Defining innovation for health through the lenses of accessibility
Significant improvements in the health status worldwide are universally recognized, but such gains are to be measured against the widening health inequalities among and within countries created by a largely dysfunctional global economic system.
Health and scientific knowledge have tremendously increased over the last decades, but the benefits of science are very unequally distributed, and they may not be sustainable if economic development is not pursued together with social and gender justice. Millions of people in low and middle-income countries have no or little access to the health services and tools that would allow them to address their priority needs. In particular, the lack of availability and accessibility of essential medical tools poses a major barrier to the realization of people’s right to health and enjoyment of the benefits of scientific progress, at a time when the scope of health challenges for low and middle income countries grows even wider, as a result of epidemiological transition.
The structural linkage between health and biomedical innovation and access to essential health tools was established in the report of the WHO Commission on Intellectual Property Rights, Innovation and Public Health (CIPIH Report, April 2006) : innovation is meaningless if its results are not reaching those in need. This strategic link forms the conceptual basis of the Global Strategy on Public Health, Innovation and Intellectual Property (GSPA, WHA61.21), the first consensual instrument negotiated and agreed upon by the international community to seriously tackle the 10/90 gap .
Innovation may mean different things to different people. Needs-driven innovation for health is a complex concept that covers a wide range of cultural, scientific, medical, social and economic issues. In order to be used, and thus solve the identified health problem that it aims to address, innovation needs to be primarily problem-oriented and population-oriented. That is the first step: people’s access to and informed participation in the process that allows relevant constituencies – small communities for that matter - to share, debate and prioritize their needs; as well as, possibly, to define the best approaches to overcome them.
Innovation for health, in other words, cannot be simply drug-oriented, or health-tool focused. It cannot be restricted to discovering new medical products and tools alone. Medicines, diagnostics and vaccines are undoubtedly key, but research and development (R&D) is just one crucial step at the forefront of innovation, it does not encompass the width and the definition of it. In the real world, innovation can also result in new applications of existing tools and approaches; new strategies for utilising resources; new political visions and legislations for enabling the appropriate, home-grown solutions of specific health needs; new policies for creating a favourable social and economic environment for improving access to health.
HIP understands innovation as going beyond science and the development of innovative tools. It encompasses a wide spectrum of complementary factors. Among these, HIP prioritizes financing mechanisms such as fair fiscal policies that can enhance revenue capacity to advance human welfare in countries and secure sustainable public sector funding for health, including support to needs-based R&D; health systems strengthening; industrial policies that limit country dependence from external actors, including appropriate IP policies; as well as any relevant social and economic policies that can create a supportive environment for health, through participation and democracy.