Implementing Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property in the Eastern Mediterranean Region

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1 Implementing Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property in the Eastern Mediterranean Region 1

2 Table of Contents LIST OF ACRONYMS AND ABBREVIATIONS INTRODUCTION IMPLEMENTATION PLAN OF GSPA IN EMR COUNTRIES ELEMENT 1. PRIORITIZING RESEARCH AND DEVELOPMENT NEEDS ELEMENT 2. PROMOTING RESEARCH AND DEVELOPMENT ELEMENT 3. BUILDING AND IMPROVING INNOVATIVE CAPACITY ELEMENT 4. TRANSFER OF TECHNOLOGY ELEMENT 5. APPLICATION AND MANAGEMENT OF INTELLECTUAL PROPERTY TO CONTRIBUTE TO INNOVATION AND PROMOTE PUBLIC HEALTH ELEMENT 6. IMPROVING DELIVERY AND ACCESS ELEMENT 7. PROMOTING SUSTAINABLE FINANCING MECHANISMS ELEMENT 8. ESTABLISHING MONITORING AND REPORTING SYSTEMS ANNEX 1 RECOMMENDATIONS OF THE COMMISSION ON INTELLECTUAL PROPERTY RIGHTS, INNOVATION AND PUBLIC HEALTH

3 List of Acronyms and Abbreviations ACHR CIPIH DHS EMR EMRO EST GMP GSPA HEC HRD IGWG OECD PHI PHP RPC TRIPS UNCTAD UNIDO WHO WIPO WTO Advisory Committee on Health Research Commission on Intellectual Property, Innovation and Public Health Division of Health Sector Development Essential Medicines and Pharmaceuticals Eastern Mediterranean Region Eastern Mediterranean Regional Office Evidence-based Health Situation and Trend Assessment Good Manufacturing Practice Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property Health Economics Human Resources Policy and Management Intergovernmental Working Group Organization for Economic Cooperation and Development Public Health and Innovation Policy and Health Planning Research Policy and Cooperation Agreement on Trade-Related Aspects of Intellectual Property Rights United Nations Conference on Trade and Development United Nations Industrial Development Organization World Health Organization World Intellectual Property Organization World Trade Organization 3

4 Introduction Background Realizing the importance of the recommendations of the Commission on Intellectual Property, Innovation and Public Health (CIPIH) 1, an Intergovernmental Working Group on Public Health, Innovation and Intellectual Property (IGWG) was established following World Health Assembly resolution WHA The IGWG aimed at further processing and elaborating on the recommendations of CIPIH. Its work resulted in developing the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property (GSPA), which is a comprehensive framework that aims at promoting new thinking on innovation and access to medicines 3, providing guidelines that cover challenging aspects of access to medicines in developing and least developed countries. The Eastern Mediterranean Regional Office (EMRO) has started the process of contextualization, and eventually implementation, of the GSPA in the region, in a manner that is consistent with the region s current situation and needs. This regional strategy and plan of action is presented in a format which builds on the structure and elements of the GSPA, while assigning the roles within WHO EMRO units and divisions, wherever relevant, in light of current and/or planned activities in the region. Process 1. The WHO EMRO Essential Medicines and Pharmaceuticals () and Research Policy and Coordination (RPC) units have both joined hands and resources, and started this project on the plan of implementation of the GSPA in EMR. 2. A joint memo has been sent from and RPC through the Division of Health Services (DHS) and Assistant Regional Director (ARD) to Dr. Hussein Gezairy, the Regional Director, who has supported the initiative. The memo suggested the creation of a regional advisory group with the aim of advising and overseeing the implementation of GSPA in EMR, and this has also been agreed by the RD. 3. There are other technical units in EMR that have a definite role in this implementation process, and RPC and are in the process of conducting individual consultations with those technical units to ensure their input in this implementation process. 4. and RPC are working closely with WHO HQ, both through the Secretariat of Public health and Innovation (PHI) in the Director General s Office, as well as department, in terms of developing the global implementation plan, monitoring and reporting processes and resource mobilization. 5. Once the draft plan of implementation of GSPA in EMR is concluded and agreed in-house, the meeting of the first regional advisory group will be convened and after their input, modification of the draft and its finalisation and adoption, the implementation process will start. Approach The approach adopted during this planning process has been deeply inspired by the CIPIH report, particularly its recommendations section (See Annex 1). The regional plan is building on the Global Plan of Action in terms of contextualizing it to the situation and priorities of the EMR. In so doing, the 1 World Health Organization (2006). Report of the Commission on Intellectual Property Rights, Innovation and Public Health. Available at: 2 Available at: 3 WHA61.21 Available at: 4

