MSF Intervention at Member States follow-up meeting on CEWG, November 2012

Dr Manica Balasegaram, Médecins Sans Frontières International
Government representatives are gathering for the next 3 days at the WHO in Geneva to decide how to take forward the recommendations of the report of the Consultative Expert Working Group on R&D Financing and Coordination, including the call for an R&D Convention. MSF was given the opportunity to speak during the opening plenary of this otherwise closed meeting.  
The open-ended Member States meeting on the follow up of the report of the Consultative Expert Working Group (CEWG) on Research and Development Financing and Coordination, November 26-28th 2012
After ten years of debates and discussions and the publication of numerous expert reports, the imperative is clear for Member States to take concrete action and spur biomedical innovation in areas neglected by the current innovation system.  It is the responsibility of all governments to ensure the health needs of their populations are met. We cannot afford any further delay.
Three deadly failures must urgently be addressed.
First, suitable diagnostics, vaccines and drugs for many diseases are unavailable; there are no appropriate diagnostics or drugs for children with TB for example. A number of previously treatable diseases are becoming far more difficult to treat because of antibiotic resistance. The development of new antibiotics has been neglected, and commercial incentives are insufficient to encourage R&D.
Second, what is available is too often poorly adapted to the areas of greatest need. The suitability of products should be considered at the very beginning of product development. A recent MSF study in Niger found that the most common rotavirus genotypes documented there are not included in the two existing vaccines that aim to prevent the disease. Where tools are designed primarily for industrialized countries, the specific needs of those in developing countries are too often an afterthought.
The third aspect of this failure concerns access to the fruits of medical innovation. Even when there is enough of a profit incentive to drive medical innovation, the resulting products are too often priced out of reach. New drugs to treat HIV or cancer can cost hundreds of times more than a person’s average annual income.
Progress has been made over the last decade, but it is far from adequate. Without significantly strengthening public leadership and public funding we will be left with only a piecemeal response.
Steps must be taken urgently to operationalize key recommendations in the CEWG report. This includes:
- establishing mechanisms for setting needs & priorities for R&D;
- monitoring R&D flows and coordinating R&D efforts;
- securing sustainable financing;
-  and establishing a R&D Convention to provide a framework that allows these different elements to be integrated. These issues are all interrelated if only one element is addressed, the rest will not follow. Unless funding follows priorities for example, coordination cannot be achieved.
Today you have an unprecedented opportunity to address the weaknesses in the innovation system and ensure that R&D responds to medical needs, and that people can access the fruits of this innovation. We urge you to work towards a binding convention for needs-driven R&D. This should start by focusing on the objectives, principles, scope and functions of this framework.  In parallel, projects to implement the R&D proposals recommended in the report should be taken forward in the short to medium term to address the urgency of the situation.
We need leadership and collective action from Member States, and from WHO.
Page updated: 26 November 2012
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Lives on the edge - patient needs are not driving medical research and development, and the result is millions of lives on the edge.