By Robert Parsons
GENEVA (Reuters Health) – The World Health Organisation's Executive Board on Friday passed a resolution urging member states to improve access to medicines through specific legislation, and asking the agency's director-general, Dr. Gro Harlem Brundtland, to push for "market-based differential pricing" for life-saving drugs.
The resolution, to be presented to the WHO member countries for final approval in May at the World Health Assembly, also endorsed the World Trade Organization's "Declaration on the TRIPS agreement and public health." The declaration, produced at a WTO meeting in Doha last year, is seen as aiding developing countries in accessing medicines.
The phrasing "market-based" was added to the resolution at literally the last minute, when the UK's representative proposed the two words be inserted into a directive mandating the director-general "to advocate the necessary action worldwide to promote differential pricing for essential medicines between high-, middle- and low-income countries."
The US, not sitting on the annually rotating Board this year, expressed its approval of the amended resolution, which was passed with no further debate.
In a telephone interview with Reuters Health, Eric Noehrenberg, director of intellectual property and trade issues at the International Federation of Pharmaceutical Manufacturers Associations, also expressed approval of the modified language.
"This amendment is important," he said, "because it would be inappropriate for the resolution to be used as an excuse to pursue global price setting. This would be against the wishes of many of the WHO member states."
Ellen 't Hoen of the doctors' group Medecins sans Frontieres, which has long been monitoring the question of access to essential drugs, was of the opposite opinion. The introduction of "market-based" into the resolution, she said, effectively constrains the WHO to supporting a pricing system devoid of any government regulations and price controls.
"All in all," she told Reuters Health, "this is a serious set back. 'Market-based' is an open term that the pharmas interpret to suit themselves. It encourages the idea that, if we rely on the market and voluntary pricing discounts, we'll get prices low enough for all people to be able to afford them."
Another directive of the resolution calls for WHO to ensure that its Expert Committee on the Use of Essential Drugs, which advises governments on the most needed medications, retains its "independence from external pressure."
This point had been strongly challenged by the US–which cited potential lost input from the pharmaceutical industry and claiming that the closed-door meetings of the Expert Committee were a violation of transparency–but the Board members did not agree, and kept the initial wording, which was passed without further objection.