New Text Of Italian Transparency Proposal Shows North-South Divide Emerging

A new draft text from an informal consultation at the World Health Organization yesterday shows a North-South divide emerging as member states made changes to the proposed resolution on the transparency of drug prices and the costs of research and development (R&D), brought forward by Italy earlier this year, that is slated for discussion at the World Health Assembly later this month.

The changes, led by high-income European states, with support from the United States and Australia, were described by civil society advocates for transparency of drug prices and R&D costs as an attempt to strip the resolution of any meaning and purpose, by deleting key provisions that make it useful in promoting transparency.

The proposed resolution on “Improving the transparency of markets for medicines, vaccines and other health-related technologies,” was tabled by the Italian Ministry of Health in February, recently gained support from a number of countries, and is scheduled to be discussed later this month at the annual World Health Assembly (WHA) from 20-28 May.

Knowledge Ecology International (KEI) posted a comparison of the differences between the 29 April and 7 May transparency resolution drafts here.

At the closed-door informal consultation held yesterday, a group of developed countries also attempted to postpone further discussions on the resolution until 2020.

A second session of the informal consultation will take place this Friday 10 May, at which the draft of the text that will be presented at the WHA will be finalised.

Civil Society Responds to the Resolution Changes

“The intensity of discussions around the proposed transparency resolution is indicative of the widespread interest and palpable sense of urgency among member states struggling with unaffordable medicine prices. At the same time there is a worrying chasm developing between the global North and South, as seen in this week’s informal discussions,” Tim Reed, Executive Director of Health Action International, told Health Policy Watch.

“At a time when the WHO should be showing leadership and clarity, stifling the debate not only sends the wrong message, but perpetuates a status quo no longer tenable for patients, public health systems and society at large,” he said.

“By tabling the resolution at the World Health Assembly the governments sponsoring the resolution are seeking to level the power imbalance between those selling medicines and those buying them with the ultimate aim of addressing the unaffordability of high medicine prices,” Katy Athersuch, Senior Policy Advisor at Médecins Sans Frontières (MSF, Doctors Without Borders), told Health Policy Watch.

“We were disappointed but not surprised to see that several northern European governments, particularly Germany, UK, Denmark and Sweden have attempted to strip the resolution of any meaning and purpose. It’s disappointing, because these governments seem to be trying to protect the interests of their pharmaceutical industries at the expense of increasing affordability of medicines not only for people in developing countries, but even for their own citizens,” she said.

“Tuesday’s informal was a full scale attack on efforts to expand transparency, led by a handful of northern European countries protecting domestic industries, with some assists from Australia and the United States,” James Love, Director of Knowledge Ecology International (KEI) told Health Policy Watch.

“The UK and several others tried to muddy the waters by adding several confusing and distracting provisions in the text that had nothing to do with transparency, and Germany, Sweden, Denmark, and the UK were the most aggressive and seeking to delete anything that was remotely useful in making prices, R&D costs, patent landscape and trial outcomes more transparent,” he said.

Below are the countries that made revisions to the resolution, along with the number of their revisions.

  • Australia: 8
  • Austria: 3
  • Brazil: 9
  • Denmark: 15
  • Germany: 25
  • Hungary: 2
  • Poland: 2
  • Spain: 8
  • Sweden: 11
  • UK: 11
  • USA: 2

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