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Shaping a new R&D agenda

What’s behind all this is that medical innovation is driven by the health problems of the rich and all but ignores the medical needs of the poor.  It’s a system that is extremely costly, too: pharmaceutical companies doing the research recoup their investments by charging high prices for the products they develop – they can keep these prices high thanks to patent-protected monopolies.  And this means that those who cannot afford to pay must go without.
The problems with today’s medical innovation system led over 280 scientists from 50 countries, including five Nobel Prize winners, to write to the World Health Organization in January 2006 to push for the development of an alternative framework for medical R&D.
They noted: ‘At a time of huge progress in basic research science, and more money being spent on biomedical R&D than ever, we are deeply concerned about the ability of existing mechanisms to translate this into a global improvement in public health . . . We see research activities increasingly complicated by legal restrictions, such as intellectual property rights, which can interfere with free data exchange and can limit biomedical research progress. We do not see a good balance between medical need and resource allocation in the existing system to support R&D.’
Conclusive evidence of a broken system of innovation
In April 2006, the WHO Commission on Intellectual Property, Innovation, and Public Health (CIPIH) released a report, confirming the trend that medical innovation has declined in quantity and quality in recent years. It also stated that there was no evidence that granting pharmaceutical patents in developing countries was boosting innovation for diseases mainly affecting people in these countries.
The report was groundbreaking in that it concluded that the problems of access to medicines and medical innovation need to be addressed together. The Commission proposed that alternative mechanisms should be found to encourage R&D that responds to the health needs of developing countries, and ensures that this leads to affordable and technologically appropriate medical tools for prevention, diagnosis and treatment.
A plan of action
Two years of multilateral negotiations later, WHO member states adopted a Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property, in which they committed to explore new mechanisms, like patent pools, R&D treaties, or prize funds - that separate the costs of research and development from the price of the final product and drive R&D towards priority health needs. In this way they should not only ensure that the neglected health needs are met, but that any new medicines, diagnostics and vaccines are developed with an affordable price tag included in the development brief right from the very start. 
Of course, much depends on how the Strategy will be implemented in the years ahead.  But the document represents an historic achievement, as WHO and its member states agreed to address the problems of access to medicines and medical innovation and come up with new ways of stimulating drug development. 
Expert working group
A key outcome of the Global Strategy adopted by the member states of the WHO in 2008 was to set up an expert working group that would look at the current financing and coordination of R&D and examine proposals for new and innovative sources of financing, to stimulate research and development into the diseases that hit people in developing countries hardest.
Following a false start, the WHO, on request of the member states, set up a Consultative Expert Working Group on R&D financing and coordination in 2010. This group is made up of health experts from around the world and is taking forward the task of examining mechanisms for R&D. MSF has participated in hearings organised by this working group and along with several other NGOs has submitted a proposal asking the group to examine the need for an essential health and biomedical R&D treaty. 
Last updated: July 2011
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