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WHO Drug Information Vol. 13, No. 1, 1999 WHO DRUG INFORMATION VOLUME 13 • NUMBER 1 1999 RECOMMENDED INN LIST 41 INTERNATIONAL NONPROPRIETARY NAMES FOR PHARMACEUTICAL SUBSTANCES WORLD HEALTH ORGANIZATION • GENEVA WHO Drug Information Vol. 13, No. 1, 1999 General Policy Issues WHO roundtable with industry On 21 October 1998, Dr Gro Harlem Brundtland, the newly elected Director-General of WHO, met with key figures of the research-based pharmaceutical industry to explore ways in which access to affordable, innovative and essential drugs can be improved. The roundtable was attended by members of major pharmaceutical companies which included American Home Products, Glaxo Wellcome, Novartis, Pasteur- Mérieux-Connaught and SmithKline Beecham, together with representatives of the International Federa- tion of Pharmaceutical Manufacturers Associations (IFPMA). The meeting offered an opportunity for both sides to address issues of public health concern and to determine common ground. WHO's goal is to build a constructive dialogue with the private sector, and harness support to improve access to drugs and vaccines for populations in need. Global partnerships for health Let me underline where WHO stands: we are committed to national drug policies and the concept Gro Harlem Brundtland of essential drugs and vaccines. The Action Pro- Director-General gramme on Essential Drugs has been our main World Health Organization instrument in helping governments implement these concepts. When the action programme was estab- A roundtable, as we intend to apply the word in lished in 1975, very few countries had adopted WHO, is not a single event but a method of work. It national drug policies. The developing countries derives from our commitment to meet with broad were faced with serious problems of availability, constituencies involved in public health at the global cost, quality, and rational use of drugs. Today, level and address key issues relevant to the fulfil- nearly 90 countries have national drug policies in ment of our mandate in combating ill-health and place or in preparation. The WHO Model List of building healthy populations. Essential Drugs has been widely adapted by na- tional authorities and three out of every four coun- I have invited representatives of the research- tries in the world now have an essential drugs list. based pharmaceutical industry to a roundtable because I believe that we have a common aim in WHO plays a key supporting role by helping coun- health. I am convinced that we can collaborate tries to assess their needs, identify problems and effectively if we deal with our differences and find solutions. WHO sets norms, standards and address them directly and openly as we did in the regulations for implementation by regulatory au- meeting on the Revised Drug Strategy held earlier thorities, while quality assurance of pharmaceuti- in October*. Then, after an initial breakdown in cals is an overriding concern. Nowhere is the communication, Members States reached a con- responsibility or challenge greater. Of course, sensus on important issues which are also of operational research is a core function and so is concern to the pharmaceutical industry. How did safety monitoring. The two are closely linked. WHO this come about? Because of broader access to works with partners around the world to monitor the information, more time to listen, and a greater use of drugs — not only to sound the alarm when commitment to build bridges. faced with emergencies and outbreaks but to share the good news when progress has been made against a major disease. * Meeting of the ad hoc Working Group on the Revised Drug Strategy convened by WHO from 13 to 16 October WHO's global vaccination programme has achieved 1998. WHO Drug Information, 12(4): 209 (1998). an immunization rate of 80% for all children in the 1 General Policy Issues WHO Drug Information Vol. 13, No. 1, 1999 world. This is a success both from an industry and Public health and a public health perspective. However, we need to move on with new vaccine research and develop- the pharmaceutical industry ment and WHO is actively engaged with the World Bank, UNICEF, leading foundations and industry to Richard B. Sykes, President, International pave the way to new breakthroughs in vaccine Federation of Pharmaceutical Manufacturers development and delivery. This kind of joint project Associations and Chairman, Glaxo Wellcome, has also been established in other areas. For United Kingdom example, the Medicines for Malaria Venture has recently been set up and will be incorporated into The research-based pharmaceutical industry and the Roll Back Malaria initiative. I hope that WHO the World Health Organization share a common and the pharmaceutical industry can work together goal of fighting disease and improving health. With to strengthen this particular component. this essential unity of purpose, it seems clear that we should be working closely together wherever it Still much remains to be done. One-third of the is feasible to do so. I am confident that the discus- world's