Category Archives: Millennium Development Goals

Making the case for research and innovation for health in the post-2015 development agenda

In this guest post, Claire Wingfield—product development policy officer at PATH—writes about a new paper exploring why research and development (R&D) of high-priority health tools for diseases and conditions affecting low- and middle-income countries (LMICs) should be a critical component of the post-2015 development agenda.

A dearth of adequate health technologies and interventions targeting poverty-related diseases—like HIV/AIDS, malaria, tuberculosis, and neglected tropical diseases—means that millions of people in LMICs continue to die each year from preventable and treatable diseases and conditions. Progress on developing new interventions targeting the health priorities of LMICs has faltered because these diseases occur almost exclusively among the world’s poorest and most marginalized populations. Thus, there is little or no perceived commercial market encouraging companies to develop products targeting LMICs. Because the health burden imposed by poverty and social vulnerability remains far too high, achieving health for all is one major goal of the post-2015 development agenda.

In a new paper—developed by the Council on Health Research for Development, the Global Health Technologies Coalition, the International AIDS Vaccine Initiative, and PATH—the authors make the case for the inclusion of research and innovation for health as a central component of the post-2015 development agenda. The paper describes the impact that increased investments in R&D and innovation for health—particularly for the world’s poorest—have had in contributing to progress toward achieving the Millennium Development Goals (MDGs)—particularly for MDGs 4 (reduce child mortality), 5 (improve maternal health), and 6 (combat HIV/AIDS, malaria, and other diseases).

Credit: PATH/Gabe Bienczycki
Credit: PATH/Gabe Bienczycki

These investments have helped to create an enabling environment for research in and for the benefit of LMICs by increasing demand for new health technologies, expanding coverage of proven interventions, and strengthening the innovation infrastructure in these countries. Building on the work of The Lancet Commission on Investing in Health—a group of renowned economists and global health experts—the paper discusses the need for increased R&D investments by all countries to achieve the dramatic health gains envisioned in the post-2015 agenda.

Adequate levels of investment, as suggested by The Lancet Commission, are critical for spurring the development of new health tools, provided they align with financing needs in R&D—notably predictability and flexibility. But even that sort of investment alone does not guarantee more products, and it does not drive innovation toward the right type of products—those that are suitable, acceptable, affordable, and accessible to populations most in need. It is essential, therefore, that indicators for R&D for health tools that primarily affect LMICs address a comprehensive set of outcomes including financing needs, infrastructure and human resources needs, enabling policies, necessary partnerships, capacity strengthening, and access requirements.

Because poor health and disability contribute substantially to poverty, research and innovation for health is linked to improving economic prosperity and is critical to eradicating poverty. Therefore, it must be continuously prioritized within the post-2015 development agenda. Ultimately, the success or failure of the post-2015 agenda relies just as much on how the goals and targets are implemented as it does on how progress will be measured. Thus any research and innovation indicators measuring progress against the goals and targets outlined in the post-2015 agenda must also increase accountability of researchers, governments, and funders, and inform research processes. Inclusion of research and innovation for health must facilitate an enabling environment for research and innovation in LMICs and encourage endemic countries to set and pursue a domestically-driven health research agenda.

Credit: PATH/Evelyn Hockstein
Credit: PATH/Evelyn Hockstein

The post-2015 development agenda is an opportunity for LMICs to set their own health agendas and research priorities and to assert their leadership in strengthening the R&D landscape focused on the needs of the poorest and most marginalized populations. Therefore, it is essential that there is broad agreement among all of the relevant stakeholders that research and innovation for health—which includes the scaling up of proven health interventions as well as the development of new and improved high-priority health technologies—is critical to meeting the ambitious goals of eradicating poverty and ensuring sustainable development for all within a generation.