5 basic framework of the Global Plan of Action, has been followed, in terms of its elements, subelements and identified stakeholders. Implementation Plan The implementation plan consists of three parts: 1. Elements and sub-elements of the GSPA modified for the EMR. 2. Plan of activities which will take place until the convening of the advisory group meeting, date of which is yet to be determined 3. Monitoring mechanism of the implementation of GSPA in EMR List of Explanatory Notes 1. EMR lead responsibility 5

6 Element 1. Prioritizing research and development needs Implementation Plan of GSPA in EMR Countries Sub-elements and specific actions Stakeholder(s) Comments (1.1) mapping global research and development with a view to identifying gaps in research and development on diseases that disproportionately affect developing countries (a) develop methodologies and mechanisms to identify gaps in research on Type II and Type III diseases and on developing countries specific R&D needs in relation to Type I diseases (b) disseminate information on identified gaps, and evaluate their consequences on public health (c) provide an assessment of identified gaps at different levels national, regional and international to guide research aimed at developing affordable and therapeutically sound products to meet public health needs WHO; Governments; other relevant stakeholders RPC WHO; Governments; other relevant stakeholders RPC WHO; Governments; other relevant stakeholders RPC As a global activity, the lead responsibility within WHO would lie with PHI WHO/HQ in collaboration with relevant departments there (TDR, RPC etc.) and they must guide regional offices if they require input from them in the development of these methodologies. Once the methodologies have been developed and gaps have been identified, PHI WHO/HQ has to provide guidance for dissemination of this information in the region and how regional offices can collaborate on evaluation of the consequences of identified gaps on public health. Guidance from and in collaboration with PHI WHO/HQ Ongoing activities in EMRO Planned activities for EMRO (1.2) formulating explicit prioritized strategies for research and development at country and regional and inter-regional levels (a) set research priorities so as to address public health needs and implement public health policy based on appropriate and regular needs Governments; regional organizations The issues highlighted in GSPA would reflect in EMR research strategy 6

7 assessments (b) conduct research appropriate for resource-poor settings and research on technologically appropriate products for addressing public health needs to combat diseases in developing countries (c) include research and development needs on health systems in a prioritized strategy (d) urge the leadership and commitment of governments, regional and international organizations and the private sector in determining priorities for R&D to address public health needs (e) increase overall R&D efforts on diseases that disproportionately affect developing countries, leading to the development of quality products to address public health needs, user friendly (in terms of use, prescription and management) and accessible (in terms of availability and affordability) RPC relevant stakeholders (including academia, relevant health- related industries, national research institutions and public private partnerships) RPC relevant stakeholders (including academia, national research institutions, and public private partnerships) RPC WHO; Governments; other stakeholders (including private sector) RPC relevant stakeholders (including academia, relevant health related industries, national research institutions, and public private partnerships) Research appropriate for resource-poor settings and research on technologically appropriate products for addressing public health needs to combat diseases in developing countries will be reflected in EMR research strategy as a priority. Research and development needs on health systems will be reflected as a priority in EMR research strategy It will take place through advocacy for appropriate research policy and coordination though the work of RPC. A situation analysis paper will be developed to look at R&D efforts in the region on disease that affect countries in the region and that lead to the development of quality products to 7

8 (1.3) encouraging research and development in traditional medicine in accordance with national priorities and legislation, and taking into account the relevant international instruments, including, as appropriate, those concerning traditional knowledge and the rights of indigenous peoples (a) set research priorities in traditional medicine (b) support developing countries to build their capacity in research and development in traditional medicine RPC and stakeholders (including academia; national research institutions; public private partnerships; and concerned communities) stakeholders (including academia, relevant health-related industries, national research institutions, public private partnerships) address public health needs, user friendly (in terms of use, prescription and management) and accessible (in terms of availability and affordability) A report will be produced in close collaboration with two WHO collaborating centres in the region on traditional medicine in on how to set research priorities in traditional medicine in the region, this work will take place also in close collaboration with traditional medicine unit in at HQ A list of all institutions involved in research and development in EMR will be developed and a questionnaire will be sent to them to know about their needs for capacity building. 8

9 (c) promote international cooperation and the ethical conduct of research (d) support South-South cooperation in information exchange and research activities stakeholders RPC organizations; regional stakeholders RPC Concerns about ethical conduct of research will be reflected in the regional research strategy Guidance from and in collaboration with PHI WHO/HQ. (e) support early-stage drug research and development in traditional medicine systems in developing countries stakeholders As in 1.3(b), a list of all institutions involved in research and development in EMR will be developed and a questionnaire will be sent to them to know about their needs for capacity building. 9

