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A Surprising U.S. Intervention at the 66th World Health Assembly Breathes Life Into a Proposed WHO Biomedical R&D Treaty

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For those hoping for a biomedical research and development treaty, the 2013 World Health Assembly (WHA) concluded with a glimmer of hope.  The WHA both called for greater study into current research and development trends and adopted an unexpected U.S. proposal to convene a series of advisory meetings, tasked with developing demonstration projects intended to gauge the likely efficacy of a convention.

A WHO treaty on biomedical research and development has been under consideration for nearly a decade. Debate began in earnest, however, when the WHO Consultative Expert Working Group: Research and Development (CEWG) backed the proposal.  Most controversially, the CEWG report proposed the establishment of a pooled financing mechanism, which would collect contributions from Member States.

Debate at the 2012 WHA was heated, with most of the controversy centering on the mandatory contributions (set at a suggested 0.01% of each country’s GDP).  The United States took particular exception to this plan, stating that it could not “support any proposal that would put in place a new financing mechanism that could be characterized as a globally-collected tax.”  Although many influential low- and middle-income countries were vocal in their support of a convention, strong resistance from the United States, European Union and Japan effectively postponed any progress on the treaty until 2013. The end result was a resolution which simply “welcomed” the report and called for further meetings, which would result in a “substantive item dedicated to the follow up of the CEWG report” at the 2013 WHA.

The largest blow to treaty advocates was dealt by the decision reached at the end of the November 2012 meeting of Member States, then confirmed by the Executive Board (EB) in January 2013.  The emotionally charged EB meeting (at which Margaret Chan even broke into song in an attempt to lighten the mood) failed to reopen the Member States’ weak proposal. The EB merely passed along a draft resolution calling on the WHO to establish a “global health R&D observatory” and advising a three-year delay before revisiting the issue.

It thus came as a shock when the United States proposed a series of demonstration projects at the 2013 WHA in May. Discarding the reticence exhibited at the EB meeting, the U.S. called for faster action, in particular requesting WHO to convene an advisory meeting “at the earliest possible date” to consider demonstration projects.  The U.S. also signaled willingness to reopen debate on a treaty before the three years were up. Both the demonstration projects and proposed “global health R&D observatory” were approved by the WHA in May.

While the future of the biomedical R&D treaty remains far from certain, the developments at the World Health Assembly suggest that the barriers may not be as insurmountable as many had feared. Advocates for the treaty can only hope that policymakers take to heart Margaret Chan’s reminder: “We know we have to influence people at the top, but it is people at the bottom who matter most.”

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    […] against and slowed down a proposal to negotiate a binding convention on financing R&D for NDs, the EU still remained opposed to the Treaty at the 66th WHA last […]

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