By Bonnie Drury and Ezra Steinhardt

Controversy continues over WHO negotiations for a binding global medical research & development treaty — and the negotiations may now stall until May at the earliest.

In late November 2012, members of the Consultative Expert Working Group on Research and Development:  Financing and Coordination (the CEWG) agreed the text of a draft resolution to address the lack of R&D for neglected diseases, which predominantly afflict poor populations in developing nations.

The draft resolution fell short of endorsing proposals desired by some large emerging market countries, that would have set the scene for a binding global health R&D treaty — an agreement that could have potentially reshaped intellectual property incentives for research into neglected diseases.  Instead, the most concrete action taken in the resolution was to establish an “observatory” to monitor health R&D.

More recently, in early January, a Member State WHO Executive Board meeting proved the issue remains highly contentious.  Developed countries resisted proposals for pooled funding (which would require members to spend a proportion of GDP on R&D that addresses the health needs of developing countries) in order to preserve the viability of their research-based pharmaceutical industries.  Developing countries, for their part, expressed concerns that the current system of donor financing was both insufficient and unsustainable.

Prominent NGOs, such as Médicins Sans Frontières (MSF), have described the resolution as weak, citing in particular the proposed “observatory”, which they argue should be given a more specific remit. Others continue to be disappointed by a lack of progress towards a binding medical R&D health treaty, and the manner in which the previous draft resolution was negotiated (negotiating sessions went late into the night, limiting participation from some Member States).

Fueled by these objections, a growing number of developing countries are seeking to re-open the resolution in order to strengthen its language, so that it imposes an obligation on Member States to take further actions (rather than merely urging them to do so).  At least two developed nations, the US and Australia, however, have remained adamant that the consensus resolution should not be re-opened.

On 29 January, the Board approved the draft resolution with modifications.  A reference to the CEWG was ultimately removed, due to strong opposition from the EU and the United States.  In light of the controversy, the decision whether to reopen the consensus has been referred to the WHO’s next Assembly, in May 2013.