|Plenary session, Thursday, August 31 2006, 14:00-15:30|
|Chair(s): Louis J. Currat, Switzerland, Nick Drager, Switzerland|
|Health Impacts of Trade Agreements: A critical Reflection|
|Sisule F. Musungu, Acting Coordinator, Innovation, Access to Knowledge and Intellectual Property Programme (IAIPP), South Centre, Geneva, Switzerland|
|The Social Responsibility of the Private Sector and the Right to Health|
|Klaus Leisinger, Special Advisor on UN Global Compact to the UN Secretary General; Director, Novartis Foundation for Sustainable Development, Basel, Switzerland|
|Strengthening the Long-term Capacity of the Public Sector|
|Pascoal Mocumbi, European and Developing Countries Clinical Trial Partnership (EDCTP) High Representative, Mozambique|
|Public-Private Partnerships for Health|
|Roy Widdus, Global Health Futures Network, Geneva, Switzerland|
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To tackle global health problems that disproportionately affect the poor, the skills and expertise of the private as well as the public sectors are needed; thus, Public and Private Partnerships (PPP's), which sharply increased in number between 1995 and 2005. As one of the speakers, Dr. Roy Widdus, said, "They can be seen as valuable 'social experiments' which achieve synergy through complementarity" and most of all "to which few, if any, realistic alternatives exist". The plenary session that took place this afternoon at the Geneva Forum comprehensively addressed the issues arising from PPPs.
Mr. S. F. Musungu is the Team Leader, Intellectual Property, Investment and Technology Transfer at the South Centre in Geneva. He is also Chairman of the Board of Directors of Health Action International - Africa (HAI Africa). Mr. Musungu, who has consulted for, and acted as an advisor to, various UN agencies, international organizations, non-governmental organizations and national governments, is the author of a number of publications and papers on intellectual property, trade, and human rights.
In his presentation about the health impacts of trade agreements, Mr. Musungu pointed out that in a globalized world; trade agreements have several health impacts. Indeed they are currently seen as the main framework for encouraging incentives as well as financing innovation in the health sector. They also provide a framework for the liberalization of health services and affect the provision of health-related services. Finally, they have a direct impact on pharmaceuticals and other health care products and equipment due to their role as tariff regulators. According to Mr. Musungu, PPP's are closely linked with trade agreements as they are shaped by them. However, even if PPP's can bring innovative solutions to health problems, they can also be the origin of public policy failure.
The speaker expressed his concerns about the current situation where there are no appropriate funding and incentive mechanisms for the creation of health products for the diseases that disproportionately affect developing countries. Moreover, even in cases where there are solutions, there is a tragic lack of access because of the absence of global mechanisms that seek to address the twin issues of innovation funding and access in an appropriate manner. Mr. Musungu then mentioned the World Health Assembly resolution 59.24, May 2006, which calls for the establishment of a global strategy and plan of action. He affirmed that this could be a critical opportunity to address the weaknesses and negative impacts of key trade agreements. But he concluded his presentation by posing the question to the healthcare community whether they would indeed be able to work towards this.
Professor K. M. Leisinger has been President and Chief Executive Officer of the Novartis Foundation for Sustainable Development since 2002. In 2005, he was appointed by the United Nations Secretary-General Kofi Annan as 'Special Advisor on the Global Compact'. In addition to these positions, he teaches and conducts research as Professor of Sociology at the University of Basel. He also serves as advisor to various national and international organizations dealing with sustainable development.
Prof. Leisinger's presentation raised the issue of corporate responsibility in the pharmaceutical industry and the right to health. Recognizing that responsible business can be part of the solution to the challenges of globalization, the Global Compact has been created to promote responsible corporate citizenship. In this way, the private sector - in partnership with other social actors - can help realize a more sustainable and inclusive global economy. Thus, Prof. Leisinger outlined various elements of an enlightened corporate business including organizing debates with other stakeholders, developing and implementing corporate guidelines and communicating with the public. He also emphasized the risks linked with corporate responsibility which are mainly due to the over-simplification of complex issues and the shift of national responsibilities away from the primary duty bearers, thereby providing an excuse to irresponsible governments.
Dr. P. Mocumbi was the Prime Minister of Mozambique from 1994 until 2004. He is representing the Medicines for Malaria Venture and is High Representative of the European and Developing Countries Clinical Trials Partnership (EDCTP). As a minister of health, he was responsible for the successful creation of the nurses' 'maternal-infantile health' basic level course and has wide experience of the role of the State in health provision.
Dr. Mocumbi's speech focused on strengthening the long-term capacity of the public sector. He reminded us that despite technical advances and repeated commitments from governments and international organizations, we are witnessing gross inequities across the world in the field of health and access to health. He insisted on the close relationship between poverty, security and access to health, declaring that "AIDS is a global security threat because of its impact on governance". Dr. Mocumbi went on to emphasize the challenges now facing the Public sector: financing of health systems, organization and structure of the healthcare system and finally human resources for health crises. All nations are expected to plan and lead the implementation of the basics: building health systems, providing affordable education and promoting gender equality and universal protection of human rights. Creativity and innovation are essential to find healthcare financing to address under-funded, poorly managed public health sectors. Additionally, exploring complementary financing to strengthen community participation and ownership could be seen as a key to improving health partnerships.
Dr. R. Widdus presently serves as Project Manager of the Initiative on Public-Private Partnership for Health at the Global Forum for Health Research. From 1995 to January 2000 he was Coordinator of the Secretariat to the Children's Vaccine Initiative. He has experience in a variety of work settings including research, teaching, biotechnology and pharmaceutical industries, and policy development for science and health in government and international agencies.
The term 'public-private partnership' (PPP) is applied to a diverse range of ventures designed to improve access of poor populations to particular health products or services, said Dr. Widdus. PPP's came into being to fill the gap left by independent actors, mostly due to market inefficiencies, lack of government resources in poorer countries and insufficiency of international aid. PPP's include many actors, all coming either from the public sector, civil society or the for-profit sector. Each of them has a specific role and benefit which needs to be clearly identified but many possible collaborative relationships can occur between public and private sectors. Therefore Dr. Widdus split PPP's into different categories with regards to their strategy. The three most relevant types are: product development partnerships, 'Access' partnerships and global coordination or funding mechanisms. The speaker insisted on the need to segment PPP's as a means to address the issue better and to find the most effective solution for each problem.