The Rt Hon Justine Greening MP
Secretary of State
Department for International Development
22 Whitehall
London
SW1A 2EG

Date: 17th February 2016

Dear Justine,

Re: An historic opportunity for a new global Research and Development (R&D) agreement.

I am writing to express my concerns regarding our failing system for biomedical research and development (R&D), and to urge the UK government to take advantage of an upcoming historic opportunity for R&D reform. This issue was recently brought to my attention by a young constituent of mine who is campaigning on ‘Missing Medicines’ run by Youth Stop AIDS (supported by Restless Development and STOPAIDS).

Millions of people all over the world don’t have access to the life-saving medicines they urgently need. This is because our current system for R&D results in:

• High Prices: pharmaceutical companies have a 20-year monopoly on the new drugs they produce, meaning there is no competition and they can, therefore, charge extremely high prices. For example, Sofosbuvir, a new drug for Hepatitis C, was first marketed at US $84,000 for a 12 week treatment cost - far out of reach of people in many high income countries, not to mention low and middle income countries - even though it would cost only US $68 and $136 to produce in generic form. Prices for some countries will go down due to voluntary licensing, but many countries in need find themselves outside of the scope of these deals.

• Skewed incentives: medical research is driven towards the medicines likely to earn the most profit, meaning that if the development of vital medicines is not profitable they’re not developed. For example, Tuberculosis (TB) claims the lives of 1.5 million people every year and the prevalence of drug resistant strains continues to increase. Yet biomedical research for TB has been extremely underfunded – in 2014 there was a shortfall of $1.33 billion. The main reason for this is that 95% of people living with TB reside in low and middle-income countries and so the ‘market’ for TB does not offer pharmaceutical companies a sufficient return on investment. As a result, only 2 new drugs have come onto the market in the last 50 years. Hay fever, on the other hand has received 15 new treatments in the same period.

• Inefficiency: sharing of knowledge between researchers is not incentivised, meaning the progress of scientific research is hindered and research is often duplicated. For example, the patient care group Prescrire tested the added therapeutic value of 1345 drugs between 2000 and 2013 and found that only 7% offered ‘a real advantage’ to drugs already on the market. The failing R&D system is a global issue; it affects not only developing countries but also many of us in the UK. It is widely recognised that our current R&D model has been unable to tackle our antibiotic crisis, or provide affordable treatments for cancer or Hepatitis C on the NHS.

The UK is a supporter of TRIPs flexibilities and, therefore, acknowledges the negative impact that intellectual property can have on access to medicines. I am aware that the UK government has been supporting a number of different Product Development Partnerships (PDPs) which have brought new and affordable technologies to the market. However, these PDPs are still not coming close to delivering the increase of new treatments in the pipeline that is required, and only deal with some aspects of the problem rather than the holistic solution we need.

As you may know, the World Health Organisation (WHO) created the Consultative Expert Working Group (CEWG) to seek solutions. They recommended a package of reforms that would seek to:

• Introduce alternative incentives to producing new medicines, such as cash prizes, to replace patent monopolies and ensure affordability while still providing the innovator companies with an ample return on investment.

• Prioritise health research according to need rather than profit, by supporting the development of a global R&D Observatory at the WHO.

• Establish a pooled fund for R&D financed by all countries contributing 0.01% of GDP to ensure the R&D burden is shared.

These reforms should be realised through a new, legally-binding global framework - similar to the convention on Human Rights - called The R&D Agreement. It has the potential to unlock access to affordable and appropriate treatment globally.

The UK has a historic opportunity to take action on reforming our R&D model next year when WHO member states meet in March to discuss the CEWG report and potential R&D Agreement. I urge the UK government to attend this open-ended meeting and push for global progress on creating a draft R&D agreement. By doing so, the UK government would meet the Conservative manifesto commitment to ‘lead a major new global programme to accelerate the development of vaccines and drugs to eliminate the world’s deadliest infectious diseases’.

I would be happy to help organise a meeting between Youth Stop AIDS, myself and the Department for International Development to talk more about this issue.

Yours sincerely,