[Ip-health] April 2011: WHO to tackle pandemic influenza, de-linkage, prizes, R&D financing and non-communicable diseases

Thiru Balasubramaniam thiru at keionline.org
Fri Mar 18 09:55:30 PDT 2011


April 2011: WHO to tackle pandemic influenza, de-linkage, prizes, R&D  
financing and non-communicable diseases

By thiru
Created 18 Mar 2011 - 6:16am

April 2011 ushers in a busy period for the World Health Organization.  
During the second week of April 2011, WHO will hold two important  
events: 1) the first meeting of the Consultative expert working group  
on research and development: financing and coordination (CEWG) [1]  
which takes place in Geneva from 5-7 April 2011 and 2) a consultation  
with industry on 6 April 2011 in Geneva convened by co-chairs,  
Ambassador Bente Angell-Hansen (Norway) and Ambassador Juan Jose Gomez- 
Camacho (Mexico) of the Open-Ended Working Group (OEWG) of Member  
States on Pandemic Influenza Preparedness: Sharing of Influenza  
Viruses and Access to Vaccines and Other Benefits . On 27 April 2011,  
WHO will host the WHO Global Forum: Addressing the Challenge of  
Noncommunicable Diseases [2] in Moscow, Russia. On 28-29 April 2011,  
WHO and Russia will host the "First global ministerial conference on  
healthy lifestyles and noncommunicable disease control [3]".

In contrast with the opaque Expert Working Group on R&D Financing  
(EWG), a body shrouded in secrecy under the leadership of Dr. George  
Alleyne, the Consultative Expert Working Group (CEWG) sets a model for  
transparent norm-setting. The CEWG's mandate is provided by WHA  
resolution 63.28 passed in May 2010, Establishment of a consultative  
expert working group on research and development: financing and  
coordination [4]. This resolution guiding the CEWG underscores the  
importance of de-linkage and prizes by noting:

"Recognizing the need to further “explore and, where appropriate,  
promote a range of incentive schemes for research and development  
including addressing, where appropriate, the de-linkage of the costs  
of research and development and the price of health products, for  
example through the award of prizes, with the objective of addressing  
diseases which disproportionately affect developing countries”;  
(Footnote 1, Resolution WHA61.21, Annex, Element 5, paragraph 5.3a)."
Resolution 63.28 instructs the CEWG to "review the five promising  
proposals identified by the Expert Working Group in its report;  
and ...further explore the six proposals that did not meet the  
criteria applied by the Expert Working Group". Consequently, with a  
clean slate, the CEWG will review the proposals of Bangladesh,  
Barbados, Bolivia and Suriname on prizes and the R&D Treaty.

The first meeting of the CEWG will hold an open session on Tuesday, 5  
April 2011 from 9:30 AM to 3:30 PM open to all Member States and other  
stakeholders. The registration form for the open session can be found  
here: http://www.who.int/phi/news/cewg_2011/en/index.html [1]. On  
Wednesday, 6 April 2011, the CEWG will convene an Open Forum from 9 AM  
to 6PM in the WHO Executive Board Room; member states and other  
interested stakeholders are invited to present their proposals and  
submissions before the experts. This represents an important  
opportunity for Member States, intergovernmental organizations, civil  
society, academics and industry to present their respective  
perspectives to the CEWG. The registration form for potential  
presenters to the Open Forum is: http://www.who.int/phi/news/phi_cewg_appl_form_2011_en.pdf 
  [5]. Finally, on Thursday, 7 April 2011, the CEWG will host an Open  
Briefing Session at 5:30 PM in Salle B at the conclusion of the CEWG;.  
According to WHO, the Chair of the CEWG will brief member states and  
interested stakeholders on the outcomes of the first CEWG meeting and  
outline its future plan of work.

While the CEWG holds its Open Forum on 6 April 2011, the co-chairs of  
the Open-Ended Working Group (OEWG) of Member States on Pandemic  
Influenza Preparedness: Sharing of Influenza Viruses and Access to  
Vaccines and Other Benefits will be sequestered in an industry   
consultation with Member States in attendance. The 3rd meeting of the  
OEWG will take place from 11-15 April 2011. The background documents  
for the fourth meeting of the OEWG can be found here: http://apps.who.int/gb/pip/e/E_Pip_oewg3.html 
  [6]. The first paper presents options for sustainable financing of  
benefit sharing [7] in relation to pandemic influenza preparedness and  
the second paper is the finalized McKinsey paper funded by the Gates  
Foundation entitled, "Technical studies under Resolution WHA63.1 [8]".

The process section of the report states:

"Work to establish the terms of reference for studies, based on the  
report of the Open-Ended Working Group (document A63/48), began  
immediately after the Sixty-third World Health Assembly, in May 2010.  
The terms of reference were finalized and sent to Member States on 22  
July 2010. Given the breadth of the areas under study and the limited  
human and financial resources of the Organization to carry out the  
full studies, the Secretariat sought external support. The Bill &  
Melinda Gates Foundation provided support through a contract with  
McKinsey & Company, which was selected on the basis of its broad  
expertise in public health, financing, health economics and influenza  
vaccines; its ability to start work on the project quickly; and its  
global team.

