What to watch at WHA 71
As is always the case with the approach of summer, the global health community is gearing up for another session of the World Health Assembly (WHA), which will be held in Geneva from May 21–26. WHA brings together the World Health Organization’s (WHO) 194 member states, civil society, and the United Nations system to review WHO’s progress against previous commitments and chart the course for the next 12 months. This 71st session of WHA will see a number of debates on topics affecting global health research and development (R&D).
13th General Program of Work
Perhaps most significantly, this year’s WHA will see the approval of the next General Program of Work (GPW 13), which will set WHO’s strategic objectives and activities for 2019–2023. Reflecting Director-General (DG) Dr. Tedros Adhanom Ghebreyesus’ first real opportunity to legislate a course change for WHO and put his stamp on the organization, the draft GPW 13 is framed around an ambitious “triple billion” set of targets, aiming to:
- Cover 1 billion more people with universal health care,
- Better protect 1 billion more people from health emergencies, and
- Ensure that 1 billion more people enjoy better health and well-being.
Encouragingly, the current draft of the GPW 13 includes a concrete cross-cutting workstream across these three broad targets to support R&D by strengthening coordination and collaboration, stepping up WHO’s normative work to encourage uptake of new innovations, and by using WHO’s convening authority to ensure best practices and the latest techniques to support R&D are shared across geographies.
The three ambitious targets will require significant additional investment by member states, as well as a significant reprioritization of WHO’s existing staff and resources—both of which are heavy political lifts for the DG and his team. The extent to which WHO succeeds in mobilizing additional resources will largely determine whether GPW 13 achieves its ambitious vision to fundamentally change the way WHO does business.
Access to Medicines
The debate on how WHO should engage in activities to address concerns around access to medicines continues unabated. The January Executive Board (EB) meeting saw intensely heated debate, with the Brazilian delegate challenging the United States representative by stating, “We have been debating this for five years. You say everything ‘poses implementation issues.”
To move past this stalemate, the EB ultimately recommended a compromise solution calling for WHO to undertake a strategic consultation and strategy development process over the course of 2018 and to present the resulting strategic roadmap to the EB in January 2019. Notably, the current draft resolution specifically calls out the need for WHO to consult with member states, but excludes mention of non-state actors in official relations with WHO. GHTC will work to ensure that the final resolution includes a provision for civil society to be consulted.
Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property
Following the spirited discussion at the EB meeting regarding the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property (GSPOA-IP) and the appropriate role of WHO in advancing policies around intellectual property for health products, the EB proposed a compromise resolution. It calls on member states and WHO to implement those recommendations from the Expert Review Panel that align with the existing elements of the Strategy and Plan of Action, while continuing to discuss those recommendations that fall outside the current scope.
Having led the charge for an expansive view of the GSPOA-IP mandate at the EB, Brazil will almost certainly take a very active role on this item at WHA as well. Much like the EB debate, the focus for WHA will be on the more aggressive recommendations proposed by the Expert Review Panel that some countries argue fall outside the scope of the original GSPOA-IP. Key recommendations include:
- The WHO Secretariat to identify mechanisms to increase health technology transfer in the context of the Technology Facilitation Mechanism established
by the Sustainable Development Goals
- The WHO Secretariat, in collaboration with other international organizations working in intellectual property, to advocate for the development of national
legislation to fully reflect the flexibilities provided in the Agreement on Trade-Related Aspects of Intellectual Property Rights and Public Health
and the Doha Declaration
- Member States to commit to dedicating at least 0.01 percent of their gross domestic product to basic and applied research relevant to the health needs
of developing countries
- Member States to encourage the implementation of schemes which partially or wholly delink product prices from research and development costs
As a result, this agenda item will likely require a drafting group to convene to litigate line-by-line language changes given the profound disagreement among member states on whether recommendations that fall outside of the GSPOA-IP’s current scope should be implemented or not. GHTC will follow these negotiations closely given that the recommendations currently viewed as out of scope include provisions on a percentage of GDP target funding level for R&D, initiatives on price transparency, and local R&D capacity building.