WHO: Long on agenda, but short on the facts

By Jeremiah Norris  / 

Sun, Nov 04, 2007 - Page 8

The WHO makes great sport of taking the pharmaceutical industry to task for its inability to provide everyone in the developing world with the drugs they need. This so-called market failure is being used at negotiations in Geneva this month to bring research and patents under official control, managed by the WHO.

But the WHO has trouble managing itself. Before it pushes on with this agenda, it should make sure it has strong evidence.

In fact, though, it lacks evidence for this -- and many more of its global recommendations.

In the May issue of The Lancet, researchers found that "WHO guidelines do not seem to be closely followed when [the] WHO develops recommendations for member states."

The editor of The Lancet told reporters that this "is a pretty seismic event ... it undermines the very purpose of [the] WHO."

The most sensitive indicator of broad health trends is the infant mortality rate. In September, UNICEF released new data showing that "the global rate for the under-five population fell from 20 million annually in 1960 to 9.7 million in 2006."

But The Lancet published in the same month an article showing "disappointing results in the reduction of child mortality worldwide" and concluded by asking "why should journals trust the research such agencies produce and why should anyone trust their health policies and initiatives?"

The WHO's new Draft Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property (IGWG) aims to further weaken intellectual property and bring research and development under the control of governments and international bodies. It claims there are too few drugs for the "neglected" tropical diseases found in poor countries and that drug prices -- and the international patent system -- prevent the poor from getting what medicines do exist.

In fact, three of these "neglected" diseases are AIDS, tuberculosis and malaria. Since 2004, donors have spent an enormous US$41.8 billion on them.

Six tropical diseases, often considered "neglected," account for 0.3 percent of all global deaths -- and all of these diseases have multi-million-dollar research projects underway.

As for the alleged barrier of drug prices, numerous studies -- including the WHO's -- show that the most important barrier to the poor getting medicines is lack of medical staff and infrastructure to administer the drugs. And the biggest factor in the actual price paid by patients is local regulation, taxes and tariffs in poor countries.

So there is plenty of evidence, but the WHO is ignoring it.

Indeed, past evidence, from telephone monopolies to Chinese central planning, shows that nationalizing any business stifles innovation and, in the case of drugs, would hinder future efforts to create drugs for the poorest countries. This is particularly threatening, as drug-resistant strains of HIV/AIDS, malaria and tuberculosis become more prevalent in these regions.

The WHO wants to bring drug development under official control, replacing the commercial research and development, underpinned by intellectual property rights, that has proved so successful in so many fields. Not only will this treaty undermine innovation, it is supported by false premises and flies in the face of real evidence.

Taiwan, denied participation in the WHO, knows all too well how politics trumps evidence or sense in international organizations. Member states need to knock this treaty on the head at this month's meeting before the WHO does lasting damage to global health.

Jeremiah Norris is director of the Center for Science in Public Policy at the Hudson Institute, a policy think tank in Washington.