in BRICS over the past 20 years: the winners and losers 

Socioeconomic inequalities and mortality trends in BRICS, 1990–2010

BRICS: opportunities to improve road safety 

Progress towards universal health coverage in BRICS: translating economic growth into better health 

Impact of BRICS’ investment in vaccine development on the global vaccine market  

The economic and social benefits of childhood vaccinations in BRICS 

BRICS’ role in global health and the promotion of universal health coverage: the debate continues 

Tracking the flow of health aid from BRICS countries 

Tuberculosis in BRICS: challenges and opportunities for leadership within the post-2015 agenda 

BRICS in the response to neglected tropical diseases 

BRICS’ contributions to the global health agenda 

Inquinamento atmosferico nelle città del mondo: il database dell’Oms 

Le emissioni di gas a effetto serra accelerano 

Fears over policy based on ‘planetary boundaries’ model 

UNDP cuts HQ staff, creates new lower-level jobs

Italy won’t let corruption stop dev’t aid to Mindanao

Obesity rising  

 

 

 

 

Financing Research for Health: Why the Multilateral Process Paused, and What Action Governments Should Take rather than Wait

Many low and middle-income countries (LMICs) are still struggling to finance indigenous R&D, and several are failing to meet continental declarations of intent such as the African Union target of 1% of GDP on R&D. In the next two years, LMICs may make significant strides in pushing their own R&D models, but it is clear that a radical re-think of how to fund, and how to incentivise R&D is needed if they are to get drug development for diseases of poverty resourced. A bold new strategy requires perspectives including the voice of NGOs and civil society, if progress in R&D is to result in greater access and health equity. This is why LMICs should take the lead and not rely on external aid nor wait for international treaties to arrange what they can start and fund at home

Financing Research for Health: Why the Multilateral Process Paused, and What Action Governments Should Take rather than Wait

by 

 Priya Shetty Global Health Consultant, Brighton, UK  

Danny Edwards Council on Health Research for Development (COHRED*), Geneva, Switzerland

Carel IJsselmuiden COHRED, University of KwaZulu-Natal, Pietermaritzburg, South Africa

 

There are some problems in global health that seem so intractable as to defy solution: one of these is the flawed model of research and development (R&D). Developing new drugs and vaccines is so expensive that a market-based system simply cannot support the millions of dollars needed in investment when these medicines are being developed for people who cannot afford costly drugs and are without health insurance.

For a while in 2012, it seemed as if the world would see a much-awaited R&D treaty that would revolutionise funding of global health research. This time, it also looked like the pharmaceutical industry was on board, a major coup considering that the business goals of industry are often not in alignment with ensuring that the world’€™s poorest have access to cheap medicines. But hopes were dashed when the idea was once again placed on the backburner until 2016, a decision reached in May 2013 at the 66th World Health Assembly in response to the report of the Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG).

Many in global health saw this as enormously disappointing news, and with good reason. The restrictions of intellectual property laws still limit the  production of generic medicines, and gains in access to generic drugs are under constant threat of reversal, particularly for the most costly drugs. Despite the launch of ventures such as the Drugs for Neglected Diseases Initiative (DNDi), neglected diseases such as trachoma and Buruli ulcer still garner pitiful amounts of attention, and even less funding. Last year, with the exception of the USA, high-income country governments cut their funding for neglected diseases by an average of 20%.

Under pressure to take some action after the multilateral process stalled, governments agreed to create a Global R&D Observatory to improve monitoring and evaluation of health research financing, and to identify “€œdemonstration projects“to test mechanisms for boosting global R&D financing. These projects should help us understand better what sort of incentives -€“ such as an R&D prize fund -€“ could entice researchers to target particular R&D goals.

However, the eight demonstration projects that were chosen a year later, last December, left many, especially civil society and NGOs such as MSF underwhelmed. The criteria for selecting the projects were revealed so close to the meeting as to leave no time for critique or input, and while the projects seem entirely robust scientifically, they did not yet prioritize testing price-delinkage mechanisms -€“ yet the fact that the high cost of R&D is linked to the price of the final product is central to the reason that the current system is broken. Demonstration projects that fall closely in line with the existing system will only prove a circular argument – that if a project is designed to work within the current system, it will succeed. Yet this is far from what is needed. These considerations are without prejudice to a just approved resolution by the 67th WHA that allows WHO to establish a pooled fund for sustainable R&D for developing countries, based upon delinking drug prices from the cost of the R&D.

