5 Blindspots on the road to the UN High Level meeting on TB

By Sharonann Lynch | 14 Jun, 2018


Please see the article in Politico at the bottom of this email along with some of the other problems with the UN High Level meeting on TB below. More advocacy, including from AIDS activists, is needed in a short time period.

What we know
TB is the leading infectious disease killer and the main cause of death of people living with HIV
TB gets its first high-level meeting (HLM) at the United Nations in September 2018
Governments will repeat the promise to “end TB,” but the draft outcomes document has a number of problems
Time is running out on the main negotiations: there is a cut off of 19 June for any new text to the draft outcomes document
Blindspots and potholes

There are no national-level targets in the draft declaration, only global cumulative goals. As we know from HIV, national coverage targets in the outcomes document helps activists pressure governments for inclusion of such targets (testing, treatment, and prevention coverage), in national strategic plans. Also, specifying targets adds more muscle to follow-up monitoring and reporting.

As expected, some member states and other actors are challenging the inclusion of access to medicines language that re-affirms the rights of countries to utilize TRIPS flexibilities and other safeguards to protect public health. These rights were laid out in the WTO Declaration on the TRIPS agreement and public health in 2001, and have been further clarified and re-affirmed in the outcomes documents following the UN High-Level Meeting (HLM) on HIV in 2011 and the UN HLM on NCDs in 2011, the Sustainable Developments Goals (SDG3), and 3 weeks ago at the World Health Assembly.

Why it matters: These rights are not just a legacy from the last two decades of people fighting for their lives as part of a larger access to medicines movement, but also a lifeline for people tomorrow who will need of affordable medical technologies. The question now is whether champions of affordable access — be it government or civil society can ensure that we don’t slide backwards.

The best chance we have of ensuring access to emerging medical commodities is to build in equitable access principles and practices into how research and development is financed and conducted. This includes having governments recognize the shared responsibility of funding R&D and ensuring the products of government-funded research are affordable and accessible, including by delinking the cost of R&D from the final price. There is a precedent: such language was part of the political declaration of the 2016 UN HLM on anti-microbial resistance. While similar strong language appeared in the first draft of the TB outcomes document, some governments are now actively trying to remove it.

There is clear and strong resistance from governments to include financial targets needed to TB programmes (which would require doubling current funding to reach the US$13 billion) and to support TB R&D to develop the new tools and technologies to prevent, diagnose and treat TB (US$2 billion annually).

What happens after TB gets its day at the UN? Either we slide back into mediocrity, lack of transparency and accountability, or we hold governments to account for the commitments they made. This will depend largely on whether there will be regular reporting on progress, or the lack there of, an accountability body such as a Global TB Leaders Taskforce, and a follow-up HLM in meeting in 2023. Member states are resistant to some of these suggestions from the TB community.


Draft TB declaration: US, EU push against funding, delinkage pledges

-- By Sarah Wheaton
6/12/18, 6:32 PM CET

The EU and U.S. are resisting concrete commitments on new funding for tuberculosis ahead of a high-level U.N. meeting about fighting the world’s top infectious killer.

The two regions are also pushing to eliminate language that would urge countries to work to separate the cost of R&D from the price of a drug — so called delinkage — according to a draft of the political declaration to be signed by heads of state at the U.N. General Assembly on September 26.

The draft, obtained by the NGO Knowledge Ecology International and shared with POLITICO, shows proposed changes to an earlier version based on a June 8 meeting. The EU and U.S. propose striking from the text a commitment to “a doubling of annual investments,” in the section on sustainable financing for research.

The U.S. is the biggest single public funder of TB research, followed by the EU, according to NGO Treatment Action Group.

Both the major powers also call to strike a passage that acknowledges the “importance of delinking the cost of investment in research and development from the price and volume of sales” as a way to ensure access to new treatments.

Access-to-medicines campaigners tout delinkage as a way to encourage innovation while keeping prices low. However, the EU and U.S. have traditionally backed the pharmaceutical industry’s preference for finding new intellectual property incentives.

Thiru Balasubramaniam, a Geneva-based official with Knowledge Economy International, said the documents showed the EU and U.S. are “hell-bent on purging the political declaration” of references to IP flexibilities, and lamented the delinkage deletion.

The TB document “does not portend well for the upcoming U.N. negotiations on non-communicable diseases,” Balasubramaniam said, referring to another high-level meeting September 27.

To view online: https://www.politico.eu/pro/draft-tb-declaration-us-eu-push-against-funding-d...