In September 2016, the United Nations Secretary General issued a report on its Panel on Access to Medicines. The Panel called for a “new deal to close the health innovation and access gap.”
According to a press release issued by the Panel, “the world must take bold new approaches to both health technology innovation and ensuring access so that all people can benefit from the medical advances that have dramatically improved the lives of millions around the world in the last century.” The Panel was convened by the UN Secretary-General to propose solutions for addressing the incoherencies between international human rights, trade, intellectual property rights, and public health objectives.
Recommendations
The panel suggested that governments should initially form a working group to begin negotiating a Code of Principles for Biomedical R&D, and report annually on their progress in negotiating and implementing the Code in preparation for negotiating the Convention.
Transparency was a recurring theme throughout the report. The Panel repeatedly raised concerns regarding the negative impact of insufficient transparency on both health technology innovation and access, and was highly critical of the lack of transparency surrounding bilateral free trade and investment negotiations. The Panel believes transparence is a core component of robust and effective accountability frameworks needed to hold all stakeholders responsible for the impact of their actions on innovation and access.
The panel also recommended the UN General Assembly convene a Special Session no later than 2018 on health technology innovation and access to agree on strategies to and an accountability framework that will accelerate efforts toward promoting innovation and ensuring access in line with the 2030 Agenda for Sustainable Development.
These recommendations come at the end of a ten-month process for the Panel under the leadership of Ruth Dreifuss, the former President of the Swiss Confederation and Festus Mogae, the former President of the Republic of Botswana.
According to President Ruth Dreifuss, “Policy incoherencies arise when legitimate economic, social and political interests and priorities are misaligned or in conflict with the right to health. On the one hand, governments seek the economic benefits of increased trade. On the other, the imperative to respect patents on health technologies could, in certain circumstances, create obstacles to the public health objectives and the right to health.”
Reactions to the Report
PhRMA
In a statement released September 14, Stephen J. Ubl, President and CEO of Pharmaceutical Research and Manufacturers of America (PhRMA), noted, “The UN High Level Panel (HLP) on Access to Medicines was a missed opportunity to address the wide array of barriers to access that far too many people face every day.”
Ubl continued, noting “the ability of patients to obtain quality care depends on many factors – including health care infrastructure, government policies, adequacy of funding, the presence of trained health care providers, health literacy and stigma. Addressing these barriers, in the pursuit of universal health coverage, requires collaborative efforts and creative solutions which are workable in the long term and practically implementable.”
PhRMA wishes the report focusesd more on providing the opportunity for an “informed, balanced, and inclusive dialogue” that could have made a difference in the lives of patients without adequate access to treatments for the aforementioned, and other, reasons. Instead, the Panel’s report acknowledges its limitations in its mandate and unable to look at all factors. As such, the report focuses narrowly on solutions which fail to recognize and address the complexity of biopharmaceutical research and development and the significant work already taking place to advance access to care.
In sum, Ubl closes out by strongly stating, “Neither this report nor its recommendations can be a sound basis for further consideration or action by the UN system.”
EFPIA
The European Federation of Pharmaceutical Industries and Associations (EFPIA) agreed, at least in part, with PhRMA’s reaction to the report. While EFPIA “concurs with the report’s positive assessment of the pace of rapid scientific progress and its subsequent observation that many patients around the world still do not have access to these innovative and life-saving medicines, but the report fails to address key issues such as healthcare infrastructure and capacity.”
According to EFPIA Director General Richard Bergstrom, “For EFPIA and its member companies, access remains a priority, and with this in mind, we reiterate our commitment to partnering and finding solutions that aim to bring better healthcare.” However, he concluded his statement by saying, “We regret that the limited focus of the HLP report fails to move us forward on these key issues.”
United States
The United States also released a statement on the report through the Under Secretary for Public Diplomacy and Public Affairs of the State Department. That statement notes deep disappointment with the report, “which detracts from, rather than advance” critical objectives of increasing safe, effective, affordable, and life-saving medicines around the world, and to support policies that drive development of new medicines.
The United States believes that the narrowly-focused mandate was flawed and unlikely to lead to outcomes that adequately address the complex issue of access to care. The report stated the belief that we can both increase access to medicines and support innovation for the development of new and improved drugs for the world’s most critical health challenges. There can be no access to drugs that have not been developed: support for innovation is essential.
According to the statement, the United States Government “remains committed to advancing access to existing and new medicines, including by supporting innovation through robust intellectual property protections and working with public and private partners to find new solutions to the world’s pressing public health challenges.”
Doctors Without Borders
One of the few organizations that seems to agree with the UN report is Doctors Without Borders. Rohit Malpani, director of policy and analysis for Doctors Without Borders’ access campaign, stated,
[The report] puts forth actionable recommendations to help overcome the challenges that our medical teams have faced for decades – being left essentially empty-handed when the medicines, vaccines and diagnostics we need for our patients don’t exist, or are too expensive. [Its] global scope recognizes that today all countries face challenges in ensuring availability and affordable access to the medical tools that people need to live healthy and productive lives.
Additional Information
For a Fact Sheet issued by the UN Panel, click here.
For a letter issued by the Panel’s Co-Chairs, click here.