10 Element 2. Promoting research and development Sub-elements and specific actions (2.1) supporting governments to develop or improve national health research programmes and establish, where appropriate, strategic research networks to facilitate better coordination of stakeholders in this area a) promote cooperation between private and public sectors on research and development Stakeholder(s) stakeholders RPC Comments Ongoing activities in EMRO Planned activities for EMRO Through regional research strategy. (b) provide support for national health research programmes in developing countries through political action and, where feasible and appropriate, long-term funding Governments; regional organizations; WHO (technical assistance); other relevant stakeholders RPC Through regional research strategy. (c) support governments in establishing health-related innovation in developing countries Governments; regional organizations; WHO (technical assistance); other relevant stakeholders RPC Through regional research strategy. (2.2) promoting upstream research and product development in developing countries (a) support discovery science, including where feasible and appropriate, voluntary open-source methods, in order to develop a sustainable portfolio of new products stakeholders 1. An annotated list of institutions involved in discovery science in EMR will be 10

11 (b) promote and improve accessibility to compound libraries through voluntary means, provide technical support to developing countries and promote access to drug leads identified through the screening of compound libraries (c) identify incentives and barriers, including intellectual property- related provisions, at different levels national, regional and international - that might affect increased research on public health, and suggest ways to facilitate access to research results and research tools RPC and stakeholders RPC and organizations (including WIPO and WTO); other relevant stakeholders RPC and developed, 2. The needs for supporting discovery science in the region by these institutions will be listed and ways will be identified to support these institutions and their work. Through identifying institutions involved in discovery science, a list of those among them will be developed who maintained compound libraries, and ways will be discussed with them to provide them with support to promote access to drug leads identified though streaming their compound libraries. 1. Through regional research strategy. 2. The issue will be put on the agenda of the regional advisory 11

12 (d) support basic and applied scientific research on Type II and Type III diseases and on the specific R&D needs of developing countries in relation to Type I diseases (e) support early-stage drug research and development in developing countries stakeholders RPC through regional research strategy stakeholders (including relevant health- related industries, academia, international and national research institutions; donor agencies; development partners; nongovernmental organizations) and RPC through regional research strategy committee on health research (ACHR) and their guidance will be sought for developing this work in the region. As in 2.2(a): 1. A list of institutions involved in discovery science in EMR will be developed, 2. The needs for supporting discovery science in the region by these institutions will be listed and ways will be identified to support these institutions and their work. As in 2.2(a), and 2.2(d): 1. A list of institutions involved in discovery science in EMR will be developed, 2. The needs for supporting discovery science in the region by these institutions will be listed and ways will be 12

13 (f) build capacity to conduct clinical trials and promote public and other sources of funding for clinical trials and other mechanisms for stimulating local innovation, taking into account international ethical standards and the needs of developing countries (g) promote the generation, transfer, acquisition upon agreed terms and voluntary sharing, of new knowledge and technologies, consistent with national law and international agreements, to facilitate the development of new health products and medical devices to tackle the health problems of developing countries stakeholders (including relevant health- related industries; academia; development partners; charitable foundations; public- private partnerships; nongovernmental organizations) /RPC organizations, other relevant stakeholders (including; academia, international and national research institution; relevant health-related industries and development partners) Seek guidance from and collaborate with PHI HO/HQ in connection with the ongoing project on technology transfer with the support of the European Union. identified to support these institutions and their work. A situation analysis report will be produced mapping institutions in the region involved in conducting clinical trials, needs for their capacity building and relevant ethical, quality and regulatory issues. (2.3) improving cooperation, participation and coordination of health and biomedical research and development (a) stimulate and improve global cooperation and coordination in research and development, in order to optimize resources stakeholders RPC with PHI WHO/HQ Guidance from and in collaboration with PHI WHO/HQ. (b) enhance existing fora and examine the need for new mechanisms, in order to improve the coordination and sharing of information on research and relevant stakeholders Through regional research strategy 13

14 development activities (c) encourage further exploratory discussions on the utility of possible instruments or mechanisms for essential health and biomedical R&D, including inter alia, an essential health and biomedical R&D treaty (d) support active participation of developing countries in building technological capacity (e) promote the active participation of developing countries in the innovation process (2.4) promoting greater access to knowledge and technology relevant to meet public health needs of developing countries (a) promote the creation and development of accessible public health libraries in order to enhance availability and use of relevant publications by universities, institutes and technical centres, especially in developing countries (including academia, research RPC and Interested Governments; [WHO]; other relevant stakeholders (including nongovernmental organizations) RPC relevant stakeholders RPC relevant stakeholders RPC stakeholders and through exploration with the interested member states and existing relevant and interested regional institutions. Through ACHR discussion about a possible R&D Treaty and other instruments or mechanisms for encouraging essential health and biomedical R&D. Through regional research strategy. Through regional research strategy. Through regional research strategy. 14

