February 20, 2019

WHO EB moves forward actions on budget, access to medicines, and AMR R&D

Matthew Robinson, MA
Policy and Advocacy Officer
Flickr/United States Mission Geneva, Eric Bridiers

The 2019 global health multilateral calendar kicked off as it always does with the World Health Organization (WHO) Executive Board (EB) meeting in late January in Geneva. Opening the meeting, WHO Director-General Dr. Tedros Adhanom Ghebreyesus continued his emphasis on framing global health discussions as being about how to achieve universal health coverage and further emphasized the importance of innovation and data-driven approaches to achieving this ambitious goal. In this context, it is not surprising that this year’s session featured a packed agenda with significant implications for research and development (R&D).

2020-2021 Program Budget

One of the first and most important items on the agenda was WHO’s budget for the coming two years, which will directly impact R&D-related programs including the essential medicines and diagnostic lists and prequalification.

WHO proposed an overall budget (base, polio, and emergency fund) of US$4.79billion—an 8 percent increase over the 2018‒2019 level of $4.42 billion. The base program budget—which covers funding for the essential lists and prequalification, among other items—would see a 13 percent increase over 2018‒2019 levels.

In welcome news, the secretariat laid out five key priority areas in the budget, including one focused on increasing WHO’s investment to support innovation and data. How this focus translates concretely and what it means in terms of resources allocated remains unclear. It also remains to be seen whether WHO will be able to marshal the voluntary contributions needed from member states to reach this increased budget target.

Access to Medicines

The EB again took up the issue of access to medicines, which has been a controversial topic at EB meetings for several years. As directed by a 2018 World Health Assembly (WHA) resolution, the secretariat produced a draft roadmap outlining the organization’s proposed activities on access to medicines.

Generally speaking, the plan was well received by member states, with the marked exception of activities related to intellectual property (IP) and pricing. A number of countries, led by the United States, argued that the only role WHO should play in these areas is as a member of the tripartite agreement with the World Intellectual Property Organization, and the World Trade Organization, and that any expansion of WHO’s mandate beyond this is inappropriate. On the opposite side, Brazil and aligned countries argued that IP and pricing impacts the right to health and that WHO therefore has a unique and outsized role to play. It appears that neither side is willing to budge, so we expect this to remain an area of friction as the plan undergoes further refinement before it is expected to be voted on at the WHA in May.

Antimicrobial Resistance

Following on the 2016 United Nations High-Level Meeting (HLM) on Antimicrobial Resistance (AMR), EB members heard a progress report on commitments made in the HLM political declaration. Overall, progress has been steady although a number of areas lag behind, particularly regarding the overuse of antibiotics in agriculture and livestock.

While there was no resolution anticipated on this topic, several member states including the United States jointly proposed a resolution containing very positive language for R&D.

The resolution urged member states to “enhance cooperation at all levels for concrete action towards combatting AMR, including through…research and regulatory capacity and technical assistance, including, where appropriate through twinning programs that build on best practices, emerging evidence and innovation.” Additionally, it called on WHO’s Director-General to “support member states to mobilize adequate predictable and sustained funding and human and financial resources and investment through national, bilateral and multilateral channels to support…research and development on existing and new antimicrobial medicines, diagnostics, and vaccines, and other technologies.”

It is fair to say that R&D fared well over the course of this year’s EB, and GHTC looks forward to moving these conversations forward heading into the WHA in May.

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