[Ip-health] PLoS Blog on Demonstration Projects in post-CEWG follow-up process

Suerie Moon suerie_moon at yahoo.com
Fri May 24 05:44:06 PDT 2013


Demonstrating Progress: Building a More Equitable Global R&D System
By PLOS Guest Blogger

Posted: May 24, 2013 

Suerie Moon and John-Arne Røttingen from 
Harvard University call for WHO member states to embrace new approaches 
to governing the global research and development system. 

This week at the World Health Assembly in Geneva, WHO member states 
are debating how to strengthen the global pharmaceutical R&D system 
to better meet needs in low- and middle-income countries.  Last November, governments agreed to establish a set of “demonstration projects” to test out the recommendations of a WHO expert group on how to develop more affordable, adapted medicines to address long-neglected health needs. But it remains unclear what exactly these demonstration 
projects should be and what they should demonstrate. A key principle is 
that these projects are not just pilots – they should also demonstrate new mechanisms, principles or approaches.
We should not waste precious time and money demonstrating again what the past decade has already shown. For example, we have seen that increased public and philanthropic funding can fill pipelines with candidate technologies and bring improved products to market. We have seen that not-for-profit product development partnerships can develop such improved products at relatively low-cost.  We have seen that creative approaches to managing intellectual property can reduce barriers to research and competitive drug production.  And we have seen that governments can pool their funding and jointly decide to invest in R&D (as with HIV diagnostics), and create additional market pull by financing commodity purchases (as with pediatric HIV medicines and pneumococcal vaccines). Finally, there is a long history of collaboration and capacity building between scientists from the North and South, including for basic research and clinical trials. These are all important
 advances for global health R&D and should be supported, but they are not sufficient.
So, what does need to be demonstrated? Attention is needed in at least two areas: new approaches to financing and to governance.
Both “push” and “pull” mechanisms have long been used in traditional approaches to R&D. One promising new approach is “open knowledge innovation,” in which a wide community of contributors works toward a shared goal, 
research results are rapidly shared, and access to the benefits of new 
knowledge are widely available. While two projects have demonstrated promise and some success with this model, many questions still need to be answered about when, 
where and how it could work best to lower costs and accelerate 
innovation. Push financing should be dedicated to testing open knowledge innovation approaches.
In terms of pull mechanisms, an important proposal to test is awarding milestone or end prizes to incentivize the development of a specific product, in exchange for 
monopoly rights such as those provided by patents. A key benefit of this approach would be lower prices for medicines, since competitive 
production could begin immediately. The size of the prize could be 
determined by the value of the invention, including the expected magnitude of the public health contribution, the expected cost of R&D, how well it meets the target product profile, or other factors.
Finally, new approaches to governing the global R&D system are needed, including better information on inputs, processes and outputs; better coordination and priority-setting; and reliable financing.
Governments should not squander this unprecedented opportunity to 
test new approaches to investing in, incentivizing and governing 
needs-based innovation for health.

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