Center for Global Health R&D Policy Assessment

Meetings I attended in Geneva a few weeks ago provided new information and insights into what is going on with the World Health Organization and its Expert Working Group on Research and Development Financing (“the EWG”). It also helped me to understand where our new project at Results for Development Institute (R4D) to assess in depth the top proposals for speeding up the development of life-saving new drugs, vaccines, and other health tools fits into the larger landscape.

The EWG, composed of two dozen eminent figures in health research and chaired by Sir George Alleyne, the former head of PAHO, was appointed by the WHO Executive Director in late 2008. During the course of last year, the EWG sought information and recommendations on ways to generate more funds for R&D on the diseases of low and middle income countries, and on how to use money more effectively to accelerate the development of new medical technologies – drugs, vaccines, diagnostics, etc. The Group obtained this information in a number of ways, including commissioning background studies and soliciting on-line contributions from governments, academics, the pharma industry, global health advocates, and others.

The EWG completed its deliberations at the end of 2009, and has produced a report and an executive summary. Around the time that a draft of the report began to circulate in November, the EWG process became engulfed in a political firestorm. NGOs and some developing countries complained that the report had been “leaked” to the pharmaceutical industry, allowing for undue influence to be exercised over its findings while they were still being formulated. Some NGOs also accused the EWG and WHO of ignoring certain proposals for financing R&D that had been submitted by civil society organizations, or of dismissing these proposals without considering them seriously. On the other side, the EWG argued that it was as open-minded and objective as possible, and had made important strides in analyzing the relative strengths and weaknesses of each proposal that it had received.

Now, the EWG report is to be discussed at a special consultation hosted by WHO in Geneva on May 13, a few days before the start of the World Health Assembly. Presumably, unless a number of member countries to the WHO object, the report will be endorsed by the WHO Executive Board and adopted by the Assembly when it convenes. Whether there is still some chance that the report will be blocked is unclear.

In all the controversy over the alleged leaks and possible bias, what has been lost from sight is another fact of greater long term importance: namely, that the EWG report, while very useful in its cataloguing of nearly 100 health R&D financing “proposals” and beginning to look at their pros and cons, was not able with the time and resources at its disposal to look at depth at the most promising proposals. So what is going to happen next to take this agenda forward?

Based on my conversations with senior WHO officials, it seems that WHO is aiming for an orderly hand-off to others to keep up the momentum generated by the EWG. In particular, the recommendation to expand the monitoring, or “tracking”, of expenditures on R&D for the diseases of poor countries is likely to be pursued by the George Institute, which has an ongoing project called G-FINDER which does this.

Regarding advocacy for the innovative R&D financial proposals that were highlighted in the EWG report – direct public sector grants to biopharma, prizes, purchase agreements, patent pools, open source drug development, and so on – it appears that WHO is going to leave it up to the current sponsors of these ideas to promote them further.

And what about carrying out more in-depth analysis of the top proposals, to see if these are really likely to have the desired impact on the breadth and speed of health technology development, and to judge more closely if these ideas will be able to garner a critical mass of political support to enable them to be put into practice?

This is where our new project, “The Center for Global Health R&D Policy Assessment”, comes in. While we cannot possibly cover all of the ideas laid out in the EWG report (hopefully others will step up to look at some of them), our new Center, launched last November with three years of core funding from the Bill and Melinda Gates Foundation, will take a careful look at half a dozen of the top ideas for innovative approaches to financing, incentives, intellectual property, and other policies targeted at accelerating global health R&D.

The Center builds on an idea we first expressed in a 2009 article in Health Affairs (Hecht, Wilson, and Palriwala, “Improving Health R&D Financing for Developing Countries”, Volume 28, Number 4, July/August 2009). Our new website will contain a wide array of information on innovative health R&D policy proposals, and will keep readers up to date on the progress of our first batch of in-depth assessments. We will use the website to solicit input at various stages of the individual assessments, and more generally to seek views on how to promote faster progress in developing drugs, vaccines, diagnostics, and other technologies that will improve the health of the billions who live in or near poverty around the world.

So stay tuned, and keep visiting our website for more blogs and other information. If you have questions about what we are doing to advance the EWG agenda to the next stage, respond to this blog or email me at rhecht@resultsfordevelopment.org.