Florian Sparr on strengthening the global R&D system: innovation for health needs in developing countries

florian starrOn Friday 4 May 2012 “Strengthening the Global R&D System: Innovation for Health Needs in Developing Countries” took place in Geneva.

The keynote address, “Investing in Global Public Goods” was given by Joseph E Stiglitz, recipient of the Nobel Memorial Prize in Economic Sciences (2001) and professor at Columbia University.

The event was organised by the Global Health Programme Graduate Institute, Geneva, in collaboration with the Harvard Global Health Institute, USA, and the University of Oslo, Norway.

This public seminar functioned as platform for exchange and in preparation for the upcoming 65th World Health Assembly which takes place on 21 – 26 May 2012 in Geneva.

The WHO consultative expert working group on research and development: financing and coordination (CEWG) has just released its report, Research and Development to Meet Health Needs in Developing Countries: Strengthening Global Financing and Coordination.

Professor John-Arne Røttingen, chair of the CEWG, introduced the main conclusions. The report is the outcome of a WHO-led process which started in 2003 and was developed through four successive stages.

The main problem being addressed is that there is a lack of R&D for diseases that disproportionally affect developing countries. This has led to a dearth of drugs for these diseases, as the financial returns are often limited.

Evidently, market forces alone will not lead to the development of sufficient affordable and appropriate new technologies and goods for the “neglected diseases.” When public goods are under supplied by the market it requires public support and public financing – as mentioned in the position paper on the EU Horizon 2020 research strategy (Salud por Derecho et al. 2012). As Andrew Witty, CEO of GlaxoSmithKline, wrote in 2011, to overcome the barriers a wide range of tools, partnerships, and approaches will be needed.

The underlying core ideas of the CEWG report are that affordable products can best be achieved through a free open market competition mechanism requiring a delinking of R&D costs and prices of products. R&D is a global public good where there is a strong need for collective action and agreed financing contributions to avoid free riding that leads to under-investment. The proposals of the CEWG that could best promote health R&D are open approaches to research and development and innovation, milestone prizes, equitable licensing and patent pools.

The recommendations for the financing of R&D are that all countries should commit to at least 0.01% of GDP to government-funded R&D devoted to meeting the health needs of developing countries in relation to the types of R&D defined in the CEWG mandate. Professor Stiglitz said that this amount is not something that is going to cause any hardship anywhere. For this a very modest sum, there is the potential of the international community coming together to address the need that will affect the lives of a very large fraction of the world’s population.

80% of the people in the world live in developing countries, so we are not talking about the health needs of a small fraction, but of the vast majority. The minority of 20% cannot separate themselves from the other 80%. For Professor Stiglitz, this seems to be a very compelling case. All the other participants also appreciated the conclusions of the report and commended it. It was broadly agreed that, although there is impatience for decisions and actions that should be made, there should be some more time for a political debate on national and international levels to reach well considered conclusions.

My perception of this event is that, especially through this report of the CEWG, the line of approach should be very clear. This event provided appreciable information and impulses for the World Health Assembly agenda item 13.16, Progress Reports: Health Systems and Research.

Now it is up to the governments and the responsible politicians to make the right decisions that these recommendations can be implemented and in the end improve the situation of the vast majority of the world’s population.

Salud por Derecho et al. (2012), Research and Development for Poverty-Related and Neglected Diseases: A Priority in the next EU Research Framework Programme. “Horizon 2020”. 2012.

WHO (2012), Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG), Final Report. 2012.

Witty. A (2011), New strategies for innovation in global health: a pharmaceutical industry perspective. Health Aff (Millwood). 2011 Jan; 30(1):118-26.

Florian Sparr is currently concluding a degree in health management and health promotion at the University of Applied Sciences Pinkafeld/Burgenland in Austria, where his main topic of research is health literacy. He is also undertaking an internship at the Global Health Programme in Geneva until the end of May 2012.