Expert group calls for needs assessment and adjustment of public-private risks and benefits
An independent expert group tasked by the World Health Organization with rethinking European policy priorities in light of the pandemic has concluded that health innovation is “widely flawed” and must be changed to better address future health threats.
“The pandemic has clearly demonstrated that the existing model of innovation—where most of the risk is borne by the public sector and most of the returns flow to private companies—is widely flawed, with misaligned incentives,” said the report, published on 10 September.
The expert group was chaired by Mario Monti, the former prime minister of Italy and European Commissioner turned Bocconi University president. Its scientific coordinator was Elias Mossialos, a Greek former minister who is now head of the Department of Health Policy at the London School of Economics and Political Science, while a scientific advisory board was chaired by Martin McKee, a professor of European public health at the London School of Hygiene and Tropical Medicine.
“Enormous investments in biomedical innovation do not always flow to where they are needed most,” the report said. It argued that the current system of innovation incentives means companies are less motivated to develop needed but less profitable treatments, such as those addressing rare diseases. Such treatments are “only produced where there are other incentives present, such as extensions of patent protection”.
The experts said Europe needs to move away from this model by adopting a “continuous process of assessing unmet health needs”, which they said should span “all stages of the innovation process, from basic research through to late-stage clinical trials and post-marketing surveillance”.
Such unmet needs at present include the development of new antimicrobials, for which the need to use them as little as possible to avoid the evolution of resistance is incompatible with pricing models based on sales volumes.
Transparency and dialogue
In addition, public-private innovation partnerships, “unlike some in the past…must be based on transparency, with sharing of the risks and benefits of innovation”, while procurement of treatments must be based more on dialogue between manufacturers and service providers.
Governments, research funders and other bodies must also review how they support health systems, the experts said, to make it easier for health systems to carry out large-scale evaluations of potential treatments.
More generally, the experts called for greater investment in innovation, data collection and sharing, and “strong national health systems”. They also backed developing a ‘one health’ policy that recognises the link between human, animal and environmental health.
“We are calling for action at all levels of society—on fixing fractured societies, on safeguarding planetary health, on innovation and investment in health systems, and on better European and global governance,” said WHO Europe region director Hans Kluge, who convened the panel