15 institutions, relevant health-related industries; nongovernmental organizations; publishers) RPC (b) promote public access to the results of government funded research, by strongly encouraging that all investigators funded by governments submit to an open access database an electronic version of their final, peer-reviewed manuscripts stakeholders (including academia and research institutions) RPC through regional research strategy Through regional research strategy. (c) support the creation of voluntary open databases and compound libraries including voluntary provision of access to drug leads identified through the screening of such compound libraries (d) encourage the further development and dissemination of publicly or donor-funded medical inventions and know-how through appropriate licensing policies, including but not limited to open licensing, that enhance access to innovations for development of products of relevance to the public health needs of organizations (including WIPO); other relevant stakeholders (including relevant health-related industries) RPC through regional research strategy stakeholders (including academia and national research institutions) 1. Guidance from and in collaboration with PHI WHO/ HQ. As in 2.2(b), through identifying institutions involved in discovery science, a list of those among them will be developed who maintained compound libraries and ways will be discussed with them to provide them with support to promote access to drug leads identified though streaming their compound libraries. A paper will be produced looking at existing relevant licensing policies in the region. 15

16 developing countries on reasonable, affordable and non-discriminatory terms /RPC (e) consider, where appropriate, use of a research exception to address public health needs in developing countries consistent with the Agreement on Trade- Related Aspects of Intellectual Property Rights Governments /RPC 1. Analysis of research exception provision and its availability in national patent laws in the region. 2.5 establishing and strengthening national and regional coordinating bodies on research and development (a) develop and coordinate a research and development agenda Governments; regional organizations; WHO; other relevant stakeholders 2. Appropriate action will be taken to disseminate this information to the countries which already have research exception in their laws and guide them to its use and benefits. Countries that do not have research exception available in their national laws will be supported to include it in their national laws. Through regional research strategy. RPC (b) facilitate the dissemination and use of research and development outcomes Governments; regional organizations; WHO; other relevant stakeholders Through regional research strategy. 16

17 RPC 17

18 Element 3. Building and improving innovative capacity Sub-elements and specific actions Stakeholder(s) Comments (3.1) building capacity of developing countries to meet research and development needs for health products Ongoing activities in EMR Planned activities for EMR (a) support investment by developing countries in human resources and knowledge bases, especially in education and training including in public health Governments; other International intergovernmental organizations; other relevant stakeholders (including development partners) RPC Through regional research strategy. (b) support existing and new research and development groups and institutions, including regional centres of excellence, in developing countries Governments; other International intergovernmental organizations; other relevant stakeholders (including research and development groups, relevant health-related industries and development partners) RPC Through regional research strategy. (c) strengthen health surveillance and information systems (3.2) framing, developing and supporting effective policies that promote the development of capacities for health innovation stakeholders (including nongovernmental organizations, research institutions, academia) EST/RPC In collaboration with Evidencebased health Situation and Trend Assessment (EST) unit in DHS 18

19 (a) establish and strengthen regulatory capacity in developing countries (b) strengthen human resources in research and development in developing countries through long-term national capacity building plans relevant stakeholders (including national and regional regulatory agencies) Governments; other international intergovernmental organizations; other relevant stakeholders (including development partners; international and national research institutions) RPC 1. Through assessment of regulatory capacity which is an ongoing work of in the region, 2. Technical assistance for strengthening regulatory capacity in the region, which is also an ongoing work in many countries. Through regional research strategy. (c) encourage international cooperation to develop effective policies for retention of health professionals including researchers in developing countries organizations (including International Organization for Migration and ILO); other relevant stakeholders EMRO Human Resources Policy and Management Unit (HRD)//RPC Governments HRD//RPC 1. Guidance from and In collaboration with PHI WHO/HQ. 2. In collaboration with HRD EMRO. (d) urge Member States to establish mechanisms to mitigate the adverse impact of the loss of health personnel in developing countries, particularly researchers, through migration, including by ways for both receiving and originating countries to support the strengthening of national health and research systems, in particular human resource development in the countries of origin, taking into account the work of WHO and other relevant organizations (3.3) providing support for improving innovative capacity in accordance with the needs of developing countries 1. Guidance from and In collaboration with PHI WHO/HQ. 2. In collaboration with HRD EMRO. 19

