Public Health Innovation and Intellectual Property: A Regional Perspective

On Tuesday September 30th, Pan-American health stakeholders participated in a meeting hosted by the Creative & Innovative Economy Center (CIEC) and the National Hispanic Medical Association (NHMA) to discuss the issues of public health, innovation and intellectual property.
Attendees encouraged delegates from the Pan-American Health Organization, who were also in Washington D.C. for their annual assembly, to support measures that maintain intellectual property rights and encourage innovation while improving access to medicines.

The following is an overview of the discussion and key stakeholder concerns:

IGWG Update

At the end of May 2008, the World Health Assembly adopted the World Health Organization’s Intergovernmental Working Group’s proposed strategy to improve access to medicines in developed countries.
Thirteen action points remain unresolved and will be clarified by the WHO Secretariat and presented to the WHO Executive Body in January 2009 for approval by the May 2009 World Health Assembly (WHA).
Leading up to the Executive Board meeting, an expert working group will be formed in Geneva to focus on the financing mechanisms to enrich R&D specific to neglected diseases. The group will be formed in October, and will meet once.
A quick start program will be launched soon and will focus on identifying the gaps that exist in R&D today. The program will look also consider the role of traditional medicines and methods of building regulatory capacity.

The role of the Pan-American Health Organization (PAHO)

The regions are now looking at how to implement the WHO plan. PAHO will be discussing a draft resolution at their annual assembly, which will form the basis of what will be implemented regionally.
There appear to be clauses in the regional plan that stray from the international agreements reached in Geneva.
Some clauses would put one regional group in the position of deciding the focus for R&D efforts and what information relative to trade/IP rights would be disseminated.

Stakeholder concerns

In the proposed plan, insufficient attention is paid to many factors that undermine public health, such as poverty, gaps in infrastructure, personnel shortages, unsafe or unreliable formulations, and low health literacy.
Too much emphasis is placed on the role of intellectual property rights on drug development and access in developing countries. The reality in today’s developing countries is that most of the 319 drugs on the WHO’s list of essential medicines are not under patent.
Potentially pits persons with acute and primary health care needs against persons with chronic health care needs.
The proposed plan was developed without the consultation or involvement of any patient organizations whose constituents represent the beneficiaries of the plan. It is important that the contributions of all stakeholders be taken into account in order to develop an effective and sustainable strategy to meet the health needs of developing countries.

Points of Consensus and Recommended Actions

A strong IP system is important for the development of future drugs. Market forces and humanitarian needs must be balanced.
In most of Latin America and the Caribbean, most essential medicines are no longer protected by patents. However, a good distribution system in many of those countries is lacking.
Fundamental barriers to health should be addressed as a priority, such as the lack of adequate health infrastructure, lack of clean drinking water, and the lack of physicians and health care workers.
- The WHO has stated that 25% of all diseases in Africa would be eliminated y ensuring that everyone has access to clean water. It would be prudent to begin tackling these fundamental problems if the developed world truly wants to help those living in developing countries.
- Poverty and socio-economic factors are common among the Hispanic communities. All face barriers to health care which result in lower health status and early death.
It is important to develop and fund programs that support healthy lifestyles, which are necessary for preventing chronic diseases.
Building local partnerships within the communities is a good first step so that they can own the initiatives and take control of them.

Opportunities for Stakeholder Engagement

The WHO Executive Board will be meeting in January. Health stakeholders are encouraged to try to attend, or at least to share their opinions with their country delegate.
Engage and meet with country PAHO/WHO delegates to raise their awareness of the need to ensure a strong environment for medical innovation.