[Ip-health] Transparency and delinkage embedded into draft UN Political Declaration on Universal Health Coverage

Thiru Balasubramaniam thiru at keionline.org
Fri Aug 2 02:57:53 PDT 2019


https://www.keionline.org/31262

Transparency and delinkage embedded into draft UN Political Declaration on
Universal Health Coverage

Posted on July 31, 2019 <https://www.keionline.org/31262> by Thiru
<https://www.keionline.org/author/thiru>

UPDATE: On 29 July 2019, the co-facilitators (Ambassadors of Georgia and
Thailand) of the intergovernmental consultations on a UN political
declaration on universal health coverage announced that the silence
procedure was broken by “several delegations on paragraphs 29, 68, 69, 70
and 71.” The aforementioned paragraphs contain references to sexual and
reproductive health and rights (SRHR). The co-facilitators informed the UN
General Assembly that they would hold further consultations to resolve the
impasse.
------------------------------

On 23 September 2019, the United Nations General Assembly will convene its
first high-level meeting on universal health coverage. The theme of the
meeting is: “Moving together to build a healthier world”. In preparation
for the UN High-Level Meeting on Universal Health Coverage, the Ambassador
of Georgia to the United Nations (H.E. Mr Kaha Imnadze) and the Ambassador
of Thailand to the United Nations (H.E. Vitavas Srivihok) were appointed
co-facilitators of the intergovernmental consultations on the political
declaration. After two months of intense negotiations, on 24 July 2019, the
co-facilitators presented the final draft of the Political Draft of the
High-level Meeting on Universal Health Coverage
<https://www.un.org/pga/73/wp-content/uploads/sites/53/2019/07/FINAL-draft-UHC-Political-Declaration.pdf>.
The co-facilitators described the final text
<https://www.un.org/pga/73/wp-content/uploads/sites/53/2019/07/FINAL-draft-UHC-Political-Declaration.pdf>
as
reflecting a “fine and delicate balance”. This text was placed by the
co-facilitators in silence procedure from 25 July 2019 till 6 PM on 29 July
2019; consequently, countries had until 6 PM on Monday, 29 July 2019 to
raise objections on the final text.

James Love, Director of Knowledge Ecology International (KEI) provided the
following observations on the 24 July 2019 text:

The new text reflects the need to compromise with countries that want
reforms and countries that want to block reforms. The language on
transparency in paragraph 50 is overall good. It does mention the
transparency of costs of health products, which is very important, in
addition to prices, since prices will depend upon policies. It could have
been better, and it could have also mentioned the WHA resolution. The
language on R&D financing in paragraphs 52 and 53 is unnecessarily weakened
by the reference to voluntary initiatives, but it closes strong with the
reference to “incentive mechanisms that separate the cost of investment in
research and development from the price and volume of sales, facilitate
equitable and affordable access to new tools and other results to be gained
through research and development.” This type of language on delinkage, in
the context of incentives, is important.

Paragraph 50 of the UN political declaration on universal health coverage
calls upon member states to improve “availability, affordability and
efficiency of health products by increasing transparency of prices of
medicines, vaccines, medical devices, diagnostics, assistive products,
cell- and gene-based therapies” and encourages the World Health
Organization (WHO) to “continue its efforts to biennially convene the Fair
Pricing Forum with Member States and all relevant stakeholders to discuss
the affordability and transparency of prices and costs relating to health
products”. The reference to the transparency of prices *and costs* provides
a strong mandate to the WHO to expand its work on transparency to include
R&D costs.

   50. Improve availability, affordability and efficiency of health
   products by increasing transparency of prices of medicines, vaccines,
   medical devices, diagnostics, assistive products, cell- and gene-based
   therapies, and other health technologies across the value chain, including
   through improved regulations and building constructive engagement and a
   stronger partnership with relevant stakeholders, including industries,
   private sector and civil society, in accordance with national and regional
   legal frameworks and contexts, to address the global concern on high prices
   of some health products and in this regard encourage WHO to continue its
   efforts to biennially convene the Fair Pricing Forum with Member States and
   all relevant stakeholders to discuss the affordability and transparency of
   prices and costs relating to health products;

Paragraph 51 of the draft UHC text provides a reference to the WTO TRIPS
Agreement and the WTO Doha Declaration on the TRIPS Agreement and Public
Health.

   51. Promote increased access to affordable, safe, effective and quality
   medicines, including generics, vaccines, diagnostics and health
   technologies, reaffirming the World Trade Organization Agreement on
   Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement) as
   amended, and also reaffirming the 2001 WTO Doha Declaration on the TRIPS
   Agreement and Public Health, which recognizes that intellectual property
   rights should be interpreted and implemented in a manner supportive of the
   right of Member States to protect public health and, in particular, to
   promote access to medicines for all, and notes the need for appropriate
   incentives in the development of new health products;

Paragraphs 52 and 53 contain language on a “range of innovative incentives
and financing mechanisms for health research and development” including
mechanisms predicated upon delinkage, “the idea that temporary monopolies
and the associated high drug prices should not be used to fund
pharmaceutical research and development, as well as a set of policy
proposals that would replace monopolies and high prices with alternative
incentives based upon cash rewards, and expanded funding for research, drug
development, and clinical trials through a combination of grants,
contracts, tax credits, and other subsidies.” (Source:
https://delinkage.org/overview/)

   52. Explore, encourage and promote a range of innovative incentives and
   financing mechanisms for health research and development, including a
   stronger and transparent partnership between the public and the private
   sectors as well as the academia, recognizing the need for increasing public
   health-driven research and development that is needs-driven and
   evidence-based, guided by the core principles of safety, affordability,
   effectiveness, efficiency, equity and considered as a shared
   responsibility, as well as appropriate incentives in the development of new
   health products and technologies;


   53. Recognize the important role played by the private sector in
   research and development of innovative medicines, encourage the use, where
   appropriate, of alternative financing mechanisms for research and
   development as a driver of innovation for new medicines and new uses for
   medicines and continue to support voluntary initiatives and incentive
   mechanisms that separate the cost of investment in research and development
   from the price and volume of sales, facilitate equitable and affordable
   access to new tools and other results to be gained through research and
   development;


-- 
Thiru Balasubramaniam
Geneva Representative
Knowledge Ecology International
41 22 791 6727
thiru at keionline.org


More information about the Ip-health mailing list