population lacks access to essential drugs. sions which have taken place during this WHO Those concerned with public health or equity will roundtable will be a first step towards a closer agree that this is truly unacceptable. Despite the partnership based on dialogue and mutual under- large sums spent on research and development, standing. less than 1% is directed to providing treatment for those diseases that strike developing countries. We all agree that medicines have made a tremen- Frankly, this does not make sense. The price of dous contribution to the improvement of health care drugs — especially for the newer products — puts during the 20th century, and particularly during the them out of reach in the majority of developing 50 years that WHO has existed. Of course, much countries. We must work together to ensure devel- effort still needs to be concentrated on ensuring opment of new drugs for major public health that the benefits of modern medicine are made threats. The challenge is there. But we must also available to all in need. The pharmaceutical indus- create an infrastructure to ensure that drugs for try will play its part in helping to achieve this goal. killer diseases like tuberculosis and malaria are However, our primary focus is and will continue to provided to those in need. be the scientific and technological research needed to produce new medicines to respond to health Emerging diseases, growing drug resistance, global problems that have so far eluded treatment. economic instability and uncertainty about the public health impact of new trade agreements are As we go forward into the 21st century, we have all relevant key issues. WHO will be present in all of every reason to be confident that the medical these arenas. Health is an integral part of our way progress witnessed so far will continue and acceler- of life, how our world evolves, how human re- ate. Prospecting for new medicines has entered an sources are nurtured, how trade expands and era of unprecedented opportunity and offers new economies grow, and how environments perish or insights into areas unimagined until now. Within the survive. The pharmaceutical industry has the industry, much is being done to ensure that we responsibility for developing, producing and selling harness this new science and technology and pharmaceutical products — drugs and vaccines. deliver medicines of real value. WHO has the responsibility for helping countries acquire access to essential drugs. The pharmaceu- The contribution of genetics tical industry is in the business of making a profit. Genetics is a vital newcomer to the drug discovery But we are in the business of seeing to it that the process and helps explain many things that we most vulnerable — who have little or no purchasing have observed in practice. The study of genetics power — are allowed equitable access to medi- offers an entirely new approach by identifying cines. factors that influence an individual's susceptibility to a certain disease. This new knowledge derives from WHO sees great potential in this roundtable as a the international human genome project devoted to first step in a serious attempt to build a sustainable sequencing the three billion DNA bases in humans. mechanism and provide affordable, essential drugs of quality to the needy. We look forward to forging a This tremendous effort will bring about significant strong, durable and committed partnership with improvements in the provision and practice of those having a common purpose in health. health care. Intransigent health problems such as 2 WHO Drug Information Vol. 13, No. 1, 1999 General Policy Issues asthma and heart disease, which are increasing at There is growing recognition that special measures an alarming rate throughout the world, will be are needed to encourage research and develop- understood. Genetic testing will enable individual ment for diseases such as malaria and tuberculo- patients to be targeted for specific treatment to sis. The involvement of the International Federation maximize efficacy and minimize side-effects. In of Pharmaceutical Manufacturers Associations other words, drugs can be tailored to people for (IFPMA) in the new WHO Medicines for Malaria maximum response. Venture demonstrates industry's willingness to find new ways forward. Similarly, legislation has suc- Effective prevention cessfully been introduced in the United States to In the future, the use of genetics will allow us to provide incentives to companies developing orphan screen for susceptibility and we will be able to drugs and the European Union is now setting up a identify which individuals will develop diseases long similar system. Regulatory authorities and WHO before the symptoms appear. This genetic informa- may wish to explore such an approach for tropical tion can then be combined with known conventional diseases since this would harness the industry's risk factors. Although in many cases these benefits skills and resources for new drug development in can only be provided within a sophisticated medical an important area.
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