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UN health talks could lead to new ways of developing urgently needed drugs and diagnostics

Geneva - Health talks opening today in Geneva have the potential to change the way medical research is conducted and ensure that urgently needed products are developed and made accessible, the international medical humanitarian organisation Médecins Sans Frontières (MSF) and Knowledge Ecology International said today.

Representatives from Ministries of Health are gathering today for the second round of negotiations of the Intergovernmental Working Group for Public Health, Innovation and Intellectual Property (IGWG).

They are charged with coming up with a plan of action to ensure new medical products are developed, and existing ones are made affordable. "The R&D system is broken. It is not delivering," said Dr. Tido von Schoen-Angerer, Director of MSF's Access to Essential Medicines Campaign. "Take tuberculosis, for example. Because tests are either antiquated or too high-tech, we don't have any practical tool to diagnose TB in people with HIV - who are precisely the ones most at risk of dying.

"And because drugs to treat resistant strains of TB are too weak, up to 20% of HIV uninfected and two-thirds of HIV infected patients with multi-drug resistant TB die during treatment." Governments at the World Health Organization (WHO) in 2006 created the IGWG following the release of a WHO report that said that intellectual property is not a significant factor in contributing to innovation for diseases that disproportionately affect developing countries.

Similarly, a Lancet study concluded that only 1% of the 1,556 drugs developed in the last 25 years targeted neglected diseases and tuberculosis, although these diseases account for over 10% of the disease burden. The IGWG represents the first chance for countries to begin building a system for medical innovation and access to medicines that; prioritises such diseases; develops needed health tools; and makes them affordable.

"This is an unprecedented opportunity to change the paradigm. The IGWG has been asked to delink the cost of R&D from the price of medicines. This is enormously important," said James Love, Director of Knowledge Ecology International (KEI). "We need new mechanisms and institutional responses to move toward a paradigm of innovation plus access, rather than a set of poorly functioning trade-offs. The big ideas in the negotiation are patent pools, prizes and a treaty on medical R&D. They are also the most controversial."

Today's model, where the cost of researching and developing medicines is paid for through drug prices, means that drug development is steered towards areas where the profit rewards are the greatest, so diseases which predominantly affect developing countries are neglected. At the same time, patents are used to sustain artificially high prices for medicines, so many in need are quite simply priced out of the market.

The UN talks risk being derailed by opposition from some governments. Although this meeting is based on a World Health Assembly resolution which puts intellectual property on the agenda, the USA and the European Union countries are questioning an expanded role for the WHO regarding intellectual property and health.

Some governments are also trying to narrow the scope of the meeting to a restricted number of diseases, whereas developing countries seek comprehensive solutions. "As a medical organisation we need medical innovation to happen.

But we also need to ensure that new and existing medicines are made affordable for all those that need them," said Michel Lotrowska, Campaigner with MSF. "Innovation is meaningless if newly developed products remain out of reach."