20 (a) develop successful health innovation models in developing innovative capacity. (b) intensify North South and South South partnerships and networks to support capacity building. organizations (including WIPO, OECD and UNCTAD); other relevant stakeholders (including academia; research institutions; health related industries and developmental partners) /RPC Governments; WHO; other International intergovernmental organizations; other relevant stakeholders (including academia, research institutions, relevant health- related industries) /RPC Guidance from and in collaboration with PHI WHO/HQ. Guidance from and in collaboration with PHI WHO/HQ. (c) establish and strengthen mechanisms for ethical review in the research and development process, including clinical trials, especially in developing countries (3.4) supporting policies that will promote innovation based on traditional medicine within an evidence-based framework in accordance with national priorities and taking into account the relevant provisions of relevant international instruments (a) establish and strengthen national and regional policies to develop, support, promote traditional medicine Governments; WHO; other relevant stakeholders (including academia and research institutions) /RPC As in 2.2(f), A situation analysis report will be produced mapping institutions in the region involved in conducting clinical trials, needs for their capacity building and relevant ethical, quality and regulatory issues. A regional strategy will be developed in EMR to 20

21 stakeholders (including concerned communities) strengthen national policies to develop, support and promote traditional medicine (b) encourage and promote policies on innovation in the field of traditional medicine (c) promote standard setting to ensure the quality, safety and efficacy of traditional medicine, including by funding the research necessary to establish such standards (d) encourage research on mechanisms for action and pharmacokinetics of traditional medicine (e) promote South-South collaboration in traditional medicine stakeholders (including international and national research institutions, concerned communities) stakeholders (including national and regional regulatory agencies; international and national research institutions; development partners; concerned communities) stakeholders (including academia; international and national research institutions; relevant health-related industries; concerned communities) A regional strategy will be developed in EMR to strengthen national policies to develop, support and promote traditional medicine A regional strategy will be developed in EMR to strengthen national policies to develop, support and promote traditional medicine A regional strategy will be developed in EMR to strengthen national policies to develop, support and promote traditional medicine A regional strategy will be developed in EMR to 21

22 stakeholders (including research institutions, regional bodies, academia) strengthen national policies to develop, support and promote traditional medicine (f) formulate and disseminate guidelines on good manufacturing practices for traditional medicines and laying down evidence-based standards for quality and safety evaluation stakeholders (including national and regional regulatory agencies, relevant health-related industries) A regional strategy will be developed in EMR to strengthen national policies to develop, support and promote traditional medicine (3.5) developing and implementing, where appropriate, possible incentive schemes for health-related innovation (a) encourage the establishment of award schemes for health-related innovation Governments; [WHO]/[WHO]/[WHO]; other organizations [(including WIPO)]; other relevant stakeholders (including academia; international and national research institutions; development partners; charitable foundations) /RPC Guidance from and in collaboration with PHI WHO/HQ. The idea for initiating an award scheme for health innovation in EMR will be put on the agenda of the ACHR. (b) encourage recognition of innovation for purposes of career advancement for health researchers Governments; WHO; other international intergovernmental organizations; other relevant stakeholders (including academia; international and national research institutions; development partners; charitable foundations) RPC Guidance from and in collaboration with PHI WHO/HQ. The idea for initiating an award scheme for health innovation in EMR will be put on the agenda of the ACHR. 22

23 Element 4. Transfer of technology Sub-elements and specific actions (4.1) promoting transfer of technology and the production of health products in developing countries (a) explore possible new mechanisms and make better use of existing mechanisms to facilitate transfer of technology and technical support to build and improve innovative capacity for health- related research and development, particularly in developing countries Stakeholder(s) organizations (including WTO, UNCTAD, UNIDO, WIPO); other relevant stakeholders (including; international and national research institutions; relevant health-related industries) /RPC Comment Guidance from and in collaboration with PHI WHO/HQ in connection with technology transfer project supported by the European Union Ongoing activities in EMR Planned activities in EMR (b) promote transfer of technology and production of health products in developing countries through investment and capacity building intergovernmental organizations; other relevant stakeholders (including health-related industries) /RPC Guidance from and in collaboration with PHI WHO/HQ in connection with technology transfer project supported by the European Union (c) promote transfer of technology and production of health products in developing countries through identification of best practices, and investment and capacity building provided by developed and developing countries where appropriate stakeholders (including relevant health- related industries; academia; nongovernmental organizations; development partners; charitable foundations) /RPC Guidance from and in collaboration with PHI WHO/HQ in connection with technology transfer project supported by the European Union 23

