Biology Reference
In-Depth Information
How can some of the practical difficulties in the way of implementing the HIF
be overcome? It has been estimated that the HIF would require annual commit-
ted funding of at least $6 billion, and this amount would have to be guaranteed
many years into the future in order to provide innovators with certainty of income.
This minimum level is necessary to avoid excessive volatility in the reward rate
and to realize economies of scale in health impact assessment. The HIF would also
require an administrative structure to ensure that registered products are sold at or
below cost and to calculate their rewardable health impact.
Like the exploitation of monopoly rights under the current intellectual property
rights system, the HIF would enable payouts over a period of years. For example,
a new pharmaceutical product might earn annual payments from the HIF for its
first ten years of use. An extended payment period is important since it smoothes
the payment stream and gives innovators an incentive to promote their products to
ensure that they are widely used by those who can benefit.
The WHO expert group commented on the HIF as follows:
We considered that the ideas underpinning the HIF were of interest and that, if success-
fully implemented, it would address many of our criteria. The proposal addresses directly
intellectual property management issues in that it seeks to incentivize R&D relevant to the
disease burden in developing countries, while also facilitating access to these products by
making them more affordable. However, we considered that in practice implementation of
the HIF would be problematic on a number of grounds - particularly uncertainties about
whether a sufficiently reliable measurement of health impact could be achieved in the cir-
cumstances prevailing in developing countries (WHO
2012b
: 55).
For the HIF to become a reality, the plan needs to be examined, refined and pre-
sented in more detail. Most importantly, the health impact metric has to be worked
out and tested in several country pilot studies. It has been stated that 'access to
medicines has become the test above all others by which the rich world will be
judged in its dealings with the poor' (Horton
2002
). The HIF is one example of a
fair and cost-effective way of stimulating research and development of life-saving
medicines and making them accessible to all.
12
9.4 Conclusion
When it is obvious that the goals cannot be reached, don't adjust the goals, adjust the
action steps (Confucius).
Realizing the human right to health globally seems to be such a goal - one that is
aspirational, even utopian, but not realistically achievable just yet. However, if one
bears in mind the advice of Confucius, one can focus on the steps towards the goal.
Benefit sharing with the donors of human biological samples is indeed a very
limited and indirect contribution to realizing the human right to health, but it is an
12
For more information on the HIF, see
http://www.healthimpactfund.org
.
