Research and Development Coordination and Financing
Report of the World Health Organization Expert Working Group on Research and Development Financing
2010
This report is structured to address current financing of research and development, coordination of research and development and proposals for new, innovative sources of financing to stimulate research and development.
Available online PDF [98p.] at: http://www.who.int/phi/documents/RDFinancingwithISBN.pdf
“……….the fact that much of the improvement in health that has occurred has been in areas that are not usually considered to be within the health sector. In spite of the evidence of an inseparable bidirectional link between health and all facets of human development, galvanizing global attention to the fundamental problem and possible solutions has been slow. A global approach to the needs of countries is required, and many of the new challenges are blurring the differences between developed and developing countries.
“Innovative developing countries” are now considered to have requirements and strengths that are different from those of both the developing and the developed world. One issue that is assuming increasing prominence is the cost of and lack of access to essential health products in the context of global financial constraints and domestic fiscal space issues, and the extent to which these problems are linked to current technological innovation. Many technological developments have come from developed countries and have numerous restrictions that place them beyond the reach of the world’s poor countries, adding to the plethora of existing restrictions inherent to institutions and health systems………”
“…..The taxonomy of diseases has changed with time. In an earlier classification, diseases were classified into types I, II and III. Subsequently, data on burden of disease led to a clear distinction between communicable and noncommunicable diseases; now, a separate class of diseases is designated as “neglected”, almost all of which are communicable. None of these classifications is rigid, and there is overlap and movement from one to the other. Growing emphasis is also being placed on the social determinants of disease, another dimension of neglect in health, and the role of gender in determining disease outcomes.
There is abundant, incontrovertible evidence that developing countries bear a double burden of disease. Furthermore, many large countries are virtual spaces, with significant differences in health status within them. The tyranny of the averages hides much of the ill health that affects the world’s poor.
The old paradigm that infectious diseases affect developing countries and the poor and that chronic noncommunicable diseases affect only the rich has been put to rest.…..”
CONTENTS
1. Introduction
2. Financing research and development
2.1 Context
2.2 Incentives to stimulate research and development in the light of market and policy failures in the production and diffusion of knowledge
2.2.1 Implications of the public nature of knowledge
2.2.2 Evolution of incentives to stimulate research and development
2.2.3 Incentives for the provision of knowledge at national level
2.2.4 Mechanisms to provide public support for research and development
2.3 Possible framework for considering financing options
2.4 Applying the framework to financing options
2.5 Partnerships for product development
3. Coordination of financing for research and development
3.1 Main sources of funding
3.1.1 Public funding
3.1.2 Industry funding.
3.1.3 Funding by charities and private foundations
3.2 Conclusions
4. Coordination of research and development for communicable and noncommunicable diseases
4.1 Material
4.2 Background
4.3 Resource tracking and coordination
4.4. Current arrangements
4.5 Coordination by theme
4.5.1 By disease: malaria
4.5.2 By health area: human reproduction
4.5.3 By product
4.6 Policy coordination
4.7 ‘Mapping’ initiatives
4.8 Collaborative arrangements for global health research
4.9 General conclusions and comments
5. Innovative sources of financing
5.1 Introduction
5.2 Background
5.3 Proposals for financing
5.3.1 A new indirect tax
5.3.2 Voluntary contributions from businesses and consumers
5.3.3 Taxation of repatriated pharmaceutical industry profits
5.3.4 New donor funds for health research and development
5.4 Approaches to funding allocation
5.4.1 Product development partnerships
5.4.2 Direct grants to small companies and for trials in developing countries
5.4.3 ‘Milestone’ prizes
5.4.4 ‘End’ prizes (cash)
5.4.5 Purchase or procurement agreements
5.5 Proposals to improve efficiency
5.5.1 Regulatory harmonization (with focus on developing countries)
5.5.2 Precompetitive for research and development platforms
5.6 Promising proposals
5.6.1 Open source
5.6.2 Patent pools (UNITAID model)
5.6.3 Health impact fund
5.6.4 Priority review voucher
5.6.5 Orphan drug legislation
5.7 Gaps
5.8 Comments
Annex 1. Method for evaluating proposals to finance health research and development
Annex 2. Proposals that did not meet the agreed criteria.
Members of the Expert Working Group on Research and Development Financing
Sir George Alleyne (Barbados) Professor José Carvalho de Noronha (Brazil) Dr Pedro Conceição (Portugal) Professor Nirmal Ganguly (India) Professor Jean-François Girard (France) Professor Yan Guo (China) Professor Nabil Kronfol (Lebanon) Dr Cecilia Lopez Montaño (Colombia) Dr Sigrun Møgedal (Norway) Dr Mary Moran (Australia) Professor Peter Ndumbe (Cameroon) Dr Sania Nishtar (Pakistan) Dr Mark Rohrbaugh (United States of America) Dr Ursula Schaefer-Preuss (Germany) Dr Sibusiso Sibisi (South Africa) Dr Sue Szabo (Canada) Professor Keizo Takemi (Japan) Dr Lars Thunell (Sweden) Dr Mark Walport (United Kingdom of Great Britain and Northern Ireland) Professor Miriam Were (Kenya) Mr Philip Yeo (Singapore) Professor Yongyuth Yuthavong (Thailand) Dr Philippe Douste-Blazy, Special Adviser to the United Nations Secretary-General on Innovative Financing for Development (France)
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