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SECTION 3. Governing the COVID-19 R&D response: Existing proposals to enable access to COVID-19 pharmaceutical innovations
from COVID-19 and the Reform of the Biomedical R&D System: A Proposal for a Preferred Supplier Model
by ISGlobal
SECTION 3:
Governing the COVID-19 R&D Response: Existing Proposals for Enabling Access to COVID-19 Pharmaceutical Innovations
In what is likely to be the largest joint global effort in biomedical R&D, public sector investments have been essential in incentivising COVID-19 R&D, and public and private actors are working together to develop pharmaceutical innovations to tackle the pandemic. However, the system’s efficiency and its capacity to deliver new health technologies equitably continue to be undermined by some of the characteristics identified in Section 1: the use of patents, instead of other mechanisms, as the primary incentive for R&D preventing a faster manufacturing process that would scale up access to vaccines, the lack of transparency, and the shift towards a market-oriented mission. While Section 2 identified the role of public institutions in R&D funding and discussed some of the weaknesses of the current system, such as how the lack of transparency could threaten the fair allocation of risks and rewards in an extreme situation like the COVID-19 pandemic, this section will discuss the attempts made to establish two global governance mechanisms to address some of these weaknesses and to increase social and economic efficiency to achieve equitable access to COVID-19 health technologies worldwide.
BOX 1. Policy Tools and Incentives Used to Drive Innovation and Access
The set of incentives and policy tools used to steer pharmaceutical innovation in a certain direction has traditionally been divided into three categories: Push, Pull and Pool incentives.13,25,30 ● Push incentives are upfront grants or in-kind contributions given to contribute to the expenditure on R&D made by the recipient, that is, to subsidise research inputs. The idea is to steer the company’s research in a desired direction, assuming the risk of development failure. ● Pull incentives reward the results of research. Designed to reward research outputs, pull mechanisms incentivise companies by way of regulatory fast-tracks, development prizes, or by securing demand through advanced market commitments (AMCs). ● Pooling mechanisms collect data, IP, designs or any kind of asset related to a certain disease or therapy with a view to increasing data sharing and eliminating the barriers created by secrecy. By pooling patent-protected assets, several researchers and manufacturers can contribute to the R&D process, increase manufacturing capacity and reduce prices through generic manufacturing. Pooling reduces the cost of innovation, creates viable markets and facilitates generic competition, thereby reducing the price of medicines.
