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WHO to tackle pandemic influenza, de-linkage, prizes, R&D financing and non-communicable diseases
18 มีนาคม 2554
Date: 18 March 2011
Source:www.keionline.org
Link: http://keionline.org/node/1097
April 2011 ushers in a busy period for the World Health
Organization. During the second week of April 2011, WHO will hold two
important events: 1) the first meeting of the Consultative expert working
group on research and development: financing and coordination (CEWG) [1] which
takes place in Geneva from 5-7 April 2011 and 2) a consultation with
industry on 6 April 2011 in Geneva convened by co-chairs, Ambassador
Bente Angell-Hansen (Norway) and Ambassador Juan Jose Gomez- Camacho (Mexico)
of the Open-Ended Working Group (OEWG) of Member States on Pandemic
Influenza Preparedness: Sharing of Influenza Viruses and Access to
Vaccines and Other Benefits . On 27 April 2011, WHO will host the WHO
Global Forum: Addressing the Challenge of
Noncommunicable Diseases [2] in Moscow, Russia. On 28-29 April 2011, WHO
and Russia will host the "First global ministerial conference
on healthy lifestyles and noncommunicable disease control [3]".
In contrast with the opaque Expert Working Group on R&D
Financing (EWG), a body shrouded in secrecy under the leadership of Dr.
George Alleyne, the Consultative Expert Working Group (CEWG) sets a model
for transparent norm-setting. The CEWG`s mandate is provided by
WHA resolution 63.28 passed in May 2010, Establishment of a
consultative expert working group on research and development: financing
and
coordination [4]. This resolution guiding the CEWG underscores
the importance of de-linkage and prizes by noting:
"Recognizing the need to further ?explore and, where
appropriate, promote a range of incentive schemes for research and
development including addressing, where appropriate, the de-linkage of the
costs of research and development and the price of health products,
for example through the award of prizes, with the objective of addressing diseases
which disproportionately affect developing countries?;
(Footnote 1, Resolution WHA61.21, Annex, Element 5,
paragraph 5.3a)."Resolution 63.28 instructs the CEWG to "review the
five promising proposals identified by the Expert Working Group in its
report; and ...further explore the six proposals that did not meet
the criteria applied by the Expert Working Group". Consequently, with
a clean slate, the CEWG will review the proposals of
Bangladesh, Barbados, Bolivia and Suriname on prizes and the R&D
Treaty.
The first meeting of the CEWG will hold an open session on Tuesday,
5 April 2011 from 9:30 AM to 3:30 PM open to all Member States and
other stakeholders. The registration form for the open session can be
found here: http://www.who.int/phi/news/cewg_2011/en/index.html [1].
On Wednesday, 6 April 2011, the CEWG will convene an Open Forum from 9
AM to 6PM in the WHO Executive Board Room; member states and
other interested stakeholders are invited to present their proposals
and submissions before the experts. This represents an
important opportunity for Member States, intergovernmental organizations,
civil society, academics and industry to present their
respective perspectives to the CEWG. The registration form for
potential presenters to the Open Forum is: http://www.who.int/phi/news/phi_cewg_appl_form_2011_en.pdf
[5]. Finally, on Thursday, 7 April 2011, the CEWG will host an
Open Briefing Session at 5:30 PM in Salle B at the conclusion of the
CEWG;. According to WHO, the Chair of the CEWG will brief member states
and interested stakeholders on the outcomes of the first CEWG meeting
and outline its future plan of work.
While the CEWG holds its Open Forum on 6 April 2011, the co-chairs of the
Open-Ended Working Group (OEWG) of Member States on Pandemic Influenza
Preparedness: Sharing of Influenza Viruses and Access to Vaccines and
Other Benefits will be sequestered in an industry consultation with Member
States in attendance. The 3rd meeting of the OEWG will take place from
11-15 April 2011. The background documents for the fourth meeting of the
OEWG can be found here: http://apps.who.int/gb/pip/e/E_Pip_oewg3.html [6]. The
first paper presents options for sustainable financing of benefit sharing
[7] in relation to pandemic influenza preparedness and the second paper is
the finalized McKinsey paper funded by the Gates Foundation entitled,
"Technical studies under Resolution WHA63.1 [8]".
The process section of the report states:
"Work to establish the terms of reference for studies, based on
the report of the Open-Ended Working Group (document A63/48),
began immediately after the Sixty-third World Health Assembly, in May
2010. The terms of reference were finalized and sent to Member States on
22 July 2010. Given the breadth of the areas under study and the
limited human and financial resources of the Organization to carry out
the full studies, the Secretariat sought external support. The Bill
& Melinda Gates Foundation provided support through a contract
with McKinsey & Company, which was selected on the basis of its
broad expertise in public health, financing, health economics and
influenza vaccines; its ability to start work on the project quickly; and
its global team.
