BHOS-beleidsnota
Reactie
| Naam | Drugs for Neglected Diseases initiative (Senior Manager, External Relations C Sander) |
|---|---|
| Plaats | Geneva |
| Datum | 15 april 2022 |
Vraag2
Nederland kent een lange traditie van publieke private samenwerking. Nu de mondiale uitdagingen steeds groter worden, is het van belang deze publiek-private samenwerkingen te verdiepen en te versnellen. De duurzame ontwikkelingsdoelen zijn in 2015 vastgesteld als actieplan voor overheden, bedrijven, kennisinstellingen en burgers om duurzame ontwikkeling te verwezenlijken wereldwijd.2. Hoe kunnen overheid, bedrijfsleven en kennisinstellingen beter samenwerken om de duurzame ontwikkelingsdoelen te halen?
(EN)
The Netherlands has a long tradition of public-private partnership. As the global challenges grow ever bigger, it is important to deepen and accelerate these partnerships. The Sustainable Development Goals were presented in 2015 as a plan of action for governments, companies, knowledge institutions and private individuals to achieve sustainable development worldwide.
2. How can government, the private sector and knowledge institutions work together better to achieve the Sustainable Development Goals?
2.1. The Drugs for Neglected Diseases initiative (DNDi) welcomes the opportunity to contribute to the consultation for the new Foreign Trade and Development Cooperation policy.
2.2. DNDi is a collaborative, patients’ needs-driven, non-profit drug research and development (R&D) organization, that is developing new treatments for neglected diseases (NTDs).
2.3. DNDi was established to address a chronic challenge when it comes meeting the R&D needs of neglected populations living in poverty. Dutch Government funding since 2006 has significantly contributed to DNDi’s ability to deliver 9 new treatments for five diseases in 19 years - building on global collaborations with the public and private sectors and ample collaboration with Dutch scientists. Core funding from the Government of the Netherlands enables DNDi to approach drug development in a results-oriented and cost-effective manner. This results in significantly lower costs for drug development than seen in the private sector, and treatments which are adapted for the needs of, and are affordable and accessible to, patients in resource-limited settings.
2.4. Action to address Neglected Tropical Diseases (NTDs) is an important example of how ODA can be targeted towards tackling extreme poverty and achieve the Sustainable Development Goals. NTDs are a proxy for poverty and disadvantage, affect populations with low visibility and little political voice, cause stigma and discrimination, especially of girls and women, have an important impact on morbidity and mortality, and are relatively neglected by research.
2.5 Action towards NTDs have been formally recognized as a target for global action within SDG3 including Target 3.3 and Target 3.8.
2.6. Product Development Partnerships (PDPs) are an example not-for-profit business models designed to deliver health tools to meet public health priorities. PDPs develop new health tools for diseases and health threats underserved by commercial approaches. Due to their unique approach, PDPs have been able to develop and distribute new health technologies designed to be appropriate, accessible, and affordable for the places and people that need them.
2.7. Diseases of poverty must be overcome if we are to meet the SDG target of ending the epidemics of neglected tropical diseases by 2030 and to ensure universal health coverage. We therefore commend that the Dutch Government on its commitment for continued resources to support PDPs with the 2022 PDP IV Fund.
Vraag3
Nederland heeft sinds 2016 een actieplan beleidscoherentie voor ontwikkeling. Beleidscoherentie voor ontwikkeling heeft als doel om in niet-hulp (OS) beleid schade voor ontwikkelingslanden te verminderen en synergiën en samenwerking te versterken. Het Nederlandse actieplan is in 2018 herzien en geeft een overzicht van vijf Nederlandse beleidsthema’s die een invloed hebben op de ontwikkelingskansen in ontwikkelingslanden. Deze thema’s zijn: (1) het tegengaan van belastingontwijking/ontduiking, (2) ontwikkelingsvriendelijke handelsakkoorden, (3) een ontwikkelingsvriendelijk investeringsregime, (4) verduurzaming van productie en handel en (5) het tegengaan van klimaatverandering.3. Hoe kan de bovengenoemde Nederlandse inzet op beleidscoherentie voor ontwikkeling verder versterkt of verbeterd worden?
(EN)
The Netherlands has had an action plan on policy coherence for development since 2016. The aim of policy coherence is to reduce the negative effects on developing countries caused by policies in areas other than development, and to strengthen synergies and cooperation. The action plan, which was revised in 2018, identifies five Dutch policy themes that can enhance developing countries’ opportunities for development: (1) combating tax avoidance/evasion, (2) development-friendly trade agreements, (3) a development-friendly investment regime, (4) more sustainable production and trade, and (5) combating climate change.