On the basis of the report of the Working Group and the terms of  
reference, the WHO Secretariat and the McKinsey team began to develop  
the outline of the study in mid-August 2010. First, the parameters of  
the study and the timetable for delivery were addressed, and, in view  
of the broad scope of the studies, a phased approach was agreed, so  
that preliminary findings could be shared at the meeting of the  
Working Group in December 2010 and the full study would be completed  
before the Sixty-fourth World Health Assembly."
For more information about KEI's communication with WHO on this matter  
McKinsey's involvement in vaccines work, please consult: http://keionline.org/node/1084 

On 27 April 2011, WHO will convene the WHO Global Forum: Addressing  
the Challenge of Noncommunicable Diseases [2] in Moscow, Russia. As  
alluded to in an earlier piece entitled, "Noncommunicable diseases in  
the 2011 global public health agenda [10]", the WHO Global Forum will  
serve as testing ground for the WHO to phase in a multi-stakeholder  
global governance model. As noted in my earlier piece, "although the  
details of the Global Health Forum are still nebulous, certain  
informed observers have noted the Forum is a response of the WHO  
secretariat to the "Committee C" concept proposed in 2008 in the  
Lancet by Gaudenz Silberschmidt (Switzerland), Don Matheson  
(University of Otago),and Ilona Kickbusch (Graduate Institute of  
International and Development Studies). As WHO is reeling from an  
expected shortfall of $200 million to $600 million in the 2010-2011  
budget, it is seeking creative ways of leveraging unearmarked  
voluntary contributions from donor governments, foundations and the  
private sector. Whether the Global Health Forum can bridge this gap or  
be subject to "Trojan multilateralism" (Devi Sridhar, Oxford Global  
Health Governance) remains to be seen." Certain observers see the  
Global Health Forum as Trojan mulilateralism to bypass the governance  
structure of the World Health Assembly, the highest decision making  
body of the WHO.

The concept note for the 2011 Global Forum states:

"The WHO Global Forum: Addressing the Challenge of Noncommunicable  
Diseases will bring together a wide group of stakeholders to share  
views and experiences to date on the challenges and opportunities in  
noncommunicable disease prevention, treatment and control. Forum  
participants will identify and commit to priority actions to  
strengthen global action to prevent and control noncommunicable  
diseases prior to and beyond the HLM.
The Forum provides an excellent opportunity to raise awareness of the  
September 2011 HLM on noncommunicable diseases, and to provide input  
into the preparation for the HLM as well as discussions on  
noncommunicable diseases at the sixty-fourth World Health Assembly in  
May 2011.

The objectives for the Forum are:
• Provide an opportunity for a wide range of stakeholders to discuss  
and share perspectives on the prevention and control of  
noncommunicable diseases (NCDs)
• Understand expectations, roles and contributions of the different  
stakeholders in support of the September 2011 UN High-level Meeting  
(HLM) on NCDs and its expected outcomes, as well as activities post  
the HLM.
• Update knowledge and share experience on progress in addressing NCDs  
including through implementing the Action Plan for the Global Strategy  
for the Prevention and Control of NCDs.
• Promote ways of accelerating the implementation of actions for  
international and national partners under each objective of the Action  
• Mobilize a broader base of stakeholders in support of NCD prevention  
and control, in particular in developing countries."

The expected deliverables of the Forum are:
• A short report that could be presented by one or more of the  
stakeholder groups during the World Health Assembly in May 2011 to  
support Member States' preparation for the HLM.
• Lessons learnt in organizing multi-stakeholder discussion forums.
• A statement to be delivered to the Moscow Ministerial Meeting  
representing key
perspectives from the stakeholders.

The last event on the WHO calendar for April is of course the joint  
Russian/WHO "First global ministerial conference on healthy lifestyles  
and noncommunicable disease control [3]" to be held in Moscow on 28-29  
April 2011.

This invitation only ministerial conference is expected to attract 300  
participants with each Member State being allotted two slots (one for  
the Minister and one for an additional member of the country delegation.

The conference website lays out the following aim and goals:

The aim of the conference is to "support Member States develop and  
strengthen policies and programmes on healthy lifestyles and NCD  
prevention. These efforts are based on the Global strategy for the  
prevention and control of NCDs and its action plan, which include  
multisectoral and innovative approaches in prevention and care.
"The conference has three main goals:

* to highlight the magnitude and socio-economic impact of NCDs;
* to review international experience on NCD prevention and control; and
* to provide evidence on the pressing need to strengthen global and  
national initiatives to prevent NCDs".

The Moscow ministerial is predicated upon the WHO Global Strategy for  
the Prevention and Control of Noncommunicable Diseases [11] endorsed  
at WHA 53 in May 2000 and the Action Plan passed at WHA 61 in May  
2008. This Ministerial is expected to lay the groundwork for the  
United Nations General Assembly High-level Meeting on the Prevention  
and Control of Noncommunicable Diseases on 19-20 September 2011.

Source URL: http://keionline.org/node/1097
[1] http://www.who.int/phi/news/cewg_2011/en/index.html
[2] http://www.who.int/nmh/events/global_forum_ncd/en/
[3] http://www.who.int/nmh/events/moscow_ncds_2011/en/
[4] http://apps.who.int/gb/ebwha/pdf_files/WHA63/A63_R28-en.pdf
[5] http://www.who.int/phi/news/phi_cewg_appl_form_2011_en.pdf
[6] http://apps.who.int/gb/pip/e/E_Pip_oewg3.html
[7] http://apps.who.int/gb/pip/pdf_files/OEWG3/options-for-sustainable-financing-en.pdf
[8] http://apps.who.int/gb/pip/pdf_files/OEWG3/technical-studies-en.pdf
[9] http://keionline.org/node/1084
[10] http://keionline.org/node/1071
[11] http://www.who.int/nmh/publications/who_nmh_2009_2/en/index.html
[12] http://keionline.org/sites/default/files/CONCEPT NOTE (English),  
Global Forum 27 April 2011.pdf
[13] http://keionline.org/sites/default/files/ADG - 10 March 2011 -  
Permanent Missions - AS DELIVERED.pdf



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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