In support of the inclusion of research and innovation for health in the post-2015 agenda, over 150 organizations and individuals recently signed a petition to United Nations (UN) Secretary General Ban Ki-moon and Member States urging the UN to keep the research, development, and delivery of new and improved health tools for diseases and conditions impacting LMICs at the heart of the post-2015 development agenda. It is our hope that the Members States and other UN officials shaping the agenda will head this call.

Claire Wingfield (PATH)

 

Note: From the September issue of TDR news: “We are making good progress in a number of key initiatives with partners. For example, we’ve worked with COHRED, the Council on Health Research for Development, to develop a new internet platform that lists training opportunities and other important research management information in West Africa. West Africa Health Research Web (WAHRWeb) is a database and an announcement platform for research capacity training opportunities like ethics, grant writing, and clinical trials management for the 15 countries of the West African Health Organization (WAHO).”

Research for Health must stay at the heart of the post-2015 Sustainable Development Framework

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SPEED READ

– Work on outlining the post-2015 development agenda is coming to an end. The UN 68th General Assembly will meet in New York in September to define a set of Sustainable Development Goals (SDGs).

– “Ensure healthy lives and promote well-being for all at all ages,” reads proposed SDG 3. However, where does research for health stand in the new framework’s draft?

– To make sure that research, development, and delivery of new and improved health tools are kept at the heart of the post-2015 development agenda, the Council on Health Research for Development (COHRED) teamed up with the Global Health Technologies Coalition (GHTC) and the International AIDS Vaccine Initiative (IAVI) to address an appeal to Secretary General Ban Ki-Moon and Member States of the UN.

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Looking beyond 2015

While the current Millennium Development Goals expire next year, work on outlining the post-2015 development agenda is brewing up. The UN 68th General Assembly will meet in New York in September to define a set of Sustainable Development Goals (SDGs) to focus on in the 15 years to come. The new “Sustainable Development Framework 2015-2030” is the result of a lengthy process. In particular, the proposal on SDGs was prepared by a 30-member Open Working Group (OWG), established under mandate by the Rio+20 Outcome document in June 2012. The OWG final report lays out some 169 targets spread across 17 SDGs that range from ending poverty in all its forms everywhere to strengthening the means of implementation and revitalize the global partnership for sustainable development.

Despite the considerable efforts deployed so far and the undeniable progress done in the process of arriving at this new post-2015 framework, however, many observers fear that to ensure “healthy lives at all ages”, one of the key goals currently envisioned in the development framework, a more explicit and full support to health research and related policies and capacity building will be needed in the final discussion.

To make sure that research, development, and delivery of new and improved health tools are kept at the heart of the post-2015 development agenda, COHRED teamed up with GHTC and IAVI to address an appeal to Secretary General Ban Ki-Moon and Member States of the UN.

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The appeal

We, the below signatory organizations request that the UN fully supports in the post-2015 SDG-Framework the research, development, and delivery of new and improved medicines, vaccines, and other health tools for the diseases and health conditions that predominantly affect low- and middle-income countries as well as marginalized, vulnerable populations globally.

Thanks to the leadership of the UN and investments by Member States, the current Millennium Development Goals have made major contributions to improving the health and lives of millions of people around the world. A sustained focus on some of the greatest global health challenges has led to enormous progress in many areas, including significant improvements in the development and delivery of health tools such as drugs to treat HIV/AIDS, tuberculosis (TB) and malaria. Efforts to tackle diseases have also helped underpin progress in other important areas, such as gender equality, child mortality, and maternal health. Millions of lives have been saved.

However, major challenges remain, and the health burden imposed by poverty remains far too high. In this context, it is essential that the post-2015 development agenda retains a strong focus on eliminating poverty-related diseases and conditions. The post-2015 agenda must build on previous achievements to ensure that healthy lives and access to health services can be achieved in an equitable and sustainable way, leaving no one behind. This means ensuring universal access to proven health interventions. But it also means developing and delivering new health technologies which can help address the shortcomings of existing interventions and sustainably reduce morbidity and mortality over the longer term. This will require continued support for the research, development, and delivery of new tools to combat major epidemics like HIV/AIDS, TB, and malaria, as well as other poverty-related diseases and conditions ranging from neglected tropical diseases to reproductive, maternal, and child health. Continuous investment of human and financial resources in science, technology, and innovation is essential to achieve both economic and social development for all.