3. How can the Netherlands’ efforts to achieve policy coherence for development be further strengthened or enhanced?
3.1. There is a severe global misalignment of where biomedical and health research, innovation and manufacturing capacity are based, primarily in a few high-income countries. Covid –19 has demonstrated the need for a more distributed approach to ensure regional and global health security. The Dutch Government’s action plan on policy coherence for development should ensure allocation of resources for harnessing and strengthening health R&D infrastructure, and training research personnel, in endemic countries. This includes enhancing clinical research capacity, strengthening ethics review, adapting regulatory pathways, promoting gender-responsive R&D for women and children, and enhancing community engagement for both advocacy and implementation of activities to meet health needs. These investments have long term benefits as skills and resources can be deployed to address other health needs.
3.2. COVID-19 has highlighted the lack of international collaboration in preparing for and responding to pandemics, that no country can do so alone, and that more investment is needed. However, there is a risk that by focusing on a narrow definition and scope of health threats that the Dutch Government will miss an opportunity to address unmet needs with the broadest benefit to global public health and poverty alleviation.
3.3. The Dutch Government should therefore ensure its objectives are aligned with the Sustainable Development Goals and the principle of leaving no one behind, ensuring they maximise global health outcomes. Ending extreme poverty will require increased efforts to effectively tackle diseases of poverty including reaching targets set by the WHO 2030 Roadmap on NTDs.
3.4. Poverty related diseases already have a debilitating impact upon economies, societies, and health systems across low- and middle-income countries. Yet, both climate change and migration increase the current and future burden of these diseases in both developing and developed countries.
3.5. Efforts to adapt to climate change therefore warrant a greater focus on the development and access to health tools for infectious diseases, designed to meet the needs of vulnerable populations living in poverty. Therefore, the Dutch Government should include innovation and research and development needs of climate-sensitive neglected tropical diseases into its climate agenda and priorities.
Vraag5
Thema’s en sectoren van de toekomstNu de wereld in transitie is om een goede toekomst voor ons en de generaties na ons te bewerkstelligen verandert de focus van bedrijven, overheid en kennisinstellingen.
5. Op welke thema’s of sectoren ziet u kansen om internationaal te ondernemen?
(EN)
Themes and sectors of the future
The focus of companies, governments and knowledge institutions is changing in light of the global transition to ensure a bright future for current and future generations.
5. In which themes or sectors do you see opportunities for international enterprise?
5.1. Access to innovation will be a primary theme for companies, governments and knowledge institutions as we respond to global challenges and global transitions. As highlighted in the final report of the Independent Panel for Pandemic Preparedness and Response (IPPR), there is an urgent need to transform the current international architecture of biomedical R&D and innovation into a “truly global end-to-end platform... shifting from a model where innovation is left to the market to a model aimed at delivering global public goods.” From our own experience we have found that for innovation to address public health needs, access must be integrated from the outset of the R&D process and continue to be a driving factor at all stages including delivery. DNDi has piloted and implemented processes and polices, including public interest target product profiles for its medical treatments under development, that define the key characteristics of a product from the beginning of the process. This includes gold standard licensing terms for the pro-access management of any intellectual property that could affect development accessibility or affordability of any product. These actions seek to ensure that all our products are developed, where possible, public goods.
5.2. Such an end-to-end approach to R&D for global health and delivering public health priorities should be prioritized in any future investments in this Dutch priority area. This includes the inclusion of policies and practices that promote and encourage transparency and open access to new research knowledge, pharmaceutical compounds, technologies, know-how and data – which are needed for research and development of new medicines, but also to allow affordable access to the resulting product. This should also include the pro-access management of any intellectual property or other potential legal barriers to sharing knowledge or ensuring access. Leadership from the Dutch government in multilateral fora on these issues will go further to cultivating a favourable environment for greater sustainable innovation and access.
Vraag7
OntwikkelingssamenwerkingDevelopment cooperation
Nederlandse inzet op Ontwikkelingssamenwerking
Nederland is op verschillende thema’s actief op gebied van ontwikkelingssamenwerking. Zo investeren we in het realiseren van de Sustainable Development Goals (SDG’s) en zetten we extra in op opvang in de regio, toegang tot vaccins, klimaatadaptatie en -mitigatie. Nederland gaat door met wat goed gaat en focust op waar Nederland goed in is, zoals verbinding tussen diplomatie en ontwikkelingssamenwerking. Meer informatie over het ontwikkelingssamenwerkingsbeleid van Nederland is te vinden op www.nlontwikkelingssamenwerking.nl.