24 (4.2) supporting improved collaboration and coordination of technology transfer for health products, bearing in mind different levels of development (a) encourage North South and South South cooperation for technology transfers, and collaboration between institutions in developing countries and the pharmaceutical industry (b) facilitate local and regional networks for collaboration on research and development and transfer of technology organizations (including WIPO); other relevant stakeholders (including relevant health- related industries; international and national research institutions; academia; nongovernmental organizations; development partners) /RPC stakeholders (including relevant health- related industries, national research institutions, academia; nongovernmental organizations) /RPC Guidance from and in collaboration with PHI WHO/HQ in connection with technology transfer project supported by the European Union Guidance from and in collaboration with PHI WHO/HQ in connection with technology transfer project supported by the European Union (c) continue to promote and encourage technology transfer to least-developed country members of the WTO consistent with Article 66.2 of the Agreement on Trade- Related Aspects of Intellectual Property Rights (d) promote the necessary training to increase absorptive capacity for technology transfer Governments /RPC stakeholders (including research Guidance from and in collaboration with PHI WHO/HQ in connection with technology transfer project supported by the European Union Guidance from and in collaboration with PHI WHO/HQ in connection with technology transfer 24

25 institutions) project supported by the European Union /RPC (4.3) developing possible new mechanisms to promote transfer of and access to key health-related technologies (a) examine the feasibility of voluntary patent pools of upstream and downstream technologies to promote innovation of and access to health products and medical devices (b) explore and, if feasible, develop possible new mechanisms to promote transfer of and access to key health-related technologies of relevance to public health needs of developing countries especially on Type II and III diseases and the specific R&D needs of developing countries in respect of Type I diseases, which are consistent with the provisions of the TRIPS agreement and instruments related to that agreement, which provide flexibilities to take measures to protect public health Organizations (including WIPO); other relevant stakeholders (including international and national research institution; relevant health-related industries, nongovernmental organizations; academia) organizations (including WIPO, WTO); other relevant stakeholders (including health-related industries) 1. Guidance from and in collaboration with PHI WHO/HQ. 2. Guidance from and in collaboration with UNITAID s initiative on patent pools. Guidance from and in collaboration with PHI WHO/HQ in connection with technology transfer project supported by the European Union Element 5. Application and Management of intellectual property to contribute to innovation and promote public health Sub-elements and specific actions Stakeholder(s) Comment Ongoing Planned activities 25

26 (5.1) support information sharing and capacity building in the application and management of intellectual property with respect to health related innovation and the promotion of public health in developing countries (a) encourage and support the application and management of intellectual property in a manner that maximizes health-related innovation and promotes access to health products and that is consistent with the provisions in the TRIPS Agreement and other WTO instruments related to that agreement and meets the specific R&D needs of developing countries [ organizations (including WIPO, WTO, UNCTAD); other relevant stakeholders (including international and national research institutions and development partners)]) [ organizations (including WIPO, WTO, UNCTAD); other relevant stakeholders (including international and national research institutions and development partners)]) activities in EMR for EMR will prepare a report about its work in the region in terms of supporting the application and management of intellectual property in a manner that maximizes health innovation and promotes access to health product, and that is consistent with the provisions in the TRIPS Agreement including a) assessment of national IP regimes in selected countries in the region, b) developing policy guidance to protect public health considerations in the negotiations of bilateral trade agreements, c) organizing capacity building events for policy makers on application and management of IP that contributes to innovation and promotes public health in the region, d) providing technical assistance to non-wto Member countries in the region in terms of preparing them for new 26

27 IP regimes and protecting public health considerations in them. (b) promote and support, including through international cooperation, national and regional institutions in their efforts to build and strengthen capacity to manage and apply intellectual property in a manner oriented to public health needs and priorities of developing countries Governments; WHO/[WHO]; other international intergovernmental organizations (including [WIPO]/[WIPO], [WTO]/[WTO], UNCTAD; other relevant stakeholders (including international and national research institutions and development partners) As in 5.1(a), will prepare a report about its work in the region in terms of supporting the application and management of intellectual property in a manner that maximizes health innovation and promotes access to health product, and that is consistent with the provisions in the TRIPS Agreement. 27

28 (c) Facilitate widespread access to, and promote further development of, including, if necessary, compiling, maintaining and updating, user-friendly global databases which contain public information on the administrative status of health- related patents, including supporting the existing efforts for determining the patent status of health products, in order to strengthen national capacities for analysis of the information contained in those databases, and improve the quality of patents. (d) stimulate collaboration among pertinent national institutions and relevant government departments, as well as between national, regional and international institutions, in order to promote information sharing relevant to public health needs [Governments]/[Governments]; [WHO]/[WHO]; other international intergovernmental organizations (including [WIPO]/[WIPO], [WTO]/[WTO], [UNCTAD]; other relevant stakeholders (including international and national research institutions and development partners)] None Governments; WHO; Other International intergovernmental organizations; Other relevant stakeholders (including academia; international and national research institutions; development agencies; nongovernmental organizations; relevant health- related industries) PHI/WHO HQ is to take a lead on this global work. At best ROs can collaborate with HQ on their specific requests. 28

