[Vaccine-manufacturing] Health Policy Watch: WHO and World Trade Organization Host Closed Meetings to Tackle Vaccine Access and Prices

Thiru Balasubramaniam thiru at keionline.org
Tue Apr 13 23:01:05 PDT 2021


WHO and World Trade Organization Host Closed Meetings to Tackle Vaccine
Access and Prices
Medicines & Vaccines 13/04/2021 • Kerry Cullinan & Madeleine Hoecklin

Transparency in medicine pricing is a key theme of the Fair Pricing Forum
that started this week.

The World Health Organization (WHO) and the World Trade Organization (WTO)
both are hosting key global meetings aimed at improving global access to
COVID-19 vaccines and fair medicine prices this week behind closed doors.

The WHO Fair Pricing Forum started on Tuesday and its stated aim is to
activate “additional support for countries to achieve more affordable and
fairer access to pharmaceutical products during the COVID-19 pandemic and

Meanwhile, on Wednesday, the WTO Director General, Ngozi Okonjo-Iweala,
will host a meeting on “COVID-19 and Vaccine Equity: What can the WTO

The Fair Pricing Forum (FPF), supported by the Ministry of Health of
Argentina and running virtually until 22 April, is likely to focus on
transparency of medicine prices and production as well “upstream
innovation” aimed at widening the manufacturers’ pool.

This is according to Suerie Moon, co-director of the Global Health Center
of the Graduate Institute of Geneva and a member of the FPF expert advisory
group, who describes the forum as an “important space for governments to
connect and co-operate”.

Transparency and the Innovation System

“There’s a lot of focus on transparency in the agenda. COVID-19 raised
public awareness of the problem of confidentiality. But there is a lot
governments can do on transparency that they haven’t yet done – there also
needs to be a strengthening of backbones,” she said.

Moon added that linking high prices to the underlying innovation system
“has never been so front and centre of discussion as it is now”.

“There is an entire strand of the conference on innovation, looking at how
governments can change innovation incentives, how they can rewrite the
rules that structure innovation and pricing of medicines,” said Moon, of
the meeting, which paradoxically is taking place away from the media and
public eye..

She added that while the discussion in the WTO’s TRIPS Council over the IP
waiver is split along predictable North-South lines, more informal
alliances are easier to build at the Forum where there are “challenges
common to countries in the North and South and shared concerns vis-à-vis
the medicine pricing practices of the pharmaceutical industry”.

Health Policy Watch has seen two discussion papers to be discussed at the
Forum, which look at how medicines pricing could be made more “sensitive to
health systems’ ability to pay”, and “incentives for pharmaceutical
innovation to achieve fair pricing” respectively. These were developed by
two technical working groups formed at the last FPF meeting in South Africa
in 2019.

Global Framework to Address Pricing

The first paper suggests a global framework to tackle the “unaffordability
of medicines and vaccines”. It also flags that the lack of transparency
relating to prices and contracts undermines good governance ‘especially
when the public expects full accountability for public spending’.

It highlights the success of cross-border collaborative initiatives in
ensuring more affordable medicines, including global initiatives such as
Stop TB Partnership’s Global Drug Facility; the Medicines Patent Pool;
Gavi, the Vaccine Alliance; and the WHO co-sponsored COVAX global vaccine
facility; as well as regional efforts including the Pan American Health
Orgqanization’s “Revolving Fund for Vaccine Procurement” and the Beneluxa
initiative of smaller European countries, including Belgium, the
Netherlands, Luxembourg, Austria and Ireland, to coordinate policies on
pharma purchases and pricing.

The second paper argues that ‘“pharmaceutical innovation is a hybrid public
and private effort”, with the public sector paying for about 30% of the
upfront total investment in pharmaceutical R&D and the private sector
paying for about 60% of upfront investment in the later, relatively
lower-risk stages, with the remaining 10% coming from sources such donors.

It also flagged the need for “frameworks for global governance”, noting
that “the bilateral agreements for COVID-19 vaccines are a sober reminder
that public sector stewardship at the national level sometimes may serve
narrower national interests at the risk of disregarding larger issues of
global health equity”.

WTO Invites Wide Range of Pharmaceutical Companies

WTO Director-General Ngozi Okonjo-Iweala

Meanwhile, the WTO’s Wednesday meeting includes various trade ministers,
including those from the European Union and the United States, as well as
India and South Africa, which are co-sponsors of the WTO proposal to waive
intellectual property rights on COVID-19 health products for the duration
of the pandemic.

A wide range of pharmaceutical companies are also invited, including
representatives from Pfizer, Moderna and Astra Zeneca, the International
Federation of Pharmaceutical Manufacturers and Associations (IFPMA); the
Developing Countries Vaccine Manufacturers Network,  the European
Federation of Pharmaceutical Industries and Associations (EFPIA), the
Pharmaceutical Research and Manufacturers of America (PhRMA) and the Japan
Pharmaceutical Manufacturers Association (JPMA).

Speaking at meetings in the US last week, Okonjo-Iweala said that equitable
worldwide access to COVID-19 vaccines “is necessary for economic growth and
trade to bounce back from the pandemic and that a reinvigorated
multilateral trading system would strengthen both the health response and
the economic recovery”.

The first session of the  WTO meeting focuses on challenges to “equitable
vaccine distribution”, including a focus on export restrictions and trade

Thomas Cueni, IFPMA Director General, confirmed to Health Policy Watch that
his association and a number of its member company experts “have accepted
the Director General’s invitation to speak at the WTO event”.

‘“We believe this is an important opportunity to contribute to the DG’s
expressed desire to find pragmatic outcomes to increase vaccine
production.  We hope to be able to share our experience of the complexities
in researching, developing, registering, manufacturing and distributing
COVID-19 vaccines,” said Cueni

However, over 240 civil society organisations wrote an open letter to
Okonjo-Iweala on Tuesday expressing concern “over the emphasis on
industry-controlled bilateral agreements as the primary approach to
addressing global production constraints and supply shortages”.

Referring to her “Third Way” approach, which they described as “appealing
to pharmaceutical corporations to take voluntary actions”, the
organizations said this had “proven to be insufficient in this pandemic”.

Instead, they proposed that WTO member states approve the initiative to
remove “barriers towards the development, production and approval of
vaccines, therapeutics and other medical technologies necessary for the
prevention, containment and treatment of the COVID-19 pandemic” by
supporting the temporary waiver on intellectual property rules.

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

More information about the Vaccine-manufacturing mailing list