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The Lancet 2006; 368:2034 DOI:10.1016/S0140-6736(06)69814-0 Editorial It should be an unspoken prerequisite for discussions of any global strategy that a globally representative selection of discussants takes part. Too often rich countries strike deals that affect, but do not involve, poor countries. The populations of these cash-strapped nations suffer as a result. Global negotiations on intellectual property are a prime example of this unjust tradition at work. So, if any discussions were to break the mould, it should have been WHO's Intergovernmental Working Group on Public Health, Innovation and Intellectual Property, which took place this week (Dec 4–8). Unfortunately, with a delegate list that excludes more than half of WHO's member states—a third of the missing are classed as Least Developed Countries by the UN—this working group seems set to perpetuate the very problems it has set out to address. The working group's aim is to start the ball rolling on a global strategy to boost research and development of products for diseases that predominantly affect developing countries. It was set up to take forward recommendations of the independent but WHO-mandated Commission on Intellectual Property Rights, Innovation and Public Health, which produced its final report in April this year. Some of the Commission's recommendations urge WHO to take on specific responsibilities: for example, establishing the patent status of drugs on the essential medicines list. But the vast majority of the suggestions depend on developing-country governments taking the lead. The Commission calls for “sensible” patenting and licensing policies in developing countries to ensure context-relevant products are developed. It urges every country to focus on strengthening clinical trials and regulatory frameworks. And, importantly, it makes clear that developing-country governments must not agree to restrictions of use of patented data that exceed World Trade Organisation standards, and must negotiate hard with pharmaceutical manufacturers to ensure drug prices are set at an affordable level. WHO can offer valuable support to help poor countries develop and enforce better policies to protect and promote public health while fostering innovation. But a global strategy to formalise this support will not work if WHO cannot bring the necessary players to the discussion table. The Lancet
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