Basic survival needs and access to medicines--coming to grips with TRIPS: conversion + calculation

Assessing 15 proposals for promoting innovation and access to medicines globally

BACKGROUND

There is widespread recognition that the existing global systems for innovation and access to medicines need reform. Billions of people do not have access to the medicines they need, and market failures prevent new drugs from being developed for diseases that primarily affect the global poor. The World Health Organization's Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG) analyzed numerous proposals for reform. The aim of this article is to build on these previous inquiries.

METHODS

We conducted a structured analysis that grouped proposals into five broad opportunities for global policy reform to help researchers and decision makers to meaningfully evaluate each proposal in comparison with similar proposals. Proposals were also analyzed along three important dimensions-potential health impact, financial implications, and political feasibility-further facilitating the comparison and application of this information.

FINDINGS

Upon analysis, no one solution was deemed a panacea, as many (often competing) considerations need to be taken into account. However, some proposals, particularly product development partnership and prizes, appeared more promising and feasible at this time and deserve further attention.

CONCLUSION

More research is needed into the effectiveness of these mechanisms and their transferability across jurisdictions.

The role of law and governance reform in the global response to non-communicable diseases

Addressing non-communicable diseases ("NCDs") and their risk-factors is one of the most powerful ways of improving longevity and healthy life expectancy for the foreseeable future - especially in low- and middle-income countries. This paper reviews the role of law and governance reform in that process. We highlight the need for a comprehensive approach that is grounded in the right to health and addresses three aspects: preventing NCDs and their risk factors, improving access to NCD treatments, and addressing the social impacts of illness. We highlight some of the major impediments to the passage and implementation of laws for the prevention and control of NCDs, and identify important practical steps that governments can take as they consider legal and governance reforms at country level.We review the emerging global architecture for NCDs, and emphasise the need for governance structures to harness the energy of civil society organisations and to create a global movement that influences the policy agenda at the country level. We also argue that the global monitoring framework would be more effective if it included key legal and policy indicators. The paper identifies priorities for technical legal assistance in implementing the WHO Global Action Plan for the Prevention and Control of NCDs 2013-2020. These include high-quality legal resources to assist countries to evaluate reform options, investment in legal capacity building, and global leadership to respond to the likely increase in requests by countries for technical legal assistance. We urge development agencies and other funders to recognise the need for development assistance in these areas. Throughout the paper, we point to global experience in dealing with HIV and draw out some relevant lessons for NCDs.

Patent Funded Access to Medicines

Instead of impeding access to essential medicines in developing countries, the essay explores why and how patents can serve as a source of funding for the much needed access to medicine. Instead of a weakening of patents, prolonged protection periods are suggested in circumstances where there is widespread lack of access. The revenues from extended patents are seen as a source of funding for drug donations to the least developed countries.

The role of intellectual property rights in treatment access: challenges and solutions

PURPOSE OF REVIEW

The purpose of this study is to review relevant literature published from January 2011 to July 2012 that specifically addresses the impact of intellectual property protection on access to antiretroviral drugs.

RECENT FINDINGS

The articles reviewed discussed the relation of intellectual property protection and access to medicines. For most authors, the World Trade Organization (WTO) Trade-Related Intellectual Property Rights Agreement (TRIPS) and the 10-year anniversary of the 2001 WTO Doha Declaration on TRIPS and Public Health formed an important background for the review of the current state of play.

SUMMARY

Intellectual property plays an important role in implementing policies to ensure HIV treatment and care programmes. From the review, three main themes emerged: the implementation of the Doha Declaration, the role of generic competition in antiretroviral treatment scale-up and innovative licensing mechanisms. The attention for the effects of intellectual property on access to HIV medicines opened the path for new initiatives for the management of patents using public health objectives as the key driver such as the UNITAID-backed Medicines Patent Pool. Some of the literature addressed the question whether more fundamental changes in the intellectual property architecture were necessary.

Global health governance: commission on social determinants of health and the imperative for change

In May 2009 the World Health Assembly passed a resolution on reducing health inequities through action on the social determinants of health, based on the work of the global Commission on Social Determinants of Health, 2005-2008. The Commission's genesis and findings raise some important questions for global health governance. We draw out some of the essential elements, themes, and mechanisms that shaped the Commission. We start by examining the evolving nature of global health and the Commission's foundational inspiration--the universal pattern of health inequity and the imperative, driven by a sense of social justice, to make better and more equal health a global goal. We look at how the Commission was established, how it was structured internally, and how it developed external relationships--with the World Health Organization, with global networks of academics and practitioners, with country governments eager to spearhead action on health equity, and with civil society. We outline the Commission's recommendations as they relate to the architecture of global health governance. Finally, we look at how the Commission is catalyzing a movement to bring social determinants of health to the forefront of international and national policy discourse.