Opening remarks at the second session of the Intergovernmental Working Group on Public Health, Innovation and Intellectual Property
Dr Margaret Chan
Director-General of the World Health Organization
Mr Oldham, our chairman, distinguished delegates, ladies and gentlemen,
First and foremost, let me extend a warm welcome to you at the start of this second session of the Intergovernmental Working Group on Public Health, Innovation and Intellectual Property.
The resolution on this matter, adopted by the May Health Assembly, acknowledged my commitment and encouraged me to guide the process forward in some specific ways. Let me assure you: my commitment has not and will not waver.
Public health cannot move forward without innovation. I am fully aware that for some diseases that disproportionately affect the poor, we will not see breakthrough progress until we have better tools. Many diseases of the poor do not have good therapeutic drugs, or the prices are out of reach. Or diagnostic tools are outdated or too complicated for point-of-care use close to people’s homes.
The need for innovation is constant. Resistance develops and drugs fail, creating an urgent need for second- and third-line medicines. We have seen this problem most acutely with HIV/AIDS. We are seeing it again with the spread of extensively drug-resistant tuberculosis, which is far more costly and difficult to treat. For some diseases, we know our greatest hope rests with the development of vaccines.
Equitable access is important
My commitment has a firm foundation. I am fully committed to equitable access. People should not be denied access to life-saving and health-promoting interventions for unfair reasons.
I am aware that the price of medicines and other products can be prohibitive, effectively blocking access to care. I have seen studies that show the limit, in dollars, to what people are able pay to preserve even something as vital as their eyesight.
The status of health on the international agenda has been raised precisely because of the power of better health to reduce poverty. When this is our objective, we cannot allow the costs of health care to drive impoverished households even deeper into poverty.
The rise of chronic diseases, which now impose their greatest burden on low- and middle-income countries, makes the need for effective and affordable medicines all the more critical. When people need to take medicines for a lifetime, the costs increase enormously for households, health services, and government budgets.
I am aware that the price of medicines is one of several factors that influence equitable access. My commitment to equitable access underpins the priority I have given to health systems, and in particular to the capacity of health systems to deliver essential care to those in greatest need. This commitment is behind my call for a return to the values, principles, and approaches of primary health care. I should also say: my commitment to the issues before this Working Group is made with wide-open eyes. I am aware of the enormous complexity of the issues. Your negotiations are not easy. But I believe your principal concerns rest squarely in the domain of public health.
Fairness a concern of public health
You are concerned about appropriate funding and incentive mechanisms for the creation of new and affordable medicines and other products for diseases that disproportionately affect developing countries. You are working to secure an enhanced and sustainable basis for needs-driven, essential health research and development relevant to diseases that – again – disproportionately affect developing countries.
In essence, you are concerned about fairness, and fairness has long been a concern of public health.
The challenge is to work on multiple fronts: to meet the immediate need for equitable access to quality, affordable medicines, while also, at the same time, working to stimulate innovation.
Here is one problem. The route to addressing these concerns passes through many other territories, including those where legal, economic, and trade issues have prominence. This is the reality.
Here is another problem. Given the significance of issues before this working group, many see a need to move forward carefully. At the same time, a need is expressed to harness, effectively and urgently, opportunities to develop new and affordable health products. Potential areas for early implementation are being explored. Again, the issues before you are challenging.
Support from WHO Secretariat
Let me turn, briefly, to areas where support from the WHO Secretariat was explicitly requested.
As requested, the Secretariat issued a draft global strategy and plan of action on 31 July. This draft takes on board discussions during the first session of the Working Group and submissions subsequently received.
Member States asked WHO to expand the pool of invited experts and concerned public and private entities. Member States also wanted assurance of balanced representation in terms of geographical region, gender, and the development status of countries. We have done so. Member States asked WHO to fast-track NGO accreditation to allow their participation in this Intergovernmental Working Group. We have done so.
Regional and intercountry consultations, organized with support from the WHO regional offices, took place in August, September, and October of this year. Participants reviewed the draft global strategy and plan of action, and the reports of these consultations were made available on the WHO web site.
WHO Regional Committees, which also took place in August, September, and October, discussed the progress of the Working Group. In several instances, the Committees were able to consider the outcomes of the regional consultations.
A two-part web-based public hearing was held from 15 August to 30 September. Among other matters, this hearing responded to the specific request to encourage proposals for research and development, including incentive mechanisms that address the link between R&D costs and the price of resulting products.
Ladies and gentlemen,
I hope these activities, aimed at transparency, inclusion, and broad consensus-building, facilitate your work over the coming days.
I want to thank all of you for your contributions, from industry and civil society to the Bureau, the participants in various consultations, and the tireless work of our chairman. I thank Member States, NGOs, academic institutions, and subregional and regional organizations. I also want to acknowledge the initiative of the government of the Netherlands and the OECD in setting up the high-level forum, which resulted in the Noordwijk Medicines Agenda.
Rest assured that I and my staff are here to support you in any way possible. Rest assured, too, that we stand ready to take your recommendations and conclusions forward, within our mandate and competencies.
With these words as a greeting, background, and an expression of deep personal commitment and appreciation, I want to wish you a most productive and successful meeting.