29 29

30 (e) strengthen education and training in the application and management of intellectual property, from a public health perspective taking into account the provisions contained in the Agreement on Trade-Related Aspects of Intellectual Property Rights, including the flexibilities recognized by the Doha Ministerial Declaration on the TRIPS Agreement and Public Health and other WTO instruments related to the TRIPS agreement (f) facilitate, where feasible and appropriate, possible access to traditional medicinal knowledge information for use as prior art in examination of patents, including, where appropriate, the inclusion of traditional medicinal knowledge information in digital libraries Governments; [WHO]/[WHO]; other international intergovernmental organizations (including [WIPO]/[WIPO], [WTO]/[WTO], [UNCTAD]/[UNCTAD]); other relevant stakeholders (including international and national research institutions and development partners) ; ASD Governments; [WHO; other stakeholders (including] concerned communities) Guidance from and in collaboration with PHI WHO/HQ Guidance from and in collaboration with PHI WHO/HQ a. EMRO collaborated with UNDP, WHO HQ and civil society organizations to hold a regional technical consultation meeting for training pharmaceutical patent examiners on examining pharmaceutical patents from a public health perspective. b. EMRO collaborated with WHO HQ and WTO to organize a regional education and training workshops for national policy makers from ministries of commerce/ economics and ministries of health. Such regional trainings have taken place in Kuwait, Jordan and another one is planned for Syria. Traditional medicine unit in 30

31 (g) promote active and effective participation of health representatives in intellectual propertyrelated negotiations, where appropriate, in order that such negotiations also reflect public health needs Governments a. A comprehensive programme for health diplomats is being developed in EMRO which, among other issues, would also include capacity building for active and effective participation in intellectual property related negotiations. (h) strengthen efforts to effectively coordinate work relating to intellectual property and public health among the Secretariats and governing bodies of relevant regional and international organizations to facilitate dialogue and dissemination of information to countries International intergovernmental organizations (including WIPO, WTO, and UNCTAD) Guidance from and collaboration with PHI WHO/HQ b. A policy guide for FTA negotiations is being developed for policy makers from EMR countries. (5.2) providing as appropriate, upon request, in collaboration with other competent international organizations technical support, including, where appropriate, to policy processes, to countries that intend to make use of the provisions contained in the Agreement on Trade-Related Aspects of Intellectual Property Rights, including the flexibilities recognized by the Doha Ministerial Declaration on the TRIPS Agreement and Public Health and other WTO instruments related to the TRIPS agreement, in order to promote access to pharmaceutical Products (a) consider, whenever necessary, adapting national legislation in order to use to the full the flexibilities contained in the Agreement on Trade-Related Aspects of Intellectual Property Governments; WHO; Other organizations (including WIPO, EMRO is currently responding to requests from the countries, for 31

32 Rights, including those recognized by the Doha Declaration on TRIPS Agreement and Public Health and the WTO decision of 30 August 2003 (b) Take into account, where appropriate, the impact on public health when considering adopting or implementing more extensive intellectual property protection than is required by the Agreement on Trade-Related Aspects of Intellectual Property Rights, without prejudice to the sovereign rights of Member States (c) take into account in trade agreements the flexibilities contained in the Agreement on Trade-Related Aspects of Intellectual Property Rights and including those recognized by the Declaration on the TRIPS Agreement and Public Health adopted by the WTO Ministerial Conference (Doha, 2001) and the WTO decision of 30 August 2003 (d) consider, where appropriate, taking necessary measures in countries with manufacturing capacity to, facilitate through export, access to pharmaceutical products in countries with insufficient or no manufacturing capacity in the pharmaceutical sector in a manner consistent with the Agreement on Trade-Related Aspects of Intellectual Property Rights, the Doha Declaration on the TRIPS Agreement and Public Health and the WTO decision of 30 August 2003 WTO and UNCTAD) Governments; [WHO; Other organizations (including WIPO, WTO and UNCTAD)] Governments Governments EPM example Syria, Pakistan, Lebanon and Sudan. a. A policy guide for FTA negotiations is being developed for policy makers from EMR countries. b. National case studies on intellectual property regimes and access to medicines were produced for some EMR countries that signed FTAs with TRIPS-plus provisions, for example Jordan and Morocco. A policy guide for FTA negotiations is being developed for policy makers from EMR countries. EMRO will provide technical assistance to the countries on their request. 32

