Member of the WHO Expert Working Group
2010年2月1日 | EN
I am writing in my personal capacity to correct several misunderstandings in the article published 19 January (see Harsh criticism for WHO's drug access ideas).
The Report of the WHO Expert Working Group on Innovative R&D Financing supports ten mechanisms to allocate funds to R&D for neglected diseases, dividing these into five recommended approaches for which there was more evidence (section 5.4); and five promising proposals, which had less evidence for broad efficacy but which "contained innovative elements that were so promising that we considered the proposals should be examined further with a view to their amendment if possible and review for implementation or integration of their high-performing elements into other proposals" (section 5.6).
In addition, the report recommends several fundraising approaches and two efficiency proposals.
Half of this shortlist of ten recommended and promising mechanisms are novel approaches including two types of prizes (both in the recommended approaches), as well as patent pools, open source drug development and the Health Impact Fund (all in promising approaches).
This is unsurprising given the rigour and fairness of the review process, which collected thousands of pages of documentation on proposals in circulation and subjected each to the same multi-disciplinary review against the same criteria.
I would also take task with the statement attributed to critics that, "criteria adopted for assessing proposals meant the solutions would inevitably be conventional". The criteria were developed through a public consultation which led to the proposal of many new criteria (which were included) and a greater emphasis on developing country IP and access.
As a result, developing country impact criteria were expanded and given a significantly higher weighting in the final evaluation than other criteria such as financial aspects. Readers may wish to compare the original list of 17 criteria on the WHO website with the final list in the report appendix (around 100 criteria divided into three categories), which accurately reflect the input from the public consultation.
The comment from MSF that, "if 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," is also wrong.
Several proposals favoured by industry were singled out as lowest-performing approaches, including industry tax breaks and patent extensions on industry products. The requirement for legal change made up only two of the around 100 criteria used; and was rightly included, as no sensible analysis could fail to take into account whether a proposal is compatible with existing systems and easy to implement or requires a new international architecture that may take years to implement.
It is disappointing to see articles and blogs based not on the correct information in the final Report but on obsolete leaked documents (the leaked documents were an early analysis that was later dropped in favour of a group-analysis methodology) and on a necessarily brief Executive Summary.
If readers look at the full report, they will see that much of the current criticism is simply wrong, and that the proposed balance of novel and existing approaches would double or triple funding available to public, private, developing country and Western groups who play a role in conducting badly needed R&D for diseases of the developing world.
I urge readers to read the actual report, and to make up their own minds based on the facts.