Promoting Access to Medical Technologies and Innovation:
Intersections between public health, intellectual property and trade

Foreword by the directors-generals

Public health has been a priority for global action for many years. The right of everyone to the enjoyment of the highest attainable standard of physical and mental health is a universal human right, just as the burden of disease is shared by all humanity.
 
The constitution of the World Health Organization (WHO) underscores that achievements by any state in the promotion and protection of health are of value to all. In the age of globalization, progress made in public health in one country has an impact on the international community as a whole. Consequently, a compelling case can be made for effective international cooperation in public health, and such cooperation is an essential foundation for sustainable development.

Public health and medical technologies are an important focus of the international system, including in the system-wide work of the United Nations – most notably in the Millennium Development Goals (MDGs). The very founding objective of the WHO is the attainment by all peoples of the highest possible level of health. In addition, the World Intellectual Property Organization (WIPO) and the World Trade Organization (WTO) – in line with the mandates given to them by governments and their respective areas of expertise – have increasingly stepped up their efforts to support global endeavours to improve health outcomes.

International cooperation on public health takes many forms. Recent years have seen an intensified focus on the role of medical technologies – both the innovation processes that lead to new technologies and the ways in which these technologies are disseminated in health systems. Access to essential medicines as a dimension of the right to health has been a major concern for several decades. Now, however, the focus has broadened to consider how to promote the requisite innovation, how to address neglected health needs, and how to ensure equitable access to all vital medical technologies, including medicines, vaccines and medical devices. The evolving state of the global disease burden creates a constant demand for new and adapted technologies, so innovation and access are inevitably intertwined.

It is both a natural consequence of our mandated responsibilities and increasingly a practical necessity for the WHO, WIPO and WTO Secretariats to coordinate and cooperate ever more closely on issues such as patterns of innovation and access, legal and policy factors affecting the production and dissemination of medical technologies, and the interplay between public health, international trade rules and the intellectual property (IP) system. These are longstanding issues. Their relevance to a broad policy community was confirmed by the Declaration on the TRIPS Agreement and Public Health (Doha Declaration), adopted on 14 November 2001 at the Fourth Ministerial Conference of the WTO. That Declaration was followed by a number of significant developments:

• The creation of new and innovative financing and procurement mechanisms, leading to significantly increased funding for medicines procurement and vaccine development.
• An evolving and more diverse pharmaceutical industry, and increasing innovative capacity in some developing countries.
• Innovative approaches to medical research and development (R&D) and its financing – particularly for neglected diseases – with an emphasis on public–private initiatives to develop required medical technologies.
• Renewed attention to the cost-effectiveness of national health systems.
• Growing global awareness of the impact of non­communicable diseases (NCDs) on health and socio­economic development, especially in developing countries.
• Increasing recognition of the need to move towards universal health coverage.
• Insights into the intersections between public health, the IP system, trade and competition rules, and measures to promote innovation and access to medical technologies.
• Better, more comprehensive and more accessible data on prices, access, patents and trade, enhancing the empirical base for informed priority setting and policy decisions.
• Greater policy coherence and practical cooperation on the intersection of health policy, trade and IP issues within the broader perspectives established by the human rights dimension of health and the UN MDGs.

Today there is now a richer, more diverse and more inclusive body of empirical data and practical experience available to guide technical cooperation. The technical cooperation offered by the three organizations has been characterized by active dialogue, coordination and partnership, leading to more effective and tailored capacity-building activities, all based on a better informed factual background. One of the objectives of this cooperation has been to create as much policy coherence as possible between the three organizations.

This study is an example of this strengthened trilateral cooperation, capturing a broad range of experience in dealing with the interplay between IP, trade rules and the dynamics of access to, and innovation in, medical technologies. It draws together the three Secretariats' respective areas of expertise in relation to the overall framework concerning access to, and innovation in, the field of medical technologies, and it provides a platform for sharing practical experience and data, supporting and providing information to ongoing technical cooperation and policy discussions. The study is guided by the approach to cooperation on public health that has been catalysed by the Doha Declaration, by the WIPO Development Agenda, and by the WHO Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property.

We have been encouraged by the momentum, in recent years, towards a more informed, inclusive and nuanced policy debate on public health issues, buttressed by the shared outlook defined by a common resolve to work towards universal access to essential medical technologies and to strengthen and diversify innovation systems.

The issues are complex and multifaceted, and call for diverse and tailored solutions: the following pages will not yield simple answers to the difficult questions confronting policy-makers. Yet we do expect that this study will provide a sound platform for future policy debate and analysis, and will serve those who seek answers to challenging questions. The publication of this study also represents a milestone in the efforts of the three agencies to deliver on their overlapping mandates in a coherent and cooperative manner; and we pledge continuing commitment on the part of the three agencies to continue to work, together with other international partners, towards the shared objective of universal coverage and better health outcomes for all.