We are encouraged by the current inclusion of the need to support the development of new medicines and vaccines for diseases particularly affecting developing countries in the Zero Draft document of the Sustainable Development Goals. Concern remains, however, about the omission of medical devices and diagnostics which also contribute to improving health outcomes, the lack of clarity on how this effort will be funded, and how supporting policies, incentives, capacity building, collaboration, and knowledge and technology sharing will be defined and implemented.

As organizations working to save lives and improve health, we urge you to commit explicit and full support to health research and related policies and capacity building as a core component of a new, post-2015 agenda for equitable health and sustainable development for all. We ask that you press Member States to offer similar support, and to formally assess how to measure progress towards this goal, and how to fully and sustainably finance and enable the research, development, and delivery of essential new and improved health tools.

PATHMVI

A bigger role for science

It is not only the commitment to research for health that needs to be reinforced. Apparently, the recommended SDGs contain several other science-related issues that require attention. According to a recent SciDev.Net article, “[m]any of the quantified targets based on scientific evidence that appeared in earlier documents that laid out the SDGs have been replaced by blanks or removed entirely in the final document”. In other words, science experts fear that by approving a final resolution with vaguely indicated targets will permit politicians to adjust following efforts on the basis of economic convenience rather than scientific evidence. “For example, in April, possible climate change targets included an explicit two degrees Celsius limit, and dates for when carbon emissions should be arrested and reduced. The current outcome document is silent on these issues,” continues the SciDev.Net article.

 Carel IJsselmuiden

Health Research for All: the role of innovation in Global Health in the post-2015 development framework

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SPEED READ

– The Council on Health Research for Development (COHRED), along with the Global Health Council (GHC), the Drugs for Neglected Diseases initiative (DNDi), the International AIDS Vaccine Initiative (IAVI), and the Global Health Technologies Coalition (GHTC) hosted an official nongovernmental organization (NGO) side session at the 67th annual World Health Assembly (WHA) to explore the role of R&D in the post-2015 development agenda.

– The event organizers developed a statement urging MemberStates and delegates to support health research and related policies and capacity building as a core component of a post-2015 agenda for equitable health and sustainable development.

–  WHA Member States approved a resolution on health in the post-2015 development agenda that called for completing the unfinished work of the health Millennium Development Goals (MDGs) and noted the importance of universal health coverage and stronger health systems.

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The eight MDGs have been a milestone in global health and national development efforts, focusing concerted action on crucial themes such as halting the spread of HIV/AIDS, reducing child mortality and improving maternal health. However, as the final deadline of 2015 is rapidly approaching, it is evident that progress on the selected goals has been uneven within and across countries. Thus, further efforts and a renovated, stronger-than-ever global partnership is needed to arrive at a global development agenda beyond 2015.

COHRED, GHC, DNDi, IAVI, and the GHTC organized a side event focused on the critical role of global health research, development and innovation (R,D&I) in accelerating and sustaining progress in global health within the post-2015 development framework at the 67th annual WHA held May 18-24th 2014 in Geneva, Switzerland.

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Panelists included representatives from Kenya and Senegal member states as well as high-, low-, and middle-income country stakeholders from both public and private sectors: Dr. Seth Berkely, CEO of the GAVI alliance, Dr. Christine Sow, Executive Director of the GHC, Mr. Jon Pender, VP government affairs of GlaxoSmithKline, Prof. Osman Sankoh, CEO of the INDEPTH Network, Mr. Rob Terry, Manager of Knowledge Management at TDR and Prof. Carel IJsselmuiden, CEO of COHRED.

