Harsh criticism for WHO's drug access ideas

A controversial WHO report on improving developing countries' access to drugs and other medical products is under consideration by the organisation's executive board this week.

The WHO's Expert Working Group on Research and Development Financing examined funding for medical research and development (R&D) and also considered proposals for new and innovative funding sources to stimulate R&D for diseases that disproportionately affect developing countries.

But its report, made public last week (15 January), has been harshly criticised by nongovernmental organisations and some researchers for lacking originality and failing to support ideas that disrupt the status quo.

The report shortlists three financing mechanisms: raising funds by taxes; voluntary donations by business or consumers; and attracting new donors.

It also selects the five best proposals for allocating funding along with two 'efficiencies' to reduce development costs.

Mary Moran, director of health policy at the Australia-based George Institute, who led the group, said that the report has progressed the aim of getting medical products to people in developing countries.

But those campaigning for a major shift in thinking say the report has all but ignored more radical solutions such as patent pools.

UNITAID launched a patent pool for anti-AIDS drugs last month (14 December) (see BioMed Analysis: Pooling patents for HIV drugs). Yet the pools receive just one sentence in the 19-page executive summary.

"This omission is hardly understandable in the face of unquestionable public health needs," said Daniele Dionisio, director of the infectious diseases division at Pistoia Hospital in Italy and advisor to the Italian Society of Infectious and Tropical Diseases on availability of drugs in developing countries.

"The report avoids analysis of models that are felt to be a threat to the drug industry's interests."

Others said the criteria adopted for assessing proposals meant the solutions would inevitably be conventional.

"If it is a proposal that is liked by industry then it gets higher points but if it something that needs any kind of legal changes it gets fewer points," said Tido von Schoen-Angerer, director of the Campaign for Access to Essential Medicines, at Médecins Sans Frontières.

But Moran told SciDev.Net that the group had reduced a list of 90 options to a just a handful.

"You have a shortlist, you have to focus right down on to these: that's where you're going to get bang for buck and it identifies which bits do and don't work … that's a really good step forward," she said.

"We tried to find a balance that would not just work for one sector but try to capture innovation in all the different sectors."

She highlighted a passage in the report saying innovative mechanisms are "so promising we believe they should be further examined with a view to either amendment if possible and review for implementation, or integration of their high performing elements into other proposals".

The group attracted controversy last month when an early analysis of the proposals was leaked to the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), which has declined to comment on the final report.

The report will be discussed at the World Health Assembly in May.

Link to executive summary of the working group report

Link to the full report

See Letter to the editor.