[A2k] The WHO EB debate over membership of the new R&D Financing consultative expert working group (CEWG)

Thiru Balasubramaniam thiru at keionline.org
Mon Jan 17 23:07:05 PST 2011


http://keionline.org/node/1056

The WHO EB debate over membership of the new R&D Financing  
consultative expert working group (CEWG)
By James Love
Created 18 Jan 2011 - 1:46am
At the end of the day on Monday, the 128 WHO Executive Board meeting  
took the agenda item for creation of a new R&D Financing consultative  
expert working group (CEWG). (Yesterday's blog on this topic is here  
[1])

At the beginning of the debate of the membership of the CEWG, the  
Assistant Director General, Marie-Paule Kieny announced that she was  
modifying the list to eliminate the Sri Lankan expert, to be replaced  
by an expert from India. When the member states had the opportunity to  
intervene, Brazil asked the Secretariat for additional details on the  
names of the persons not selected for the CEWG, as well as for  
background materials on the experts, including, for example, the CV's  
of the experts. Bangladesh echoed Brazil's concerns. Thailand  
diplomatically raised an objection to the inclusion of Paul Herrling,  
the Novartis executive recommended for the CEWG by Switzerland.  
Thailand indicated that Herrling had an impressive resume, but they  
thought persons from the pharmaceutical industry would have a conflict  
of interest and gently suggested that Herrling could best serve by  
providing advice and expertise to the CEWG during its deliberations,  
rather than being a member of the CEWG itself.

Herrling's nomination was then defended aggressively by Dr. Chan, the  
WHO Director General.   Chan began by basically attacking Thailand for  
raising the issue, said that the WHO often has persons from industry  
on WHO advisory boards, and that everyone has conflicts. She did not  
mention that Herrling was the author of the proposal for "The Fund for  
R&D in Neglected Diseases (FRIND), [2]" which was seeking $10 billion  
in grant money, to undertake R&D on 10 neglected diseases, that this  
proposal was among the 3 proposals recommended by the previous EWG,  
and one that would be reevaluated by the CEWG. According to the EWG:

three proposals are in circulation to provide reliable, long-term  
funding to product development partnerships, and to automate or  
centralize funding decisions across product development partnership  
portfolios to a lesser or greater degree. These are:

	• Fund for Research and Development in Neglected Diseases
	• Industry Research and Development Facilitation Fund
	• Product Development Partnership Financing Facility.
According to the official WHO participant list [3], the EB meeting is  
chaired by Dr M. Kökény, a former minister of health from Hungary. The  
Hungarian delegation is lead by Dr H. Páva who speaks for the European  
Member states in the EB discussions. The Hungarian Chair then  
undertook what some observers saw as a "fast gavel" and declared the  
DG's recommendations approved, and the agenda item concluded. Brazil  
then intervened to indicate that it was not in agreement with the  
Chair, and wanted to have to the DG respond to its concerns, and those  
of Thailand. The chair then offered some perplexing statements about  
how the agenda item was closed, but also how the EB would in some  
ambiguous way, think about the issues raised by Thailand. The session  
then broke, for an event previously organized by Germany, on the  
future of the WHO. There was considerable buzz in the room when  
meeting broke with the strong possibility that the issue of the  
conflicts of interest will be revisited by the EB at some point this  
week.

KEI was quite surprised the WHO Secretariat tried to place Herrling on  
the CEWG, given that he is the author of a proposal asking the CEWG  
for $10 billion in grants to subsidize pharmaceutical industry  
research into neglected diseases. We would have thought the previous  
controversy over the industry influence on the influenza pandemic  
expert group would have make the WHO more sensitive to the public's  
concerns over conflicts of interest. Apparently not.

For some background on the Herrling proposal, see Malini Aisola's  
analysis from a year ago:A closer look at the WHO EWG endorsed  
proposals on funding product development partnerships [4]

For those who have not followed the history of the WHO CIPIH/IGWG/EWG/ 
CEWG process, there has been considerable tension and controversy over  
proposals to de-link R&D costs from product prices. Proposals for a  
biomedical R&D treaty or the expanded use of innovation inducement  
prizes to replace product monopolies are particularly controversial,  
to the degree that they advance a de-linkage agenda. Paul Herrling's  
FRIND proposal was presented as the IFPMA alternative to reform  
proposals, and it was criticized in several areas, including those  
discussed in the Aisola comment. Whatever one thinks of the merits of  
the $10 billion Herrling proposal, it seems bizarre that Herrling  
would be asked to serve on the body that was asked to evaluate his  
proposal, an issue that KEI and others have raised with several EB  
delegates.

And that is not all. During the 2010 World Health Assembly, when some  
thought the earlier Expert Working Group report would be accepted,  
there was an attempt to merge the three proposals for funding that the  
EWG had endorsed, even though they were extremely different in their  
designs. This included a high profile meeting at the Intercontinental  
Hotel, where Herrling, Holly Wong from IAVI, and Mary Moran spoke, and  
presented a new initiative called PDP+ [5]. So at this point, not only  
is Herrling the author of the FRIND proposal, but he is also now a  
collaborator in the PDP+ proposal, which is an attempt to merger the  
three leading contenders for the CEWG approval.

None of KEI's concerns suggest negative views on Paul Herrling  
himself. In fact, among public health groups, Paul Herrling is one of  
the highest regarded big pharma executives, and someone that KEI and  
others respect and enjoy working with. We just do not see how the WHO  
can have him evaluate his own funding proposals.

Source URL: http://keionline.org/node/1056
Links:
[1] http://www.keionline.org/node/1055
[2] http://www.who.int/entity/phi/Novartis.pdf
[3] http://apps.who.int/gb/ebwha/pdf_files/EB128/B128_DIV1.pdf
[4] http://keionline.org/node/751
[5] http://keionline.org/node/843



------------------------------------------------------------


Thiru Balasubramaniam
Geneva Representative
Knowledge Ecology International (KEI)
thiru at keionline.org


Tel: +41 22 791 6727
Mobile: +41 76 508 0997








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