Candidates from around the world vying to be the next director general of the World Health Organization in recent weeks have presented their views to member states on a range of public health issues. Two of the six candidates answered a question put to them by Intellectual Property Watch relating to medicines prices, innovation and intellectual property. Here are their answers.
The question by IP-Watch to candidates was: For a long time, WHO has worked without success on addressing alternative models of financing for R&D and more affordability/accessibility of medicines for poor populations. Recently, the issue has become a mainstream concern with high prices in developed countries too, while questions of incentivizing innovation come into play. What would be your vision of how to address this problem?
Statements by all six candidates to WHO member states were reported by Intellectual Property Watch here (IPW, WHO, 10 November 2016). Many of the candidates touched on this issue in their statements. Separately, two candidates, Miklós Szócska and David Nabarro, answered IP-Watch directly. Other candidates’ views will be reported as received.
Miklós Szócska of Hungary answered by email.
“It is fundamental to support and provide people in need worldwide to receive and to be supplied with the proper medication in the proper time and in the proper form on an affordable price based on their country economic performance,” he said. “This should be supported by collective risk sharing stated as one of my main visions by adapting and introducing new business models as well as elaborating new coordinative functions.
“Thus, there is a need to enhance the social responsibility of the pharmaceutical actors as well as acknowledging it by introducing new motivation systems,” he said.
“Furthermore,” Szócska said, “the improvement of efficiency of currently used medications is also essential according to recent research findings: inappropriate use of medication could lessen the effectiveness of the therapy. In other areas the outcome, performance based financing and motivation models should be used by realizing the aligned actions of patients, society, the social and health systems.”
In a separate press briefing during the 1-2 November hearings at WHO, David Nabarro gave a presentation on the suitability of his profile for the role as the WHO’s next director general and took questions ranging from the WHO’s response to Ebola, the high prices of medicines across the world, and humanitarian crises such as cholera in Haiti and the use of chemical weapons in Syria. Nabarro, from the UK, was also questioned on whether reform in the WHO required an outside fresh perspective and whether he feared that Brexit might impact his backing and political support by other member states.
On the subject of addressing alternative models for research and development and flexibilities on medicines for developing countries, which has also become a mainstream issue for developed countries, Nabarro said, “now there is an increasing focus on the value for money in health systems, particularly with ageing populations.”
Therefore, the question about prices that governments and insurance companies and individuals are charged for medicines, diagnostics and technologies becomes hugely important, said Nabarro, adding that this is where the WHO has a role to play, regarding medicines for hepatitis C or cancer in advanced nations or more broadly throughout the world.
In his opinion, the first requirement is price monitoring, an instrument which he said “the WHO has the legitimacy to advance.” Furthermore, this opens up the opportunity to discuss with the pharmaceutical industry the relationship between costs of production and of sales.
Looking back to Gro Harlem Brundtland’s time as WHO director general when HIV medicine prices were being discussed, price monitoring enabled dialogue on the possibilities to reduce prices, Nabarro said.
WHO’s normative work on essential drugs list and pre-qualifications and the strengthening of local regulatory capacity has had quite an important network of actors moving together towards a common purpose, he said. Therefore, he proposed to continue the notion of trying to establish essential medical care and look to price monitoring and discourse with manufacturers to bring down prices whilst upholding market shares.
Nebarro admitted to not up being as much up to speed as he would like to be, but having discussed with those who are working on these issues, he finds that the situation has changed in last 5 to 10 years. According to him, “there’s a willingness for governments to ask tougher questions about the different behaviours of the industry” and practices such as evergreening of patents.
In conclusion, in Nabarro’s view, firstly the techniques which have been used in the past that were primarily focused on developing countries have global significance and secondly, price monitoring and the identification of essential elements of care can inform the necessary dialogues which happen at national level. Therefore, shouldn’t the WHO be doing the same? he asked.
Image Credits: Flickr-Swiveler