DNDi's interventions:

Agenda item 16.2: Strengthening WHO preparedness for and response to health emergencies

DNDi welcomes the prioritization of equity as a strategic pillar within the WGPR. The lack of equity is at the core of the breakdown of the current response to COVID-19, in particular for incentivizing innovation and ensuring equitable access to essential health technologies.  

Therefore, we urge Member States to ensure that strengthening national, regional, and global research and development (R&D) coordination is a substantive element of any pandemic instrument and further recommend that Member States agree to: 

• Globally agreed norms, including transparency and open sharing of data, knowledge, IP, and technology and equitable allocation of health tools;  
• A governance architecture that ensures public leadership and greater parity between the global south and the global north;  
• Increased harnessing of and investments in surveillance, R&D, manufacturing, and regulatory capacity as part of broader efforts to strengthen health systems in low- and middle-income countries (LMICs); and 
• Sustainable and predictable financing of end-to-end R&D with clear priority given to open approaches and areas most likely to be neglected by the market. 

In order to strengthen clinical trials, we urge Member States to support: 

• Well-designed, well-powered, and comparable clinical trials to generate actionable evidence; 
• Investments in clinical trial platform infrastructure and human resources in LMICs between crises as well as during pandemics;  
• Inclusion of all health tools, not only vaccines, and all public health needs, not only pandemics; 
• Strengthening of transparent, publicly available information including protocols, data, trials, costs and use of standardised data formats; 
• Safeguard to ensure access to originator drugs for research use  
• Inclusion of historically excluded populations; and  
• Benefit-sharing principles to ensure sufficient access to end products for trial participants and broader communities.  

14.2 The global health sector strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections & 14.4 Road map for neglected tropical diseases 2021–2030

DNDi is concerned about the implications of not approving the GHSS, and urges Member States to adopt the draft in its current form in order for the WHO to continue its important work in this area. Significant challenges remain. We request that Member States take note of the following issues, approve the strategies, and actively engage in their implementation. 

• Hepatitis C:  Too few patients are diagnosed and treated, particularly in high burden countries, often still because of high prices. Actions to remove barriers to scaling up diagnosis and treatments are urgently needed.   
• HIV: Much more must be done to scale up access to optimized paediatric antiretroviral formulations and while we note with great enthusiasm the strengthened focus on advanced HIV disease, including cryptococcal meningitis, a major global effort is needed to ensure reliable and sustainable access to liposomal amphotericin B and other antifungals. 
• STIs: There is a need for greater surveillance, development of new tests and treatments, and robust strategies for appropriate use and stewardship.

The Director General’s two-year review of the Roadmap for Neglected Tropical Diseases 2021-2030 shows that the COVID-19 pandemic and related restrictions have significantly disrupted essential services and activities for neglected tropical diseases (NTDs). Concerted action is needed now to accelerate progress if the 2030 targets for eradication, elimination, and control of NTDs are to be reached. Research and development of new tools and integration into routine services will be key to achieving sustainable elimination goals.

Across all areas, progress can only be realized by political will and sustainable financing. We urge Member States to:

• Ensure that key treatment gaps are addressed, including for pregnant and breastfeeding people and for children.
• Leverage and expand national and regional capacity to develop and scale up new tools in the countries and communities most affected by NTDs.
• Promote cross-disease integration including mutualizing manufacturing needs across disease areas where feasible, pooling demand, and exploring common delivery and access mechanisms for health tools.