7. Waar is Nederland op het gebied van ontwikkelingssamenwerking volgens u goed in? Op welke thema’s zou Nederland een aanjagende rol kunnen vervullen?
(EN)
Dutch development cooperation activities
The Netherlands is actively pursuing a number of policy themes in the area of development cooperation. For example, we're investing in efforts to advance the Sustainable Development Goals (SDGs), reception in the region, access to vaccines, and climate adaptation and mitigation. The Netherlands will continue its efforts in areas where progress is being made and will focus on its strengths, such as linking diplomacy and development. For more information about Dutch development policy, go to www.nlontwikkelingssamenwerking.nl.
7. In your opinion, what are the Netherlands’ strengths when it comes to development cooperation? In which policy themes could the Netherlands play a leading role?
7.1. The Dutch Government played a catalytic role in the understanding of the ecosystem for public health R&D and was one of the first public donors in 2006 to fund efforts to address these shortcomings in the commercially focused R&D system.
7.2. For over the past 15 years PDPs, including DNDi, have received core resources from the Dutch Government. Through their investment in PDPs, Dutch government funding has helped develop and deploy more than 65 products to combat many of the world’s deadliest diseases – including tuberculosis, malaria, HIV/AIDS and a host of other neglected tropical diseases. Products from these investments have reached more than 2.4 billion people around the world, including the most vulnerable women and children.
7.3. However, it is not just what the Dutch Government has funded that it is important but also how it does so. The Netherland’s previous investments have had immediate, longer term and broader catalytic effects. The R&D process is long-term and entails risk. Individual projects may fail where others require extra investment. Through uninterrupted investment in DNDi’s portfolio of projects since 2006 the Netherlands has supported activities incorporating R&D, training and capacity strengthening, and transfer of technology to achieve lasting impact. This can only be achieved with the core contributions from donors, such as the Dutch Government, which provide the necessary flexibility to address R&D challenges as they arise.
7.4. The Netherlands’ focus on the needs of vulnerable populations and reduction of social inequality in its development policy as themes should be continued, with an understanding that R&D, including the use of new technologies, should address specific populations historically neglected by the dominant pharmaceutical business model. This includes giving special attention to gender, racial/ethnic differences, people living in poverty, children, migrants, people with co-morbidities, and other vulnerable, and marginalized populations.
Vraag8
Innoveren op OSNederlandse internationale samenwerking is flexibel en kennisintensief, we zijn vernieuwend. Zo ontwikkelt Nederland nieuwe manieren van werken en partnerschappen die daarna door bijv. de Europese Commissie en Wereldbank worden opgepakt of opgeschaald. De Nederlandse internationale samenwerking fungeert dus veelal als een creatieve en kennisintensieve incubator (een broedplaats voor nieuwe ideeën. Nederland is een relatief kleine donor, maar als lidstaat van de EU en via bilaterale hulp kan Nederland de zichtbaarheid van EU-hulp vergroten en additionele relevante kapitaalstromen generen.
8. Op welke manier en op welk vlak kan de Nederlandse ontwikkelingssamenwerking nog meer innoveren?
(EN)
Innovative development cooperation
Dutch international cooperation is flexible and knowledge-intensive. We are also innovative, developing new ways of working and new types of partnership that are subsequently adopted or scaled up by others, like the European Commission and the World Bank. In this respect, Dutch international cooperation is like a creative and knowledge-intensive incubator. We are a relatively small donor, but as an EU member state and through bilateral aid we can make EU aid more visible and generate additional, relevant capital flows.
8. In what other ways and areas could Dutch development cooperation innovate more?
8.1. The Dutch government has, in the past, played a catalytic role to stimulate pharmaceutical industry involvement and contribution to tackling poverty-related diseases and NTD elimination targets, notably through its support to Product Development Partnerships (PDPs), but also its support to the Access to Medicine Foundation, and indirectly through its Policy Framework Strengthening Civil Society and related funding support.
8.2. Future Dutch funding policies must ensure that health R&D, including the use of new technologies, addresses specific populations historically neglected by the dominant pharmaceutical business model. Through our experience in successfully developing 9 new treatments for neglected populations which have cured millions of people worldwide, we know that the treatment innovations we deliver will be of little use if they are priced out of reach, in short supply, or poorly suited to the needs of neglected patients and the health systems that serve them.
8.3. We call on the Dutch government to continue its support for alternative models for health R&D in the public interest, with a focus on improving equitable access to health products for the most vulnerable populations, including women and girls.
