Six NGOs, including Knowledge Ecology International
(KEI), Medecins Sans Frontieres
(MSF), Oxfam, Third World Network (TWN), Universities Allied for Essential
Medicines (UAEM), and Young Professionals Chronic Disease Network
(YP-CDN), recently submitted recommendations to Member States to control
non-communicable diseases (NCDs) in low- and middle-income countries in advance
of the Moscow Ministerial conference.
Ensuring a supply of affordable, appropriate and good quality medicines,
vaccines and diagnostics to persons suffering from NCDs in low- and
middle-income countries is critical in addressing treatment. The current lack
of supply results from numerous factors including the demands of high-income
countries to include data exclusivity provisions in free
trade agreements even for off-patent
medicines and the insufficient research and development to adapt NCD health technologies to low
resource settings.
A PDF of the joint statement with logos of the groups is available here: http://keionline.org/sites/default/files/ncd-6healthngos-moscow.pdf
The text of the joint statement follows:
Ensuring a steady supply of affordable, appropriate and good quality medicines,
vaccines and diagnostics via the public and private sectors to people in low-
and middle-income countries (LMIC) is a critical component of
the international response to Non-Communicable Diseases (NCDs). The Moscow
Ministerial conference provides a valuable opportunity to highlight issues of
access to medicines and health-related technologies, which is a critical but
under-discussed issue in the lead-up to the United
Nations High-Level Meeting on NCDs.
The World Health Organisation/Health Action International Project on Medicine
Prices and Availability has documented the limited availability and
affordability of NCD medications in both the private and public sectors.1,
Even for medicines that are off-patent, generic production is increasingly
threatened due to demands by high income countries to include data exclusivity
in free trade agreements2. Of great concern is the insufficient
research and development being carried out to
adapt NCD health technologies to low resource settings. Drawing on the lessons
from the struggle to increase the availability of medicines for infectious diseases such as HIV/AIDS, our coalition of civil society leaders with historical and contemporary
leadership in the access to medicines movement call on WHO Member States to
adopt the following recommendations in the context of NCDs:
1. Safeguard generic production: Member states should ensure equitable
and affordable access to essential health technologies for NCDs and support
generic production as the most effective method to lower prices. Member States
should make use of flexibilities enshrined in the Agreement on Trade Related
Aspects of Intellectual Property Rights (TRIPS)
and affirmed by the Doha Declaration on TRIPS and
Public Health to ensure generic production and refrain from promoting or
adopting TRIPS-plus measures such as data exclusivity that could limit the affordability
even for off-patent medicines. Furthermore, Member states must ensure that all
medicines are affordable and available to all. In this regard, and in addition
to all other steps taken to make medicines affordable, governments that fund
medical R&D should ensure that health-related technologies developed
through publicly subsidized research are affordable and available from
competitive generic suppliers in LMICs in accordance with the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property.
2. Incentivize research and innovation: Member states should explore and
promote a range of incentive schemes for the research and development of
medicines for non-communicable diseases as promoted by the WHO Global
Strategy and Plan of
Action on Public Health, Innovation and Intellectual
Property. In particular, member states should:
adopt strategies which (i) de-linke the costs of medicines and health related
technologies from the
cost of research and development, (ii) apply the concept of prizes as one form
of incentive mechanism for innovation in cancer treatments and (iii) provide
funding for the feasibility studies for cancer prize funds in
developed and developing countries.
3. Support quality assurance:
Member states should ensure that all health technologies including those
addressing NCDs are quality assured. In addition to strengthening national
medicine regulatory agencies, exporting countries must ensure that medicinal products produced in and exported from their
territory meet WHO quality standards. Procurement agencies, distributors and
purchasers, as the main actors purchasing medicines on behalf of developing
countries, should be certified by a centralised neutral body, potentially
hosted by WHO on the basis of existing WHO standards. All donors should set a
clear quality assurance policy in accordance with
the WHO.
1 http://www.who.int/medicines/areas/access/Medicine_Prices_and_Availability/en/index.html
2 Kesselheim AS, Solomon DH. Incentives for drug development--the curious case
of colchicine. N Engl J Med. 2010; 362(22): 2045-7.
The Moscow Ministerial will take place on 28-29 April 2011 and the UN High
Level Meeting of the General Assembly on the prevention and control of NCDs
will occur on 19-20 September 2011. Sandeep
(Sunny) Kishore from UAEM will be in Moscow to present these recommendations.
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