Bulletin of the World Health Organization

Assessing implementation mechanisms for an international agreement on research and development for health products

Steven J Hoffman & John-Arne Røttingen

Volume 90, Number 11, November 2012, 854-863

Table 1. Combinations of implementation mechanisms that have been used to support various international R&D, health and environmental agreements, by type of commitment mechanism

International agreement	Mechanism category
International agreement	Commitment	Administrative	Financial	Decision-making	Oversight	Compliance
UN Charter [General Assembly] (1945)	Convention	International organization	Membership organization	Equal voting	Expert review and civil society^a	Institutional consequences
UN Charter [Security Council] (1945)	Convention	International organization	Membership organization	Modified voting	Expert review and civil society^a	Legal processes and economic sanctions
Constitution of the World Health Organization (1946)	Convention	International organization	Membership organization	Equal voting	Expert review and civil society^a	Institutional consequences
Convention for the Establishment of a European Organization for Nuclear Research (CERN) (1953)	Convention	International organization	Membership organization	Equal voting	Expert review^a	Institutional consequences
UN Treaty I-13668: Agreement Establishing the European Molecular Biology Laboratory (1973)	Convention	International organization	Membership organization	Equal voting	Peer review	Institutional consequences
The London Amendment to the Montreal Protocol [Multilateral Fund for the Implementation of the Montreal Protocol] (1990)	Convention	International organization	Specialized multilateral fund and financial institution	Consensus	Expert review	Political pressure^a
UN Treaty I-30822: United Nations Framework Convention on Climate Change (1992)	Convention	International organization	Coordinated management	Equal voting	Peer review and self-reports	Political pressure^a
UN Treaty I-33757: Convention on the Prohibition of the Development, Production, Stockpiling and Use of Chemical Weapons and on their Destruction [Organization for the Prohibition of Chemical Weapons] (1993)	Convention	International organization	Membership organization and coordinated management	Equal voting	Expert review and self-reports	Institutional consequences and economic sanctions
UN Treaty I-31874: Marrakesh Agreement Establishing the World Trade Organization (1995)	Convention	International organization	Membership organization	Consensus and equal voting	Peer review	Economic sanctions
UN Treaty I-33836: Agreement on the establishment of the International Vaccine Institute (1996)	Convention	International organization	Membership organization	Delegated	Civil society^a	Political pressure^a
UN Treaty A-30822: Kyoto Protocol to the UN Framework Convention on Climate Change (1997)	Convention	International organization	Coordinated management	Equal voting	Expert review and self-reports	Legal processes and institutional consequences
UN Treaty I-37770: UNECE Convention on Access to Information, Public Participation in Decision-making and Access to Justice in Environmental Matters (“Aarhus Convention”) (1998)	Convention	International organization^a	Coordinated management	Equal voting	Peer review, civil society and self-reports	Political pressure^a
WHO Framework Convention on Tobacco Control (2003)	Convention	International organization	Membership organization and coordinated management	Equal voting	Self-reports	Political pressure^a
International Health Regulations (2005)	Convention	International organization	Membership organization and coordinated management	Equal voting	Expert review and self-reports	Political pressure^a
European Council Resolution 3666/06: establishing the 7th framework programme of the European Community for research and technological development [European Research Council] (2006)	Convention and institutional reform^a	Sub-agency	Membership organization	Delegated	Expert review and civil society	Legal processes
European Council Regulation 73/2008: setting up the joint undertaking for the implementation of the Joint Technology Initiative on Innovative Medicines (2007)	Convention	Joint venture	Membership organization	Delegated	Civil society^a	Institutional consequences
Governing instrument for the Green Climate Fund (2010)	Convention	Sub-agency	Specialized multilateral fund and financial institution	Delegated	Civil society^a	Political pressure^a
WHA Resolution 29.71: Special Programme for Research and Training in Tropical Diseases (1975) and Memorandum of Understanding on the Administrative and Technical Structures of the Special Programme for Research and Training in Tropical Diseases (TDR) (1978)	Contract and declaration	Joint venture	Membership organization	Delegated	Self-reports^a	Institutional Consequences
GAVI Alliance (2000)	Contract^a	Joint venture	Membership organization	Delegated	Expert review^a and self-reports	Political pressure^a
Framework Document of the Global Fund to fight AIDS, Tuberculosis and Malaria (2002)	Contract^a	Joint venture	Financial institution	Delegated	Expert review	Political pressure^a
Memorandum of understanding concerning the hosting of the International Drug Purchase Facility [UNITAID] (2006)	Contract^a	Joint venture	Membership organization	Delegated	Civil society^a	Political pressure^a
Global Alliance for Chronic Diseases (2009)	Contract^a	Joint venture	Coordinated management	Consensus^a	Civil society^a	Political pressure^a
Pneumococcal Advanced Market Commitment (2009)	Contract^a	Joint venture	Financial institution	Delegated^a	Expert review	Political pressure^a
WHA Resolution 18.44: Establishment of an International Agency for Research on Cancer (IARC) (1965)	Declaration	Sub-agency	Membership organization	Equal voting	Expert review	Institutional consequences
WHA Resolution 34.22: International Code of Marketing of Breast-Milk Substitutes (1981)	Declaration	Self-organizing	Coordinated management	Not applicable	Expert review, civil society and self-reports	Political pressure^a
Instrument for the establishment of the Restructured Global Environment Facility (1994)	Declaration^a	Sub-agency	Financial institution	Delegated	Expert review^a and self-reports^a	Political pressure^a
ECOSOC Resolution 1994/24: Joint and Co-Sponsored United Nations programme on HIV/AIDS (UNAIDS) (1996)	Declaration	International organization	Membership organization	Delegated	Civil society	Political pressure^a
Roll Back Malaria Partnership operating framework (1998)	Declaration^a	Joint venture	Membership organization	Delegated	Expert review^a	Political pressure^a
Basic framework for the Global Partnership to Stop TB (2001)	Declaration^a	Joint venture	Membership organization	Delegated	Civil society^a	Political pressure^a
G8 Gleneagles Communiqué (2005)	Declaration	Self-organizing	Coordinated management	Not applicable	Civil society	Political pressure^a
International Health Partnership and Related Initiatives (IHP+) (2007)	Institutional reform	International organization^a	Membership organization and coordinated management	Consensus	Civil society^a	Political pressure
Joint Declaration of the Consultative Group on International Agricultural Research [creating the CGIAR Fund] (2009)	Institutional reform	International organization	Financial institution	Delegated	Peer review^a	Political pressure
UN Secretary-General’s Global Strategy for Women’s and Children’s Health [creating Every Woman Every Child movement] (2010)	Institutional reform^a	Joint venture	Coordinated management	Delegated^a	Expert review and civil society	Political pressure^a

AIDS, acquired immunodeficiency syndrome; CGIAR, Consultative Group on International Agricultural Research; ECOSOC, Economic and Social Council; GAVI, Global Alliance for Vaccines and Immunization; HIV, human immunodeficiency virus; R&D, research and development; TB, tuberculosis; UN, United Nations, UNECE, United Nations Economic Commission for Europe; WHO, World Health Organization.

^a Indicates classifications were based on authors’ and/or key informants’ knowledge, whereas all other classifications were based on written materials found online (available upon request from the corresponding author).

Note: In keeping with the focus of this paper on mechanisms available to states for implementing agreements, the categorization of mechanisms in this table is with respect to the provisions of agreements. When these agreements resulted in the creation of new international organizations or other entities, the mechanisms were categorized according to states’ rights, obligations and relationships vis-à-vis these new entities.