[Ip-health] IP-Watch: Resolution On Cancer Hailed By WHO Members, Easily Adopted In Committee

Thiru Balasubramaniam thiru at keionline.org
Wed May 31 04:00:25 PDT 2017


Resolution On Cancer Hailed By WHO Members, Easily Adopted In Committee


It is not a mystery, cancer has been spreading for decades, in particular
in low and-middle income countries, and is not stopping its course in the
foreseeable future. Members of the World Health Organization in committee
yesterday adopted a resolution to improve prevention, diagnostics,
treatment, and palliative care for cancer, in statements stripped of

The draft resolution [pdf] on cancer prevention and control in the context
of an integrated approach was proposed by Brazil, Canada, Colombia, Costa
Rica, France, Netherlands, Nigeria, Panama, Peru, Russia, Thailand and

WHO members, gathered at the World Health Assembly (WHA) from 22-31 May,
also noted a WHO report [pdf] on cancer prevention and control.

WHA Committee B

The draft resolution was already discussed at the January WHO Executive
Board, but IP-related issues came in the way of consensus at that time,
such as the delinking of the cost of research and development (R&D) from
the end prices of cancer drugs (IPW, WHO, 4 May 2017). In the end, the
concept of delinkage had to be removed to get all members’ approval,
according to sources.

Call on Governments, WHO, to Act

The resolution calls for governments to undertake 22 actions, including the
implementation of national commitments for the prevention and control of
cancer, the integration and scaling-up of national cancer prevention and
control, and the development of national cancer control plans, which have
adequate resources, monitoring and accountability.

The resolution also calls to promote access to vaccinations to prevent
infections associated with cancers, to promote cancer research, and to
consider innovative financing approaches, which will promote equitable and
affordable access to cancer care.

Some 10 actions are requested from the WHO, including the harmonisation of
technical assistance provided to countries, and the strengthening of the
collaboration with nongovernmental organisations, private sector, academic
institutions, and philanthropic foundations to foster the development of
effective and affordable new cancer medicines.

The WHO is also requested to prepare a comprehensive technical report to
the Executive Board in January 2018 “that examines pricing approaches,
including transparency, and their impact on availability and affordability
of medicines for the prevention and treatment of cancer.”

Resolution Widely Supported

Colombia, which chaired three informal meetings organised between the
Executive Board and the WHA, said the resolution is an opportunity to move
forward and promote equitable access to all cancer treatments,
technologies, and prevention measures.

The resolution was supported by the majority of countries speaking today in
committee, such as India on behalf of the South East Asia region, Zambia on
behalf of the Africa region, Japan, Lebanon, the Netherlands, Qatar on
behalf of the Eastern Mediterranean region, Zimbabwe, Namibia, Swaziland,
Senegal, Australia, Thailand, Morocco, South Korea, Tunisia, Argentina,
Venezuela, Togo, and Bolivia.

The debate took place in Committee B, one of two committees charged with
going through the agenda, and preparing the decisions to be approved by the
World Health Assembly closing plenary today.

Some countries asked to become cosponsors of the resolution, such as Congo,
which said cancer is the leading cause of death in the country, the United
States, Malaysia, Georgia, Luxemburg, Tanzania, and India.

Poor Countries Hit Hardest

Most countries taking the floor voiced concerns about the growing issue of
cancer, leading to premature deaths, suffering, and high economic impact on
health budgets.

Many also underlined the fact that low and-middle income countries are hit
the hardest by the spread of cancer, due to several factors including the
lack of data on the disease burden, and the lack of awareness on cancer
prevention. The latter was stated by Zambia, on behalf of the 47 countries
of the Africa region.

Zimbabwe said shortages of medicines and lack of appropriate medical
technologies are example of barriers that low and middle-income countries
experience in their fight against cancer.

Zambia also said some “low hanging fruits” could be harvested, such as
awareness raising, vaccination, early diagnosis and treatment, appropriate
rehabilitation for cancer survivors, and palliative care. The Zambia
delegate called on WHO to keep supporting developing countries, and to help
them negotiate lower prices, including radiology equipment, and analgesics
for palliative care. The delegate also called for capacity building.

Namibia said prevention is the most affordable response to cancer but
palliative care and pain control are often neglected for cancer patients.

India, speaking on behalf of the 11 countries of South East Asia said about
1.1 million people die from cancer, many of them prematurely, while most
cancer cases are preventable, treatable, and curable. The Indian delegate
noted the rise in childhood cancers, and said establishing national cancer
control programmes is hindered by the lack of adequate financial resources.

He called on the WHO and other partners to promote the availability and
accessibility of affordable, safe, effective, and quality medicines,
vaccines, and diagnostics, including through the use of the flexibilities
included in international trade rules (World Trade Organization Agreement
on Trade-Related Aspects of Intellectual Property Rights – TRIPS). He also
called for the promotion of research and development (R&D) for new cancer
drugs and diagnostics that are accessible and affordable.

A number of other countries underlined the lack of affordability of cancer
medicines, such as Sri Lanka, and Senegal, which called for a global
mechanism for cancer treatments to promote access to chemotherapies and
radiotherapies. Others were Thailand, which also called for a pricing
mechanism to achieve more affordability, Brazil, Vietnam, Tanzania, and

Delinkage, IP: ‘Elephants in the Room’

While the question of delinking the cost of research and development from
the market price of medicines was repeatedly mentioned in discussions on
several agenda items at the World Health Assembly, during the discussion on
the cancer resolution, the issue seemed to have been carefully avoided by
countries taking the floor.

India, on behalf of the countries of the South East Asia region underlined
the need to consider the principle of delinkage when promoting R&D of new
cancer drugs and diagnostics.

‘What Everyone Needed’

A leading NGO activist on the cancer resolution, Knowledge Ecology
International Director James Love, said afterward that compromise among
often disparate sides was possible because the final resolution was “What
everyone needed, not what everyone wanted.”

In a statement, Love said, “The resolution is an important milestone in
focusing the attention of the UN body on the disparities of access to
treatment. The most controversial issue in the resolution was the text
dealing with pharmaceuticals, and in particular, pricing and access,
transparency of R&D costs, and to conduct a feasibility study of delinking
R&D costs, including incentives, from drug prices.”

“Going forward, much will depend upon the new leadership at the WHO, as
these reforms were previously blocked by the outgoing WHO Director-General
Margaret Chan, as well as the level of support for delinkage in Member
States,” said Love. “Without decent political leadership on delinkage at
the national level, it won’t happen. Fortunately, there is now growing
interest in Europe, more support in developing countries (in part due to
the positive impact of the UN Secretary-General’s High Level Panel on
Access to Medicine), and some encouraging signs in the United States.
Several members of the U.S. Congress are now calling for feasibility
studies of delinkage, and even some persons in the Trump Administration
have signaled some new openness on this issue.”

On September 26, members of the European Parliament will host two days of
meetings on delinkage, where the proposal for a Cancer Innovation Fund will
be discussed, he said.

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