A new deal for global health R&D? The recommendations of the Consultative Expert Working Group on Research and Development (CEWG).

摘要: In May 2012 at the World Health Assembly, member states of Organization (WHO) have opportunity to make substantial progress on a major global health challenge: how catalyse new knowledge for diseases that primarily affect poor and which patents provide insufficient market incentives. The existing system can neither adequately develop nor deliver technologies addressing concerns mainly or only constituting problem in developing countries. Those markets no ability pay high prices needed recover research development (R&D) costs, is way current operates. We need mechanisms delink cost R&D from price products. There been many positive efforts tackle these issues, including establishment diverse public–private product partnerships (PDPs) like Medicines Malaria Venture Drugs Neglected Diseases initiative. But treated symptoms exhibited by failures not root causes. WHO has arena discussion analysis issues 10 years work Commission Intellectual Property Rights, Innovation Public agreement Global Strategy Plan Action Health, [1],[2]. sustainable solutions access medicines established. More than hundred proposals put forward submissions different stakeholders during processes follow expert groups, but approaches are often fragmented sometimes competing. Last month Consultative Expert Working Group Research Development (CEWG), we had honour chairing, published comprehensive concluding with set bold recommendations WHA consider [3]. Acting upon CEWG would constitute transformative change rather an incremental improvement. do call more money—this health, even importantly money used smarter ways. propose strategies this area be conducted paradigm financial contributions should determined based concept both costs benefits shared. recommend role stronger coordination suggest pooling investments secure efficient allocations where demands opportunities identified through active participation countries. We creation complementary intellectual property regime currently main incentive investment. within open innovation framework either public domain free use appropriate licensing arrangements. Such “open” successfully other sectors foster innovation. This will allow products delivered competitive countries afford. also extensive patent pools better share knowledge, prizes as mechanism discovering products. Today, must rely their own limited human resources they need, depend aid technology transfers charity political decisions. Neither self-sufficiency charitable sustainable. Our proposal constitutes third goods such all countries—rich poor, developed alike—contribute according size economy. conceptualization underscores it inefficient generate cannot fully exploited resource. Based needs investments, recommending allocate least 0.01% GDP good, result doubling investments. The challenge policies get them, them acted implemented. There debate value soft law versus hard making globally agreed deliver. Some argue strong specific enough measures laws, since laws end watered down commitments, thereby achieve more. However, reason easily exactly less committing. line argument then ends two options: clear commitments committed to, weak to. Both options policy outcomes. firm belief time break Catch-22. proposes our combined legally binding instrument commitments; international convention. So far, adopted under Constitution Framework Convention Tobacco Control International Regulations. These said regulating “global bads” reduce sales consumption harmful transmission infectious agents. It regulate produce goods”. learn environmental sector Multilateral Fund protect ozone layer Green Climate established conventions. believe convention meets necessary criteria when [4]. systemic solution creates formalized platform future held accountable. We know met applause scepticism. Systemic changes always difficult interests stake. why status quo so resilient. millions potentially preventable deaths each year demand changes. willing endure phase disequilibrium [5]. requires leadership hope adaptive leadership. report good enter into negotiations establish R&D. They caught up wasting exhausting processes. Now time.