WHO Members Make Informal Progress On Plan Of Action As Executive Board Opens

By Kaitlin Mara
A small, diverse group of member states meeting informally over the weekend were able to resolve questions of which institutions should be actors in a broader plan of action for the implementation of the World Health Organization Global Strategy on Public Health, Innovation, and Intellectual Property, according to sources. The informal agreement increases the likelihood of consensus when the document is discussed at the WHO Executive Board meeting this week, they said.

The informal meeting immediately proceeded the Executive Board (EB) meeting, which advises and makes recommendations to the WHO’s decision-making body, the annual World Health Assembly (WHA) in May. The EB is taking place between 19 and 27 January.

The text produced on Sunday is available here.

The global strategy was the endpoint of a series of discussions and working groups begun in 2003, when WHO first began to explore the relationship between public health and innovation, in particular innovation on medical products related to diseases that disproportionately affect the developing world. Intellectual property protection, and its influence as an incentive for innovation and in determining prices of medical products, was necessarily a key component of the discussions and the final strategy.

The plan of action was not finalised at the close of the WHA in May 2008, and the WHO Director General was tasked with finishing several unfinished components, in particular indicators of progress for the strategy’s implementation, funding needs, and relevant stakeholders. The plan matches specific actions with stakeholder groups meant to carry them out.

A major decision made at the informal meeting on Sunday, 18 January was the inclusion of the WHO as a stakeholder at the same level of other international organisations – including the World Intellectual Property Organization, the World Trade Organization, and the UN Conference on Trade and Development – on matters of the global strategy relating to intellectual property, a source explained to Intellectual Property Watch.

Also key was the removal of the WHO from a separate list of stakeholders in exploratory discussions on instruments or mechanisms for essential health and biomedical research and development, including a possible treaty on those issues. The agreed stakeholders for the possible treaty are interested governments, and other relevant organisations including NGOs.

On the issue of access to traditional medicinal knowledge, intergovernmental institutions, including the WHO, were removed from the list of stakeholders; governments and concerned communities are now the listed stakeholders.

The informal group meeting included, according to sources, representatives from Brazil, Canada, Chile, the EU, Norway, Thailand and the United States, with India and the African Group apparently unable to attend. [Clarification: this paragraph has been changed. It incorrectly stated that China attended, and omitted Chile’s attendance at the meeting.]

DG Highlights Global Strategy, Counterfeit Drugs During EB Opener

Director General Margaret Chan said during her opening report to the Executive Board meeting on 19 January that “we should all welcome the global strategy and plan of action on public health and intellectual property,” calling it a “major step forward in addressing long-standing unmet needs.”

The strategy demonstrates, Chan added, that “international agreements that affect the global trading system can indeed be shaped in ways that favour health” and that R&D can be “needs-driven as well as profit-driven.”

Chan also placed the issue of counterfeit medical products on the same level as trafficking in human body parts, calling both “unethical practices that must be forcefully prevented,” that are “motivated by greed [and] harm public health.”

However, she noted concerns raised at the May 2008 WHA that the fight to combat counterfeit medical products might be conflated with intellectual property enforcement. Chan said the draft resolution [pdf] on the issue under consideration by the EB “explicitly recognises the need to ensure that combating counterfeit medical products does not hinder the availability of legitimate, good quality generic medicines.”

The concerns of all stakeholders regarding counterfeit medical products have not yet been assuaged, however (see IPW, WHO, 16 January 2009), and the issue is likely to generate debate when it is addressed later this week.

Delegates Discuss Avian Flu

Also discussed on 19 January were the results of the December meeting on pandemic influenza preparedness. The Intergovernmental Meeting on Pandemic Influenza Preparedness (IPW, WHO, 15 December 2008), which met from 8-13 December, had concluded with the decision to suspend talks and resume in May before the next WHA, hoping to complete its mandate then.

A brief discussion at the EB centred on questions of vaccine stockpiling and access to both viruses and benefits. The United States called for the “rapid, transparent sharing of influenza viruses,” adding that it was critical that all member states continue to share samples related to pandemic influenza – or to resume sharing samples if they had stopped – even in the interim period between now and eventual consensus. Niger, on behalf of the 46 member states of the Africa Region, called pandemic influenza “an immediate threat to public health” and asked for access to resources to strengthen capacity in the region to deal with the threat, for technology transfer, and for international mechanisms for equitable access to vaccines.

Bangladesh said that vulnerable countries – especially those that have already suffered an outbreak of the flu – should have prioritised access to vaccines and related benefits, and China said an international vaccine reserve would “inject trust and dynamism” into the system of virus and benefit sharing.

The United Kingdom raised the possibility of a more permanent solution than creating a stockpile of vaccines guarding against H5N1 – the flu strain most frequently talked about as having pandemic potential – as a pandemic could arise from a strain unrelated to H5N1 and catch the world unprepared. The conventional approach to vaccine building involves a lead time of several months, the UK explained, so “we end up chasing it with many deaths having already occurred.”

A multi-application vaccine is the “holy grail” said a WHO technical expert, for which there are no human clinical trials at present.

Kaitlin Mara may be reached at kmara@ip-watch.ch.