OECD High-Level Meeting On Neglected Diseases Agrees On Agenda For Action

By Tove Iren S. Gerhardsen
NOORDWIJK, THE NETHERLANDS – Participants at a high-level meeting of the Organisation for Economic Cooperation and Development (OECD) meeting here informally agreed on an agenda for what needs to be done in the area of neglected diseases, and although no specific commitments were made, participants said the outcome is a major contribution to ongoing processes in the area.

The “Draft Noordwijk Medicines Agenda” covers a wide range of mechanisms including some that have proven to be controversial in other settings related to innovation, intellectual property rights and trade law. These were particularly emphasised by the Netherlands, the cohost of the meeting.

Neglected diseases are predominantly found in developing countries. There are often no or inadequate medicines available for these as there is no incentive for the pharmaceutical industry to develop treatments for them because the size of the market of people who can afford to pay is too small to be profitable. Alternative models to the current intellectual property rights system as an incentive therefore have to be developed. The agenda highlights new approaches, as well as the need for funding and political commitment.

This was the topic of the 21 June OECD meeting on “Medicines for neglected and emerging infectious diseases: Policy coherence to enhance their availability.” Among the close to 200 participants were government officials, industry representatives, non-governmental organisations (NGOs) and intergovernmental organisations. Her Majesty Queen Beatrix of the Netherlands also listened in on the debate during the morning session. But some ministers who were expected did not make it to the meeting, and non-governmental groups were underrepresented on the panels, according to sources.

“This is a major success,” one official said, referring to the agenda that was declared a “consensus document” by the OECD at the end of the meeting after a number of drafts reflecting input throughout the day. The OECD did emphasise, however, that is not a legally binding document as it has not been negotiated. The official welcomed that the OECD is now “onboard among progressive forces” and has “decided to work towards new research and development (R&D) partnerships for neglected diseases.”

Harvey Bale, director general of the International Federation of Pharmaceutical Manufacturers and Associations, said the draft was “fine.” NGOs said that the draft will be a useful input to an ongoing process at the World Health Organization (WHO) on neglected diseases, called the Intergovernmental Working Group on Public Health, Innovation and Intellectual Property (IGWG).

Linkage to WHO Process

WHO Deputy Director General Anarfi Asamoa-Baah, said the one-day meeting had “achieved a lot,” and he was happy the emphasis had been placed on the IGWG. He hoped the passion, frankness and spirit of cooperation would be carried forward to the November IGWG meeting (IPW, WHO, 23 May 2007).

The lack of a clear link to the IGWG process in the initial agenda draft that had been developed during the months before the meeting was a major concern at the opening of the meeting.

The “Draft Noordwijk Medicines Agenda” now says that action should focus on “exploring in conjunction with the WHO/IGWG process” improving R&D and funding into these diseases, emphasising the need for “adequate funding” and political support for IGWG. It says this should be done by strengthening existing efforts such as product development partnerships but also by “facilitating the development and operation of a sustainable architecture for the sharing and exchange of knowledge, data and research tools.” It also mentions issues such as patent pools and “other IP and data management entities,” in collaboration with WTO and the World Intellectual Property Organization, for example.

The agenda also says that both for-profit and not-for-profit models should be explored, particularly “mechanisms to promote the transfer of technology, knowledge and technical skills to strengthen developing country innovation systems.” This is required under the World Trade Organization Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), but has proven to be very difficult to achieve in practice.

New models and partnerships between developed and developing countries were also highlighted, as was building capacity in the developing countries themselves.

TRIPS Flexibilities Flagged

In the IGWG process, a sticking point has been the issue of to what extent WHO should get involved in trade issues and especially the TRIPS flexibilities, which are provisions in TRIPS that give countries the liberty to decide when other public concerns outweigh the monopoly rights of the patent holders. At this meeting, it proved less difficult.

The agenda calls for exploration of “the use of existing flexibilities of multilateral agreements to foster innovation and access.” At a press conference, Bert Koenders, minister for development cooperation in the Netherlands, said that this referred to TRIPS flexibilities. He said that in a smaller-group high-level discussion of the draft, this had been a “very, very key point,” referring to a “better balance between IP and access.”

The agenda also calls for, “Taking steps to strengthen the capacity of developing countries to manage issues of intellectual property, including using available flexibilities to the fullest extent, and to build sustainable networks and capacity for global research.”

In his opening speech, Koenders said: “It is not acceptable for rich countries to pressure developing countries into bilateral trade agreements that sidestep TRIPS, leaving them with less scope for policymaking than some rich countries allow themselves.”

Bience Gawanas, commissioner of social affairs at the African Union, said that to assist the African countries with their disease burden, one should help them in “exploiting the TRIPS flexibilities,” and emphasised that Africa should “have the capacity to produce drugs ourselves.” Other participants, including the industry and the government of Mexico, emphasised the important role of IP as an incentive.

Angel Gurría, secretary general of OECD, said he was “very satisfied” with the outcome and said the agenda was an “action plan,” “blueprint for action,” a “reference,” and a “starting point.” He said it would support ongoing efforts in this area.

The OECD includes several developing country members, such as Mexico, Turkey and Korea. Bale said there had been a higher level of participation of developing countries at this meeting than he sometimes saw at WHO, and said OECD could provide “deeper analysis” and make the IGWG process more analytical.

Highlighting an issue raised by others during the meeting, Asamoa-Baah said he had found it “stimulating” but also a bit “suspicious” that the “rich-man’s club” of the OECD wanted to address the issue of poverty. But he welcomed the OECD bringing the power of analysis to the process.

It is not clear what will happen next, but Cameroon said it wanted to hold a follow-up meeting next year.

Tove Gerhardsen may be reached at tgerhardsen@ip-watch.ch.