PHM-Exch> WHO Exec Bd 130 Report Day 6

[Claudio Schuftan]

From: Alice Fabbri <alealifab at gmail.com>

The report is available at: http://www.ghwatch.org/who-watch/eb130

 *Highlights from the sixth day of the 130th Executive Board*

Geneva, 21.01.12


 *Draft of the global vaccine action plan: update* **

The discussion on vaccines focused on a general issue - the development of
the global vaccine action plan - and two specific draft resolutions: the
“World Immunization Week” and another one called “Towards eradication of
measles”.

Both resolutions were released very late, the first one was proposed by
Barbados and requests Member States to designate the last week of April as
World Immunization Week. The second one was proposed by Ecuador on behalf
of the Union of South American Nations (UNASUR) and, among other requests,
urges Member States to establish a time frame for the eradication of
measles.

Concerning the global vaccine action plan, many Member States (i.e. US and
Japan) recognized the importance of this agenda item for global public
health and for the achievement of the related MDGs. However, some concerns
were raised on several issues. Japan requested the Secretariat to assess
how the global vaccine action plan will coordinate with already existing
programmes on immunization in order to avoid duplication especially at the
field level.

Estonia, on behalf of EU, reminded the importance of the rational use of
immunization and called WHO to play a crucial role in norms setting and
technical support within the Decade of Vaccine (DoV) Collaboration. On the
same way, France asked for more information on the WHO relationship with
GAVI alliance and the other partners of the DoV Collaboration.

France and US requested also clarification on the establishment of a
“vaccine access forum” and its operational implications.

Timor-Leste raised an interesting point by saying that despite huge
achievements, immunization coverage remains still low in some countries due
to limited financial support. Therefore, they asked the Secretariat to
include in the report detailed information about immunization coverage and
its linkage with economic situation of different countries.

China highlighted the importance of promoting technology transfer in order
to facilitate local production of vaccines at country level.

The last point that deserves to be mentioned is the US statement on the use
of the words “access to” and “use of” vaccines. In its opinion access to
vaccine is not sufficient and the delegate pushed to add the word “use of”
into the document thus slightly reducing the meaning of immunization to a
consumable good.

The People’s Health Movement presented a statement in which civil society
urged Member States to carefully consider how conflicts of interest will be
tackled in the “vaccine access forum” since it will include stakeholders
with commercial mindsets that might rival public health goals. Moreover the
statement affirmed that immunization programmes should not be seen as a
substitute to the broader range of public health measures, such as access
to primary health care services, health education and the availability of
safe drinking water and sanitation.

The Assistant DG (Family, women’s and children’s health) took the floor
answering that further clarifications on Member States requests will be
given after the special session of the Strategic Advisory Group of Experts
(SAGE) on immunization that will be held next February in Geneva.
Addressing the France concern, she affirmed that “*up to now the DoV
collaboration has been an extremely positive one and we are working hand in
hand with all the partners of the DoV collaboration”.*

Concerning the resolution on measles proposed by Ecuador, Estonia and
Ecuador itself asked for the inclusion of the vaccination for measles in
the draft global vaccine action plan. US among others asked to replace the
word “eradication” with the word “elimination” in the text of the
resolution because the goal of eradication is still not achievable. After
this amendment the resolution was adopted.

The resolution “World Immunization Week” obtained wide support since it
could be a window opportunity. However Thailand sharply drew the attention
on the risk that the private sector could take advantage of this event to
market indiscriminately its products suggesting that the best option is to
promote only basic and evidence-based immunization programmes.


 *Substandard/spurious/falsely-labelled/falsified/counterfeit medical
products: report of the Working Group of Member States
*

*
*
Under this important Agenda Item, EB Members have agreed to the new “Member
State mechanism on
substandard/spurious/falsely-labelled/falsified/counterfeit medical
products” proposed in document EB130/22. Several developing countries,
however, quite strongly pointed out that the mechanism failed to address
WHO’s relationship with the International Medical Products
Anti-Counterfeiting Taskforce (IMPACT). On the other hand, interventions by
developed countries, such as Canada, Japan, Switzerland and the US,
encouraged the involvement of other “stakeholders”, including the private
sector, and somehow necessitated and legitimised the existence of IMPACT
until the mechanism is put in place.

