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
Commitment Administrative Financial Decision-making Oversight Compliance
UN Charter [General Assembly] (1945) Convention International organization Membership organization Equal voting Expert review and civil societya Institutional consequences
UN Charter [Security Council] (1945) Convention International organization Membership organization Modified voting Expert review and civil societya Legal processes and economic sanctions
Constitution of the World Health Organization (1946) Convention International organization Membership organization Equal voting Expert review and civil societya Institutional consequences
Convention for the Establishment of a European Organization for Nuclear Research (CERN) (1953) Convention International organization Membership organization Equal voting Expert reviewa 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 pressurea
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 pressurea
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 societya Political pressurea
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 organizationa Coordinated management Equal voting Peer review, civil society and self-reports Political pressurea
WHO Framework Convention on Tobacco Control (2003) Convention International organization Membership organization and coordinated management Equal voting Self-reports Political pressurea
International Health Regulations (2005) Convention International organization Membership organization and coordinated management Equal voting Expert review and self-reports Political pressurea
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 reforma 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 societya Institutional consequences
Governing instrument for the Green Climate Fund (2010) Convention Sub-agency Specialized multilateral fund and financial institution Delegated Civil societya Political pressurea
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-reportsa Institutional Consequences
GAVI Alliance (2000) Contracta Joint venture Membership organization Delegated Expert reviewa and self-reports Political pressurea
Framework Document of the Global Fund to fight AIDS, Tuberculosis and Malaria (2002) Contracta Joint venture Financial institution Delegated Expert review Political pressurea
Memorandum of understanding concerning the hosting of the International Drug Purchase Facility [UNITAID] (2006) Contracta Joint venture Membership organization Delegated Civil societya Political pressurea
Global Alliance for Chronic Diseases (2009) Contracta Joint venture Coordinated management Consensusa Civil societya Political pressurea
Pneumococcal Advanced Market Commitment (2009) Contracta Joint venture Financial institution Delegateda Expert review Political pressurea
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 pressurea
Instrument for the establishment of the Restructured Global Environment Facility (1994) Declarationa Sub-agency Financial institution Delegated Expert reviewa and self-reportsa Political pressurea
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 pressurea
Roll Back Malaria Partnership operating framework (1998) Declarationa Joint venture Membership organization Delegated Expert reviewa Political pressurea
Basic framework for the Global Partnership to Stop TB (2001) Declarationa Joint venture Membership organization Delegated Civil societya Political pressurea
G8 Gleneagles Communiqué (2005) Declaration Self-organizing Coordinated management Not applicable Civil society Political pressurea
International Health Partnership and Related Initiatives (IHP+) (2007) Institutional reform International organizationa Membership organization and coordinated management Consensus Civil societya 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 reviewa Political pressure
UN Secretary-General’s Global Strategy for Women’s and Children’s Health [creating Every Woman Every Child movement] (2010) Institutional reforma Joint venture Coordinated management Delegateda Expert review and civil society Political pressurea

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.