8.4. We also encourage the Dutch government to continue its efforts in development cooperation and global health diplomacy to push for transparency in health costs and the pricing of health commodities. Innovations of public health importance must be identified as public goods to ensure equitable access to the fruits of scientific progress. Essential health tools must be (1) free from intellectual property restrictions that can act as a barrier to follow-on research, large-scale production, and equitable access; (2) priced as close as possible to what it costs to make them; and (3) available, meaning that sufficient production capacity, including through transfer of technology, must be assured.
Vraag9
Een donor met durfDe Nederlandse internationale inzet is gedurfd, omdat we financiële investeringen koppelen aan onze diplomatieke inzet en expertise. We continueren thema’s waar we traditionele meerwaarde hebben: seksuele en reproductieve rechten en gezondheid (SRGR), water, voedselzekerheid en veiligheid & rechtsorde. Daarbij kunnen we nog meer gebruik maken van het diplomatieke gewicht van o.a. de EU. We investeren in systeemverandering om te zorgen dat we de SDG’s in 2030 realiseren. Met systeemverandering bedoelen we dat we de systemen die armoede en ongelijkheid in stand houden aanpakken.
9. Op welke manier/welk vlak kan Nederland als donor nog meer durf te tonen?
(EN)
A bold donor
Dutch international efforts can be characterised as bold, because we link financial investment to diplomatic efforts and expertise. We will continue our work on themes where we have always added value: sexual and reproductive health and rights (SRHR), water, food security, and security and the rule of law. We will also make better use of the diplomatic weight of the EU. To ensure we achieve the SDGs by 2030, we will invest in systemic change, i.e. tackling the structures that maintain poverty and inequality.
9. In what ways or areas could the Netherlands, as a donor, be even bolder?
9.1. Many of the challenges that have been identified in relation to the health R&D system and access to vaccines, diagnostics, and therapeutics for COVID-19 are acute examples of the chronic failures that DNDi and our partners have faced, and tried to overcome, for neglected populations over the past two decades.
9.2. The Dutch government can lead change for a global system for biomedical R&D that ensures all people benefit from medical innovation and have access to the fruits of scientific progress. The dominant market-based model for financing and incentivizing health technology R&D has become increasingly problematic, and through its neglect maintains poverty and inequality.
9.3. If we were to provide suggestions to the Government of the Netherlands in how to be bolder in its leadership, it would be to urge the Dutch government to learn the positive lessons and avoid repeating mistakes that have hindered innovation of and access to COVID-19 vaccines and therapeutics. To ensure public funding and research results in affordable health tools that reach everyone who needs them, governments, donors, industry, and the research community should take six concrete steps:
1 Increase funding and mobilize scientific collaboration for research that addresses the needs of low-resource settings.
2 Include researchers, public health experts, civil society, and political leaders from low- and middle-income countries in decision making and efforts to identify the tools and interventions that are most appropriate and effective for use in different settings.
3 Commit to open sharing of research knowledge and data to improve research efficiency and accelerate scientific progress.
4 Make health tools public goods wherever possible with policies to ensure no intellectual property or other barriers as a prerequisite for taxpayer and philanthropic funding to remove barriers to research and affordable production of new tools.
5 Ensure access from the outset in funding agreements and research planning to ensure sufficient production, equitable allocation, and affordable pricing.
6 Require full transparency on R&D funding to secure public trust and support and to demonstrate that both governments and funding recipients are accountable for R&D investments and how they are used.
Vraag10
Afrondende algemene vraag10. Heeft u nog andere punten van aandacht die u vindt dat meegenomen dienen te worden in de nieuwe beleidsnota?
(EN)
General closing question
10. Are there any other points that you believe should be included in the new policy document?
10.1. The Dutch government’s new Foreign Trade and Development Cooperation policy is being shaped within a context of multiple global crises, as well as an ever-increasing global awareness that existing development institutions are not best-designed for current global crises and previous and existing structures of development assistance are not sustainable. These shortcomings point to many reasons including the global power imbalances which perpetuate inequity in growth.
10.2. DNDi would encourage the new policy document to seek to improve global power imbalances by prioritizing new strategic alliances with partners in LMICs and fostering South-South cooperation and technology transfer.
10.3. Alternative models for development, such as PDPs, seek to rebalance the system through their partnerships in LMICs to foster engagement in ‘end-to-end’ health R&D that puts people’s needs first. We would encourage the policy document to support science and policy leadership in LMICs, to strengthen existing and emerging innovation ecosystems that prioritize the needs of neglected populations, and to ensure innovations originating in LMICs are integrated into international responses.