All the panelists stressed the importance of R,D&I for health and sustainable development. Rob Terry began his talk with a quote from Mary Lasker: “If you think research is expensive, try disease.” He then explained how the Global Health Observatory shall contribute in covering the current gaps in information on research activities in low- and middle-income countries (LMIC). Prof. Osman Sankoh, as spokesman of the INDEPTH network of 42 health and demographic surveillance systems in 20 LMICs, underscored the need for robust data on individual level to guide policymaking. Mr. Jon Pender said that the public private partnerships approach had delivered for global health and that health should remain a priority in the post-2015 agenda.  “Advocates have a job to do to ensure health is a priority in the post-MDG agenda where there will be 16 goals,” remarked IAVI in a tweet.

Both Kenya and Senegal representatives insisted on the need for new innovative health tools, higher national and international funding for R,D&I, as well as partnerships with the private sector. Principal Secretary of Health, Prof. Fred Segor said in Kenya the new 2013 S,T&I (Science, Technology and Innovation) Act pledged 2% of GDP to the national research fund. Seth Berkley said that equal health across the world cannot be achieved without new health tools and called for a truly global scientific movement to tackle effectively the challenges of R&D financing and capacity building.

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“GHC and its membership are collectively tasked with moving the needle in the direction we see for the future of global health. This means supporting evidence-based policy change and the operational elements that will mean its success. The World Health Assembly is a unique venue providing a platform for multi-sectoral, multi-issue engagement; the strength and profile of GHC’s membership means that our role can only increase over time. Going forward, we will be sure to optimize the collective impact of our actions and voices,” stated Christine Sow, Executive Director of the GHC, in a related blog post.

Reporting and commenting on the news on research and innovation as emerged from the WHA, GHTC’s coalition director Kaitlin Christenson wrote: “Early in the week, Member States also passed a resolution calling for new tuberculosis (TB) targets, which should be reflected in the post-2015 development agenda. The resolution specifically calls for a 95 percent reduction in deaths from TB by 2035 and notes research and innovation as one of three key pillars that will help achieve this goal.”

Prof. Carel IJsselmuiden, COHRED CEO and chairman of the session, ended the meeting with the following statement developed by the organizing NGOs, urging MemberStates and Delegates to support health research and innovation policies as a core component of the post-2015 agenda to achieve health and sustainable development for all:

 Statement on the role of Research and Innovation to Achieve Health for All and Sustainable Development

 67th World Health Assembly, Geneva, 22 May 2014

 Commitments to the Millennium Development Goals have made a major contribution to the success of global health efforts over the past decade, helping to sustain focus on some of the greatest global health challenges. The post-2015 development agenda must build on these achievements, to ensure that Healthy lives and access to health services for all can be achieved in an equitable and sustainable way.

Achieving equitable and sustainable Health for all requires continued support for Research and Development for new or improved medicines, vaccines, diagnostics, devices and other health tools that work for and are accessible to those most in need. Continuous investment of human and financial resources in science, technology and innovation to improve health and equity is essential to achieve economic and social development.

Strong political leadership, as well as international and multi-sectoral collaboration will be needed for achieving innovations in health care and delivery. In particular, we need policies, incentives and sustainable financing to fully support research and development of affordable and accessible vaccines, medicines, diagnostics, devices and other health tools for diseases that mostly affect low- and middle-income countries and/or marginalized populations. And we need a commitment to the development and implementation of policies that facilitate capacity building, collaboration and knowledge and technology sharing.

We urge Member States and Delegates at the World Health Assembly to explicitly support health research and related policies and capacity building as a core component of a new Agenda for equitable health and sustainable development.

By the end of the week, WHA Member States had approved a resolution on health in the post-2015 development agenda that called for completing the unfinished work of the health MDGs and noted the importance of universal health coverage and stronger health systems.

Golbahar Pahlavan (COHRED)