CALL FOR GLOBAL LEADERSHIP TO THE OPEN-ENDED MEETING OF MEMBER STATES, CONCERNING THE RECOMMENDATIONS OF THE CONSULTATIVE EXPERTS WORK GROUP

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There is a clear need for decisive action. The current incentive systems for research and development are failing to address the needs of developing countries, leaving millions of people without affordable access to the products they need for the conditions they suffer from. Global health research resource flows to low and middle-income countries remain poorly co-ordinated with national research agendas, while failing to consistently support and build their national research and innovation systems, systems which ultimately would support these countries in making the transition from aid-dependence.

We, the undersigned organisations, comprising members of the global health research community, representing civil society organisations, research institutions, and others working in research and innovation, call upon member states attending the open ended meeting convened by the 65^th World Health Assembly to analyse the report and the feasibility of the recommendations of the Consultative Expert Working Group (CEWG) to demonstrate bold, global leadership in their deliberations.

We applaud the thorough and exemplary work of the CEWG. A long road has been walked by many dedicated people to bring us to this week’s meeting. The continuing inequities in the financing available for research concerning the diseases which burden the greatest number indicate that the need for mechanisms for increased, sustained and predictable health research financing and the effective co-ordination of it is more pressing than ever.

Critically, the report of the CEWG also provides an ideal opportunity to focus the minds of the global community on the growing strength of the emergent South in research and innovation. Southern nations are increasingly capable of responding to their needs with locally developed solutions. There are many examples of what is possible in the Global South when finance is available, when a supportive innovative environment is created, and when solid, fair partnerships are formed: low-cost diagnostics, low-cost blood pressure monitoring, and earlier this year the welcome announcement in South Africa of a candidate for a single dose anti-malarial.^1,2,3The Rio+20 resolution earlier this year recognised national research and innovation systems as critically important in ensuring sustainable development.⁴ If we are serious about supporting countries in moving move beyond aid-dependence, the global community must support the ability of nations to research and to innovate to address the needs of their people. Success must not only be measured in terms of lives saved now, but also in terms of long-term, sustainable capacity built.

The CEWG report stresses the importance of supporting country-led research agendas and strengthening national systems for research and innovation. Evidence shows that where external health research funding is not aligned with national research agendas, capacity is fragmented and precious resources are diverted from the research most needed. Many countries struggle to find the financing to put in place strong research and innovation systems, the absence of which creating an environment where the alignment of external resourcing with research priorities cannot occur.⁵

We Endorse

• The proposed global convention for research and development financing, especially insofar as it has potential to support the research and innovation capacities of developing countries, and to promote country led research agendas.
• The proposal for enhanced co-ordination of resource and development funding, especially insofar as these activities, when conducted at the national level, would place greater power in the hands of countries to align the funding available with national research agendas.

We thus firstly endorse the recommendation of the CEWG for a proposed global convention for research and development financing. This convention properly brings responsibility to all nations for stimulating the development of needed health technologies for Type II and Type III diseases, and the specific needs of developing countries related to Type I disease. The proposed convention also has the important potential to strengthen the pathway to sustainable development in lower income countries. The CEWG report recommends that one of the objectives of the negotiation process for such a convention should be to enhance the innovative capacity of developing countries. To achieve this, support could be provided by the convention through the following actions:

• Capacity building and technology transfer to developing countries,
• The promotion of partnerships and collaborations based on joint agendas and priority setting related to developing country health needs and national plans for essential health research,
• The development and retention of human resources and expertise,
• Institutional and infrastructure development,
• Sustainable medium-long term collaboration.⁶

We also support the CEWG’s recommendation for more effective global co-ordination of research and development funding. We agree that research and development resources are precious and that there is a role for a focal point for collating information about the global burden of disease and the landscape of investment, for sharing lessons, and for influencing the appropriate allocation of resources.However, it is clear to us that co-ordination must mean co-ordination with the self-identified needs of recipient countries, through alignment of health research resourcing with national health research agendas. We believe that for global health resource mapping to be most effective, it must not simply be a global, top-down, approach. It must also come from the ‘bottom-up’. Countries must be supported in mapping the resource flows within their jurisdictions. One of the central values of resource mapping derives from the political power it provides countries with to assess whether resource flows within their countries accord with their self-identified priorities, and thus to take appropriate action to ensure better alignment.To reiterate:We urge Member States to seriously and boldly engage with the recommendations of the CEWG report. A successful outcome of this process could mean ensuring predictable financing for health research from all governments – firewalled from donor priorities – finance with the potential to strengthen country research and innovation systems. We also advocate supporting enhanced resource co-ordination activities – especially those activities which place greater power in the hands of those countries where the research takes place and where the fruits of that research are so badly needed.

This call to action is also available in French, Spanish and Portuguese (pdf versions).

1^ http://www.mrcglobal.org/projects/african_innovation

2^ http://www.dellchallenge.org/projects/afyazima-blood-pressure-mcuff  

3^ http://allafrica.com/stories/201208290357.html

4^ http://www.uncsd2012.org/thefuturewewant.html

5^ http://www.cohred.org/2009/04/alignment-and-harmonization-of-health-research/

6^ http://www.who.int/phi/cewg_report/en/index.html