As announcements go, this is nothing short of an explosion in the world of public health. In mid-November, the United Nations (UN) Secretary-General Ban Ki-moon announced a very impressive panel on health technology, innovation and access. It has some of the most respected names from the world of trade, public health, law, human rights and diplomacy. The 16-member panel also has two representatives of pharmaceutical companies. That is the good news. In other news the World Health Organisation (WHO) the UNâ€™s lead health agency is not on the panel. The announcement, made when the world of UN was busy focusing on COP21 in Paris, has left the WHO furious observers say. The News Minuteâ€™s calls to the WHO remained unanswered at time of writing.
The panelâ€™s co-chairs are Ruth Dreifuss, former President of Switzerland and Festus Mogae, former President of Botswana. Among others, it has Indiaâ€™s Abdul Hamied, Canadaâ€™s Stephen Lewis, Brazilâ€™s Celso Amorin and South Africaâ€™s Malebona Precious Matsoso. It comes at a time when the Doha Round of the World Trade Organisationâ€™s (WTO) has almost collapsed bringing into sharp focus issues relating to drugs, patents and intellectual property issues. Anyone who sees Indiaâ€™s Hamied and South Africa together will remember the battle that country fought at the WTO to bring affordable AIDS medicine at an unprecedented cost of $1 per day in 2001. Ranged against Hamiedâ€™s CIPLA then were the top dogs of global pharmaceutical companies and the bitter struggle ended when the late Nelson Mandela declared the disease as causing a national emergency thus enabling the use of Compulsory Licensing (CL) at the WTO.
This simple narration does not do justice to that historic public health battle about which a lot has been written and is a must-read for people interested in understanding the power of political responsibility in ensuring that public health remains true to itself. Hamied is now leading efforts to develop multi-drug combination pills notably for HIV, tuberculosis, asthma as well as the development of paediatric formulations of drugs for children in poor countries.
Something had to give. On one side are people who have access to the best of technology and medicine and on the other are ranged growing millions who have access to neither and who carry a double disease burden of communicable and non-communicable diseases. In India, for example, strokes, cancers and diabetes kill more people than AIDS, malaria and tuberculosis though the last is increasing at a galloping pace and man-made stock-outs go unquestioned.
The panel is expected to hold wide consultations with all stakeholders before presenting its report to the UNSG though it remains unclear how this process will be achieved. As a final product the panel is expected to propose recommendations for affordable and quality treatment while, at the same time, giving impetus to innovation and development of vaccines, medicines and diagnostics. â€śCurrently, most research and development in vaccines, medicines and diagnostic tests are undertaken on the basis of financial potential rather than focused on the needs of the poorest and most marginalized,â€ť the office of the UNSG has said. The recent Ebola crisis which led to more than 11,000 deaths in West Africa, is widely seen as the trigger for this move by the UN which is also hoping to address criticism that its public health organisations have been poor performers.
The world has a free trade policeman in WTO, but it does not have a spokesperson for public health. Observers say the expert panelâ€™s proposal could lead to a UNSC resolution calling on governmentâ€™s to front-end public health as an unaddressed pillar of development. This could potentially arm countries with a tool with which to take on the WTO. While UN resolutions do not have teeth and WTO can enforce stinging sanctions on its member states, analysts say the panelâ€™s push will have moral authority, courage and hopefully cohesion all of which have been absent in global public health dialogues.
The cruel cut is reserved for the WHO which, over the years, has become a victim of its own lethargy and self-righteousness. As the world only multilateral policy-setting forum, the politicizing of the organization has resulted in it going for the least common of all denominators â€“ no action.
There are questions countries and lawmakers must answer. Who will pay or compensate pharmaceutical companies for the billions they pour into discovering one life-saving molecule? What is the role and responsibility of private insurance in public health care? For too long we have been asking questions. Time to find some answers. All eyes will eventually rivet to the high-level panel as its near completion of its work. Maybe the UN will its members a 70th birthday present in the form of a public health movement. Watch this space.
Read UN note here. http://www.un.org/press/en/2015/sga1608.doc.htm