WHO’s got its facts wrong?

The World Health Organisation 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.

Friday, November 02, 2007

The World Health Organisation 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 the WHO pushes on with this agenda, it should have strong evidence but, in fact, it lacks evidence for this and many more of its global recommendations.

In the May issue of The Lancet, the world’s most prestigious health journal, 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 this revelation "is a pretty seismic event … it undermines the very purpose of [the] WHO.”

And it’s not just the WHO. In June, India released detailed research on its Aids burden which came to the startling conclusion that the UNAIDS (Joint United Nations Programme on HIV/Aids) data, also used by the WHO, massively overestimated the true number of cases.

The figure was shown to be between two and 3.1 million, not the 5.7 million claimed by UNAIDS. UNAIDS had to accept this new data--but Professor James Chin of the University of California at Berkeley had said two months beforehand that such evidence had long been available: "In recent years UNAIDS has been forced to reduce estimates of...HIV prevalence in many countries...”

The most sensitive indicator of broad health trends is infant mortality rates. In September, UNICEF (the United Nations Children’s Fund) 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.”

The Lancet concluded: "why should journals trust the research such agencies produce, and why should anyone trust their health policies and initiatives?”

Now, the WHO’s new Draft Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property (IGWG) aims to weaken intellectual property further and to 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 therefore the international patent system, prevent the poor from getting what medicines do exist.

In fact, three of these "neglected” diseases are Aids, TB and malaria. Since 2004, donors have expended an enormous $41.8 billion on them.

There are also six tropical diseases, often considered "neglected”.

These account for 0.3% of all global deaths--and all of these diseases currently 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--you can’t just hand them out.

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 nationalising any business stifles innovation and that it 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 & 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 copious real evidence.

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, Center for Science in Public Policy, Hudson Institute, a policy think-tank in Washington DC. He specialises in health and scientific matters.

Ends