The WHO diplomatic process on essential health research and development (R&D), which has led to the Inter-governmental Working Group on Public Health, Innovation, and Intellectual Property Rights (IGWG) in 2006, has been a major breakthrough for public health that will benefit many millions of people for decades to come. It is perhaps the most important initiative on pharmaceuticals pursued by WHO since the Essential Drugs List was conceived 30 years ago, which stipulates that "Research and development of developed countries should better reflect the health needs of developing countries".
Eight key elements of the strategy adopted by governments in May 2008 include: providing an assessment of health needs in developing countries and prioritising R&D; implementing possible incentive schemes for R&D; improving R&D capacity in developing countries; boosting technology transfer; improving delivery and access to all health products; and promoting sustainable R&D financing mechanisms.
The weight of this process has clearly been the harvest of the increased commitment shown by governments and particularly by several emerging and low income countries. On the longer term, the development of innovative capacity for health research in developing countries will be the most important determinant of their ability to address their own need for appropriate healthcare technologies.
The importance of this discussion lies also in the process involving government participation in identifying a framework, and the identification of long-term solutions for innovation and access. Huge progress was made in identifying new ways, incentives, and mechanisms to stimulate essential health innovation moving away from the often polarised debate of the past. Margaret Chan, WHO Director-General, in her closing remarks at the 61st World Health Assembly (WHA) that took place in Geneva in May of 2008, called the outcome on IP and innovation a "huge step forward." With it, she said, "public health leaps ahead in addressing two fundamental and long-standing needs: to improve access to existing interventions, and to include diseases of the poor in the drive to develop new products." Furthermore, "some important steps in the right direction have been made," said Tido von Schoen-Angerer, director of MSF, Access to Essential Medicine Campaign. He called for "serious steps to move forward with a set of practical proposals that are on the table".
DNDi has given its full support to the IGWG process. The interest shown towards IGWG has encouragingly spread among PDPs, and a joint letter to delegates was circulated in April 2008, highlighting the need for technology transfer initiatives; the active role of disease endemic countries; and the relevance of a public, health-driven IP management. During the negotiation DNDi has tried to convey experience-based analysis on the challenges confronting researchers in the field of neglected diseases. Governments can do much to change the current landscape, ensure international cooperation between public and private actors, and mobilise tremendous resources for medical research and development.
Portions of the plan of action will be worked out in the coming year, including a progress indicator and cost of the plan of action, to be later submitted to the Executive Board at the 62nd Health Assembly in May 2009.