Talks restart on global initiative to fund research into diseases that affect poorer countries

BMJ 2013; 346 doi: (Published 01 February 2013) Cite this as: BMJ 2013;346:f702
  1. Anne Gulland
  1. 1London

Hopes for a global convention aimed at kick starting research and development programmes on diseases that particularly affect developing countries have been reignited after a meeting of the World Health Organization’s executive board.

WHO lawyers called to the board meeting on 25 January ruled that negotiations on the issue could reopen after delegations from the European Union and United States tried to argue that the debate was closed. The board decided to refer the discussion to the World Health Assembly (WHO’s decision making forum) in May.

Observers at the meeting described how WHO’s director general, Margaret Chan, even resorted to singing—a tactic she sometimes deploys to relieve tension and restart debate.

A report commissioned by WHO and published last April recommended a convention that committed all countries to spending at least 0.01% of gross domestic product on research and development for diseases that disproportionately affected people in developing countries. 1 In addition, developing countries with a potential research capacity should aim to commit 0.05% to 0.1% of GDP and developed countries should aim to commit 0.15 to 0.2% of GDP.

After discussing the report but failing to come to agreement last May, the World Health Assembly said that a separate meeting should take place in November 2012 to thrash out the changes.2

However, health campaigners and representatives of developing countries argued that the resolution made at the November meeting was weak and needed to be renegotiated. Agreement had been reached in the early hours of the morning when translators had gone home and when representatives of just 25 of a possible 194 countries were left at the negotiating table.

Katy Athersuch, policy adviser for the charity Médecins Sans Frontières, said that the convention was a “phoenix that keeps rising from the flames,” and she welcomed the opportunity to debate it again. However, she said that developing countries were often at a disadvantage because they could not afford to send large delegations to WHO meetings.

Tomás Pippo, director of health economics at Argentina’s Ministry of Health, said that the November agreement represented progress of sorts but that that his delegation and others were not happy about some parts of the agreement. For example, the document said that another meeting should be held to assess progress “prior to the 69th WHA [World Health Assembly] in May 2016”—this wording was vague, he said, and it was unclear at what point the meeting should take place.

He said that he did not believe that there would be immediate progress at the assembly in May but that it was important to keep dialogue open.

“Complex global discussions have not been exhausted and must continue,” he added, saying that agreement must not be imposed on anyone.

He said, “Developing countries have argued that these formal debates are costly. We reply that negotiations of trade agreements are also expensive and that has not proved a barrier to them. The difference is that the results of trade negotiations are measured in money, and the results of the negotiations that we want to make are measured in lives and quality of life.”

The November agreement called on WHO to establish a global health research and development observatory, building on national and regional observatories with a view to “contributing to the identification of gaps and opportunities for health R&D.”

A joint letter to WHO’s executive board from Médecins Sans Frontières, Oxfam, and other non-governmental organisations said that the commitments made in the November agreement were “unclear and too limited.”

The letter continued, “For example, the establishment of an R&D observatory could be a positive first step, but only if the scope of its tasks includes the definition of R&D priorities in consultation with member states . . . The question of whether this R&D observatory will receive adequate financing to operate effectively is also an unanswered question.”


Cite this as: BMJ 2013;346:f702