On the basis of the report of the Working Group and the terms
of reference, the WHO Secretariat and the McKinsey team began to
develop the outline of the study in mid-August 2010. First, the parameters
of the study and the timetable for delivery were addressed, and, in
view of the broad scope of the studies, a phased approach was agreed,
so that preliminary findings could be shared at the meeting of
the Working Group in December 2010 and the full study would be
completed before the Sixty-fourth World Health Assembly." For more
information about KEI`s communication with WHO on this matter McKinsey`s
involvement in vaccines work, please consult: http://keionline.org/node/1084
[9].
On 27 April 2011, WHO will convene the WHO Global Forum: Addressing the
Challenge of Noncommunicable Diseases [2] in Moscow, Russia. As alluded to in
an earlier piece entitled, "Noncommunicable diseases in the 2011
global public health agenda [10]", the WHO Global Forum will serve as
testing ground for the WHO to phase in a multi-stakeholder global
governance model. As noted in my earlier piece, "although the details
of the Global Health Forum are still nebulous, certain informed observers
have noted the Forum is a response of the WHO
secretariat to the "Committee C" concept proposed in 2008 in
the Lancet by Gaudenz Silberschmidt (Switzerland), Don
Matheson (University of Otago),and Ilona Kickbusch (Graduate Institute
of International and Development Studies). As WHO is reeling from
an expected shortfall of $200 million to $600 million in the
2010-2011 budget, it is seeking creative ways of leveraging
unearmarked voluntary contributions from donor governments, foundations
and the private sector. Whether the Global Health Forum can bridge this
gap or be subject to "Trojan multilateralism" (Devi Sridhar,
Oxford Global Health Governance) remains to be seen." Certain
observers see the
Global Health Forum as Trojan mulilateralism to bypass the
governance structure of the World Health Assembly, the highest decision
making body of the WHO.
The concept note for the 2011 Global Forum states:
"The WHO Global Forum: Addressing the Challenge of
Noncommunicable Diseases will bring together a wide group of stakeholders
to share views and experiences to date on the challenges and opportunities
in
noncommunicable disease prevention, treatment and control. Forum participants
will identify and commit to priority actions to strengthen global action
to prevent and control noncommunicable diseases prior to and beyond the
HLM. The Forum provides an excellent opportunity to raise awareness of the September
2011 HLM on noncommunicable diseases, and to provide input into the
preparation for the HLM as well as discussions on
noncommunicable diseases at the sixty-fourth World Health Assembly in May
2011.
The objectives for the Forum are: Provide an opportunity for a wide range of
stakeholders to discuss and share perspectives on the prevention and
control of noncommunicable diseases (NCDs) Understand expectations, roles
and contributions of the different stakeholders in support of the
September 2011 UN High-level Meeting
(HLM) on NCDs and its expected outcomes, as well as activities post the
HLM.
Update knowledge and share experience on progress in addressing
NCDs including through implementing the Action Plan for the Global
Strategy for the Prevention and Control of NCDs. Promote ways of
accelerating the implementation of actions for international and national
partners under each objective of the Action Plan. Mobilize a broader base
of stakeholders in support of NCD prevention and control, in particular in
developing countries."
The expected deliverables of the Forum are:
- A short report that could be presented by one or more of the stakeholder
groups during the World Health Assembly in May 2011 to support Member
States` preparation for the HLM.
- Lessons learnt in organizing multi-stakeholder discussion forums.
- A statement to be delivered to the Moscow Ministerial Meeting representing
key perspectives from the stakeholders.
The last event on the WHO calendar for April is of course the
joint Russian/WHO "First global ministerial conference on healthy
lifestyles and noncommunicable disease control [3]" to be held in Moscow
on 28-29
April 2011.
This invitation only ministerial conference is expected to attract
300 participants with each Member State being allotted two slots (one for
the Minister and one for an additional member of the country delegation.
The conference website lays out the following aim and goals:
The aim of the conference is to "support Member States develop
and strengthen policies and programmes on healthy lifestyles and
NCD prevention. These efforts are based on the Global strategy for
the prevention and control of NCDs and its action plan, which
include multisectoral and innovative approaches in prevention and care.
"The conference has three main goals:
* to highlight the magnitude and socio-economic impact of NCDs;
* to review international experience on NCD prevention and control; and
* to provide evidence on the pressing need to strengthen global and
national initiatives to prevent NCDs".
The Moscow ministerial is predicated upon the WHO Global Strategy for the
Prevention and Control of Noncommunicable Diseases [11] endorsed at WHA 53
in May 2000 and the Action Plan passed at WHA 61 in May 2008. This Ministerial
is expected to lay the groundwork for the United Nations General Assembly
High-level Meeting on the Prevention and Control of Noncommunicable
Diseases on 19-20 September 2011.
Keywords: WHO / pandemic influenza / non-communicable diseases