Argentina announced it will host the first conference on SSFFC, and invited
all Member States to this meeting in Buenos Aires in October, saying that
they bear the cost of the participation of delegates. Its proposal will be
finalised by the 65th WHA in May.

Norway, among others who showed some reluctance to accept meeting outside
Geneva, suggested that a preparatory meeting be held in Geneva prior to
that in Buenos Aires.

The EB took note of the report with the proposed mechanism, and
accordingly, a draft resolution will be submitted to the 65th WHA in May
2012 calling for the setting up of this mechanism, and for the WHO to
increase its efforts in strengthening regulatory capacities in countries
and regions where needed.

India said that IP enforcement should remain outside discussions on QSE
(Quality, Safety and Efficacy) at the WHO, attributing the problem of
compromised medicines to weak drug regulatory structures, and called for
severing any links with IMPACT.

Nigeria, speaking on behalf of the African Region, acknowledged the fact
that SSFFC medicines comprise a major public health challenge to the
region. Nigeria encouraged the WHO’s work on medicines supply chain
security, local production, capacity building, and multisectoral
collaboration to ensure access to QSE medicines.

Mexico drew the attention of the EB to the fact that the report only refers
to medicines, whereas there are other products on the market, which the
media promotes as medical when they are not related to medicines at all.
Mexico believed these products should be controlled as well.

Brazil, a non-EB Member, mentioned the emergence of anti-counterfeiting
measures linked to TRIPS-plus standards and IP enforcement, giving the
example of the Anti-Counterfeiting Trade Agreement (ACTA), and the 19
detentions by customs authorities of medicines in transit through the EU.
On IMPACT, Brazil strongly believed that this essential aspect of the
deliberations cannot be left unresolved in the proposed mechanism.

Iran, also a non-EB Member, expressed its “deep concern” regarding the lack
of finances in the area of QSE at WHO.

Bangladesh and Thailand as well were concerned about the mechanism not
addressing WHO’s relationship with IMPACT.

The WHO Secretariat responded to queries and concerns by MS, particularly
on limited finances directed to QSE work, saying that it would be difficult
to mobilise extra budgetary resources for what is considered core work of
the WHO.


 *Consultative expert working group on research and development: financing
and coordination
*
**

Several delegations said they were looking forward to receiving the full
report by the Consultative Expert Working Group (CEWG) in April 2012.

Upon a request by Norway, seconded by Canada and Estonia among others, the
Secretariat agreed to hold informal meetings in Geneva in preparation for
the 65th WHA in May to update delegations on the progress of the CEWG after
the report is released.

In a rather controversial intervention, Switzerland noted that time will be
tight from April, when the report will be published, till the WHA in May
making it not possible for them to take a decision about it, and suggested
having a one-year process to consider the report before any decisions are
taken. This proposal was invalidated by Brazil on the grounds that the EB
cannot change the mandate put forward by a WHA resolution, referring to
WHA63.28 establishing the CEWG.

China also proposed public information sessions be held, and that all
relevant documents be made available on the WHO website.

In their statement, Brazil, a non-EB Member, noted that there are “enormous
inequalities” which still remain around the world, highlighting that there
is nearly 2 billion people deprived of access to essential medicines, most
of them living in poverty in developing countries. Brazil attached high
importance to the full implementation of the Global Strategy and Plan of
Action on Public Health, Innovation and Intellectual Property.

Bolivia, also a non-EB Member, said it has been following the CEWG process,
and mentioned their five original proposals to the Expert Working Group
(EWG) to seek innovative ways to encourage research on diseases which
particularly affect developing countries, while also delinking cost of
medicines from research expenses.

In response to interventions, and in addition to holding a briefing meeting
in Geneva, the Secretariat clarified that two regional consultations could
not be held (EMRO and EURO) because of the inability of the regions to
define dates, although the Secretariat has been proactive in terms of
approaching the regions.

The EB took note of the report.


 *WHO’s response, and role as the health cluster lead, in meeting the
growing demands of health in humanitarian emergencies *

The report on humanitarian emergencies will be uploaded as soon as
possible.
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