WHO Director-General addresses meeting on the financing and coordination of R&D
Dr Margaret Chan
Director-General of the World Health Organization
Honourable ministers, ambassadors, distinguished delegates, ladies and gentlemen,
This open-ended meeting has been convened, at your request, to thoroughly analyze the report of the Consultative Expert Working Group on Research and Development: Financing and Coordination. You are asked, in particular, to assess the feasibility of recommendations proposed in that report.
I want to warmly thank the Chair, Vice-Chair, and members of the CEWG for the massive amount of work that went into the preparation of this report. I thank them for their wisdom, their rigour, their balance, and the very open and transparent way in which they analysed proposals and formulated recommendations.
I thank them, too, for their obvious public health bias. Throughout the report, it is clear that members of the CEWG care deeply about the lives of people excluded from the benefits of R&D. I share that deep concern.
Your work benefits from national consultations and consultations organized by the WHO Regional Offices. This meeting also has broad support outside WHO in the form of great interest on the part of civil society, by the authors of recent articles and editorials in medical journals, and by additional meetings of experts convened to explore the recommended options for implementation.
Many welcome this initiative as long overdue and view its outcomes as potentially transformational for public health.
You have been given a broad range of recommendations and options to consider in the three broad areas of monitoring R&D flows, the coordination of R&D, and financing mechanisms. The three areas are interlinked. We need all three.
We need money, of course. But we need to know where money is currently being spent. And we need coordination to guide the smart investment of that money.
Only in this way can we know, for example, whether better diagnostics or better medicines are the top priority for a particular disease, and then invest resources accordingly.
Specific recommendations that you will be considering range from establishing an R&D observatory, to setting up a funding instrument that pools funds at the international level, to the start of negotiations on a global framework or convention.
You have before you hard-law options, and soft-law options. Let me remind you. Hard-law agreements, like conventions and treaties, are no guarantee that money will follow, especially if compliance mechanisms are weak.
Soft-law agreements, like political declarations and codes of practice, will go nowhere without an assurance of adequate and sustainable financing. It all boils down to political will.
For example, one proposal is to establish a global advisory body to facilitate agreement on priorities. But the impact of that body depends on the willingness to act on the priorities it identifies.
If political will and determination are present, workable solutions can be crafted. It is high time to do so.
Ladies and gentlemen,
In the broadest sense, the work of the CEWG and several other previous initiatives responds to flaws in the current R&D regime of incentives and rewards.
This is a regime driven by the market’s purchasing power and dependent on patents and patent protection for the financing of innovation. This is a system biased towards investment in commercially rewarding innovation.
The diseases that disproportionately affect the poor will never get a fair share of investment. The market may actually be huge, but demand fails because of limited or no purchasing power.
Other problems also arise when priorities follow the money. For example, the world is running out of antibiotics, a loss that hurts rich and poor countries alike. But antibiotics are not nearly as lucrative as treatments for chronic conditions.
To compensate for this bias towards commercially rewarding innovation, you will be assessing mechanisms, strategies, and instruments that can create incentives to invest in R&D for less profitable products, ensure an R&D agenda that is driven by needs, and delink the costs of R&D from the price of products.
We need creative and workable new approaches, and we also need new money. On financing proposals, the CEWG has narrowed down the options through evidence pointing out certain proposals that are unlikely to raise sufficient funds or unlikely to do so sustainably. Your further analysis of feasibility will be especially important in this area.
As I conclude, let me mention one point where I believe we can all agree at the outset: this is not an easy job you have before you.
The preface to the CEWG report notes that the issue under investigation was identified at least two decades ago. As further stated, the report seeks to bring this long-running debate, if not to a close, to a head.
I join many others in expressing my full support for a meeting that can help close the debate through fair, far-sighted, and workable solutions.
In doing so, you will transform the prospects for better health for many millions of people. The poor deserve the best medical care because they have been given so little else in life.