Lead Author: Catherine Dauphin-Llorens
Organization: Ministry of Foreign Affairs,  Directorate-General of Global Affairs, Culture, Education and International Development
Country: France


Subject: France's contribution to the High Level Expert Group from the UN Secretary-General on Access to Medicine

France would like to thank the High Level Expert Group for the opportunity to contribute to the discussions raised by this panel as well as inform the group of the following considerations:

An essential issue for achieving sustainable development goals (SDGs)

France welcomes the establishment of a High Level Expert Group from the United Nations Secretary-General on a topic as important as access to medicines. Addressing issues related to access to medicines is essential for achieving Sustainable Development Goal 3 adopted in New York last September. We must face these challenges together so that by 2030 we can put an end to the AIDS epidemic, tuberculosis, malaria and neglected tropical diseases as well as combat hepatitis, waterborne diseases and other communicable diseases.

A major historical investment for France

Access to medicines is the topic of a historical investment for France both nationally where universal coverage mechanisms have been implemented and internationally where the majority of public aid to French health development is invested in institutions and programs for improving access to treatments in developing countries, in particular for diseases targeted by SDGs.

France has provided support to the Neglected Tropical Disease Research Global Observatory since the beginning and continues to support initiatives such as those led by the Drugs for Neglected Diseases Initiative (DnDi). France’s top experts are taking part in research activities in this area, in particular through the European and Developing Countries Clinical Trials Partnership — EDCTP.

Since the beginning of the HIV epidemic, France has been at the forefront of international cooperation, especially in the areas of research and patient access to treatments, both in the north and the south. France is the second largest donor of the Global Fund to Fight AIDS, Tuberculosis and Malaria. It was the first country to contribute to UNITAID, which identifies and expedites the arrival of innovative and affordable therapeutic, diagnostic and preventive solutions on the market in order to equip developing countries with the tools they need to fight HIV, tuberculosis and malaria. The Global Fund helps finance and implement these very large-scale innovative solutions. France remains highly committed to providing access to vaccines and was one of the first to contribute to Gavi, the Vaccine Alliance. The actions taken by these organizations are shaping the drug market and other related inputs in order to make it more affordable, transparent and predictable as well as better quality. By simultaneously working on supply and demand, they do more with less and with greater continuity, thereby sustaining the impact of their actions on access to medicines. These approaches do not overlook the issue of intellectual property, as illustrated by the Medicines Patent Pool. This initiative, funded by UNITAID, works with the industry, civil society, international organizations, patient groups and other stakeholders to establish priorities and plans, issue licenses for essential medicines and centralize intellectual property assets in order to facilitate the production of generic drugs and the development of new formulations.

A broad and complex topic that cannot be reduced only to intellectual property issues and requires a collaborative, transparent and documented approach.

Access to medicines is a complex topic made up of multiple issues including non-existent or inadequate solutions, lack of data, lack of competition and transparency, problems with registration and quality, overpricing, inadequate governance or supply systems, etc.

The WHO developed a framework for guiding and coordinating collective action in this area. This framework was also adopted by its key partners. It organizes actions around four main fields of intervention: i) the rational selection and use of essential medicines; ii) affordable prices; iii) sustainable funding; iv) reliable health systems and supply systems. Although this framework includes intellectual property issues, it’s clear that they are only one of the issues related to access to medicines.

By reducing the scope of the High Level Expert Group to only include intellectual property, the panel significantly limits its methods and conveys a limited interpretation of issues affecting access to medicines. France therefore invites the panel to expand the scope of its intervention as well as its ambitions towards issues raised by the topic the expert group aims to handle.

It is unfortunate that the current call for contributions launched by the panel was not preceded by an analysis of existing interactions between access to medicines and intellectual property. This would have provided the necessary context for an insightful discussion as well as allowed the observed evolutions and trends to be assessed in order to identify difficulties and opportunities on which to focus the discussion and international coordination efforts. A number of publications would help in conducting this preliminary analysis, including the study published jointly by the World Health Organization, the World Intellectual Property Organization and the World Trade Organization. “Promoting access to technologies and innovation”1. Other discussions, including the discussion paper from the Global Commission on HIV and the Law, could have been used to define the needs, expectations and approach of this initiative. It is also regrettable that the steps taken prior to the call for contributions did not involve a greater variety of stakeholders including reference organizations such as the WHO, WIPO or the WTO.

Some confusion remains from these original shortcomings, both in the objectives of the consultation and the general conduct of the process and the expert group’s working methodology. In addition, without documented elements, the introductory remarks and the issues presented appear biased. It is likely these elements will seriously harm the working group and its findings. France therefore recommends that the next approaches be more transparent and supported by a documented analysis.

France would like to demonstrate its interest in the works of the High Level Expert Group from the UN Secretary-General on Access to Medicines and express its readiness to contribute to the pursuit of these works in a constructive approach, supported by a structured and transparent process.

Bibliography and References

1. Promoting access to medical technologies an innovation - Intersections between public health, intellectual property and trade, 2012, WHO-WIPO-WT