Worryingly, it seems there is a real possibility that, in 2016, we will be no closer to understanding how to devise a global R&D treaty, and that the demonstration projects will have revealed very little about radical and innovative ways to fund global R&D, especially for health problems faced by those with fewest resources. Other commentators  have variously described the process as a ‘€˜non-event’€™, that is ‘€˜based on flawed logic’, and will ‘€˜waste time and money’€™.

The multilateral process to develop an R&D treaty failed for many reasons. A key explanation is that two of the biggest global R&D funders, the USA and the European Union, were opposed to the financial reform aspects of the treaty, which would demand fixed contributions of GDP towards R&D from member states and would ensure that 20% of this funding is channeled through a pooled funding mechanism. Other major criticisms centered on the absence of any serious engagement with civil society or NGOs, and more critically, on the heavy-handed involvement of the pharmaceutical industry and its attempt to co-opt the R&D agenda, although it is perhaps not surprising that the pharmaceutical companies would not wholeheartedly support a treaty that proposed radical reform in how it does business.

All of this suggests that it is time for the global health community to be bolder in how it deals with this issue. WHO member states are understandably conservative when it comes to international agreements, and agreeing on a treaty that is acceptable to all is not an easy task. But the world has proven that when it wants to, such as in enforcing stricter tobacco control, it can be both co-operative and innovative.

Despite the somewhat dispiriting lack of action at the international level, there are significant actions that low and middle-income countries (LMICs) themselves can take – and indeed are already taking – to push for a better R&D system.

For instance, several new financing mechanisms, with control firmly in the hands of LMICs, are being floated. Recently, a BRICS Bank was created which would fund infrastructure and sustainable development in LMICs. Now, BRICS countries have agreed to fund the bank with $100 billion, which could weaken the dominance of funding agencies such as the World Bank in global aid. BRICS partnerships  and South-South partnerships are starting to flourish too, with India and Israel setting up a joint US$40 million fund for technology ventures, with each country investing US$20 million over 5 years.

Many LMICs are still struggling to finance indigenous R&D, however, and several are failing to meet continental declarations of intent such as the African Union target of 1% of GDP on R&D. Relying on external aid, however, means that countries risk loss of autonomy in setting their research agenda. At COHRED’€™s 2013 Colloquium in Geneva, participants suggested that LMICs set up dedicated national research funds (NRFs) as a way of ensuring that research funding is disbursed in accordance with explicitly linked local priorities. South Africa set up such a fund in 1998. Indonesia, currently in the midst of radical science and technology reform, is planning to set up a NRF, as are many African countries such as Burkina Faso, Burundi, Ghana and Kenya.

The possible benefits of such an approach are numerous. It can fund systematically, ensuring that research funds do not dry up halfway through a project: a perennial issue in low-income countries. It can raise research quality by instituting a competitive process based on merit, meaning that funding does not go to only the well connected. It can fund institutional and management capacity, areas less popular with international funders. It can be aligned with national research agendas, ensuring funded research accords to country need as is the case in most high-income countries. Even though allocating a percentage of a low national budget will not immediately replace the need for global health research funding, it directly supports LMIC autonomy in setting their own priorities and setting the tone and direction of their own research and innovation systems.

For the least-developed countries, other events also indicate that the time is right to build R&D infrastructure. On 11-12 June last year, the World Trade Organization (WTO) Council on the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), agreed that least-developed countries do not have to comply with the global intellectual property rights framework for a further eight years beyond 2013. This provides them greater freedom to build up their technological base (as India did before WTO accession in 2005) and the policy space to experiment with alternative models for incentivising R&D.

In the next two years, LMICs may make significant strides in pushing their own R&D models, but it is clear that a radical re-think of how we fund, and how we incentivise R&D is needed if we are to get drug development for diseases of poverty resourced. It is evident that processes run entirely by member states are too often mired in politics as to be actionable. A bold new strategy requires new perspectives, especially from those outside of the system, including the voice of NGOs and civil society – if progress in R&D is to result in greater access and health equity. This is why LMICs should take the lead and not wait for international treaties to arrange what they can start and fund at home.

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*COHRED, the Council on Health Research for Development, is a global, non-profit organisation whose singular goal is to maximize the potential of research and innovation to deliver sustainable solutions to the health and development problems of people living in low and middle-income countries