Description: A multifaceted model combining milestone prizes and research grants for promising drug candidates, open source sharing of knowledge and information, publicly financed clinical trials, patent buyouts of successfully developed antibiotics, and advanced purchase commitments for generic distribution.
Start date: Proposed 2014.
Proposed by WHO Assistant Director-General Marie-Paule Kieny,1 the WHO Global Consortium would be an international agreement and fund targeted at antibiotic research. It would be a mixed scheme, including milestone prizes and end prizes, which would buy out intellectual property rights into a public patent pool. The fund would also provide upfront grants, and enter into purchase agreements with pharmaceutical companies specifying the number of treatments to be administered per year.2
The funding for this consortium would be public,3 and would be contributed by states and philanthropists.4 No estimates are given of how much funding would be needed, although the end prizes are estimated at \$2-500m.5
Scope: The global consortium would affect all stages of antibiotic R&D.
Access: Medicines would get cheaper under the global consortium, as patents would be pooled and data accessible. The purchasing agreements would incentivise distribution in a way, but limited and appropriate distribution.
Innovation: The incentives are not directly linked to health impact, except in the general sense that antibiotic research is impactful.
Efficiency: It is not clear how much the mechanism would cost. The mechanism would be centrally run as far as grants and prizes were concerned, and the markets for the resulting health products would be managed to conserve antibiotics.
Governability: This mechanism would require international cooperation and a new international governing body.
Political Feasibility: It seems that this proposal was never further developed. Perhaps this is because no details were given on governance or costing.
The WHO Global Consortium is very similar to the proposals in the Antimicrobial Resistance (AMR) Review.
As a general point, Kieny references Outterson and KEI several times.
The global consortium would include a patent pool like the Medical Patent Pool (MPP), except that the global consortium’s pool would be compulsory for those in receipt of funding. The MPP does not disburse funding, and is a voluntary pool.
GAVI is a Product Development Partnership (PDP) and brings together private and public bodies to create research. The global consortium is a larger scale version of a PDP.6
The global consortium is a truly mixed proposal. In this it resembles the 3P Project and the Health Product Research and Development Fund. The global consortium contains additional features specific to antibiotics, and would operate explicitly at an international level.
The Chagas Disease Prize Fund also uses milestone and end prizes, like the global consortium, and would specify that intellectual property rights were ceded in return for the prize.
The WHO biomedical convention proposals and the MRDT differ from the WHO global consortium in that the former would cover all drugs and were not specific about the mechanisms for disbursing money, or the commitment to open intellectual property.
The global consortium would enter into purchase agreements specifying the amount of a drug to be provided. In the case of antibiotics, this is in part to limit supply. In other purchasing agreements like the pneumococcal Advanced Market Commitment (AMC), the aim is to maximise supply, but the mechanism for doing so is similar.
The difference between the global consortium and remuneration rights based proposals like the Medical Innovation Prize Fund (MIPF), the Health Impact Fund (HIF), the Cancer Innovation Fund (CIF) and the Fund for research in Neglected Tropical Diseases (FRiND) is that the consortium incorporates push funding as well as pull, and gives prizes rather than rights.
Stakeholders on board: Kieny at the WHO
A short WHO briefing paper: “A Publicly Financed Global Consortium for R&D to Fight Antibiotic Resistance.” WHO, 2015. http://www.who.int/phi/implementation/9_infobrief_current_who_model_for_development_preservation_new_antibiotics.pdf.
A longer opinion piece by Kieny: Marie-Paule Kieny. “CREATING AN INTERGOVERNMENTAL CONSORTIUM FOR NEW ANTIBIOTICS: A NEW DEVELOPMENT MODEL.” WHO, 2015. http://www.globalhealthdynamics.co.uk/wp-content/uploads/2015/05/04_Kieny.pdf.