33 (e) encourage finding ways, in ongoing discussions, to prevent misappropriation of health-related traditional knowledge, and consider where appropriate legislative and other measures to help prevent misappropriation of such traditional knowledge organizations (including WIPO, WTO, UNEP/Secretariat of the Convention on Biological Diversity); other relevant stakeholders (including concerned communities) Guidance from and in collaboration with PHI WHO/HQ (5.3) exploring and, where appropriate, promoting possible incentive schemes for research and development on Type II and Type III diseases and on developing countries specific research and development needs in relation to Type I diseases (a) explore and, where appropriate, promote a range of incentive schemes for research and development including addressing, where appropriate, the de-linkage of the costs of research and development and the price of health products, for example through the award of prizes, with the objective of addressing diseases which disproportionately affect developing countries [Governments; [WHO]/[WHO]; other international intergovernmental stakeholders (including international and national research institutions; development partners; charitable foundations; relevant health related industries; nongovernmental organizations)] Guidance from and in collaboration with PHI WHO/HQ. 33

34 Element 6. Improving delivery and access Sub-elements and specific actions Stakeholder(s) Comments Ongoing activities in EMR (6.1) encouraging increased investment in the health-delivery infrastructure and financing of health products in order to strengthen the health system (a) invest in developing health- delivery infrastructure and encourage financing of health products stakeholders (including development partners, charitable foundations, private sector and relevant healthrelated industries) /Health Economics Unit (HEC) Planned activities in EMR A report will be produced about the existing levels of finacing in health delivery infrastructure and financing of health products in collaboration with HEC. The paper will also highlight the optimal investment needs in this area. (b) develop effective and sustainable mechanisms in least- developed countries in order to improve access to existing medicines, acknowledging the transitional period until organizations (including WTO); other relevant stakeholders Guidance from and in collaboration with PHI WHO/HQ (c) prioritize health care in national agendas (d) encourage health authorities to improve domestic management capacities in order to improve delivery and access to medicines Governments Guidance from and in collaboration with PHI WHO/HQ EMRO Implementation of biennial joint Governments; WHO workplans in 18 countries in the light of WHO medicine strategy to 4 In line with the extension, provided to least-developed countries, by Article 7 of the Doha Declaration on the TRIPS Agreement and Public Health. 34

35 and other health products with quality, efficacy, safety and affordability and, where appropriate, to develop strategies to promote rational use of medicines (e) increase investment in human resource development in the health sector stakeholders (including development partners; nongovernmental organizations; charitable foundations) improve delivery and access to medicines and other health products with quality, efficacy, safety and affordability, and development of strategies to promote rational use of medicines. a. /EMRO undertaking human resource mapping in pharmaceutical sector in some countries for example Sudan. b. /EMRO providing fellowship opportunities to nationally nominated professionals in the area of pharmaceutical. (f) develop effective country poverty reduction strategies that contain clear health objectives Governments; other relevant stakeholders (including development partners) Policy and Health Planning (PHP)/ In collaboration with PHP (g) encourage pooled procurement mechanisms for health products and medical devices, where appropriate stakeholders, Division for Communicable Diseases (DCD) and Vaccine Quality Unit (VAC) in collaboration with DCD and VAC a. Assessment of pooled procurement mechanisms in GCC by /EMRO. b. EMRO working on developing a regional pooled procurement mechanism for priority vaccines. (6.2) establishing and strengthening mechanisms to improve ethical review and regulate the quality, safety and efficacy of health products and medical devices 35

36 (a) develop and/or strengthen the capacity of national regulatory authorities to monitor the quality, safety and efficacy of health products while sustaining ethical review standards relevant stakeholders (including national and regional regulatory agencies and development partners) EMRO has undertaken national regulatory assessments in some of its member states and has helped in the development of institutional development plans of national regulatory authorities, for example in Sudan, Egypt and Yemen. Assessments are planned for Lebanon, Pakistan and Syria. This is an ongoing work. (b) promote operational research to maximize the appropriate use of new and existing products, including cost-effective and affordable products in high diseaseburden settings (c) comply with good manufacturing practices for safety standards, efficacy and quality of health products stakeholders (including international and national research institutions; nongovernmental organizations, development partners and charitable foundations) relevant stakeholders (including national regulatory bodies; relevant health-related industries; development partners ; VAC 1. Thirteen national medicine price surveys have been conducted in the region. 2. Three countries are in the process of developing national programmes for rational use of medicines. 3. Operational research is an important strategic priority of work. Apart from the above mentioned two areas, there are other pieces of work in connection with operational research a. Promotion of WHO GMP standards in terms of their adoption by national regulatory authorities as national standards in order for manufacturers to comply with them. b. WHO prequalification programme has been introduced systematically in the region. GMP compliance is an important component of WHO prequalification programme. 36

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