Submitting InstitutionUniversity of Central Lancashire
Unit of AssessmentAllied Health Professions, Dentistry, Nursing and Pharmacy
Summary Impact TypePolitical
Research Subject Area(s)
Economics: Applied Economics
Studies In Human Society: Policy and Administration, Sociology
Summary of the impact
Ten million people die each year because they lack access to medicines.
The Health Impact Fund202f (HIF) is a reform plan to improve access to new
medicines. Our research on the HIF has influenced policy and public debate
and engendered worldwide media coverage and a wide range of global policy
endorsements. The HIF proposal was selected by the World Health
Organisation (WHO), endorsed by the Organisation for Economic Cooperation
and Development (OECD) project, and recently again included in the
electoral platform of the German Social Democratic Party's parliamentary
Access to life-saving medicines has been recognised as a determinant and
consequence of inequalities in health, income, and development. The
international intellectual property rights (IPR) system hampers access to
medicines for the poor. UCLan-based research contributing to the Health
Impact Fund (HIF) is designed to mitigate these problems.
The following staff were involved in the research for the HIF: Prof.
Thomas Pogge, Professor of Political Philosophy, since 2007. Prof. Doris
Schroeder, Director of Centre for Professional Ethics, since 2004.
From 2006 to 2009, Pogge, in collaboration with Hollis (see below)
analysed problems within the current IPR system, which are: exclusion of
the poor from life-saving medicines, neglect of diseases concentrated in
low-income countries, bias towards maintenance drugs, wastefulness through
excessive litigation, counterfeiting (which in turn can lead to
drug-resistant strains for some medicines), excessive marketing and last
mile problems (promoting optimal use of their drugs is insufficiently
lucrative for pharmaceutical companies) (Publication No 1 below).
Based on the above, from 2006 to date, Pogge developed and refined a
reform plan, which addresses the major drawbacks of the current IPR system
by giving innovators the option to register any new medicine for rewards
according to their health impact provided they agree to sell it at cost
(ibid.). The work in economics required to develop metrics for measuring
health impact was undertaken at Yale and Calgary University.
From 2008 to 2010, Pogge completed a human rights justification for the
HIF (Publication 2 below) and the underpinning philosophical framework,
for which he won the American Philosophical Association's 2013 Gregory
Kavka prize in political philosophy (Publication 6 below).
Adding to this, from 2008 to 2010, Schroeder, in collaboration with
Singer (see below) identified and analysed prudential and moral reasons
for IPR reform (Publication 4 below).
From 2008 to 2010, Pogge collaborated with Frewer (see below) to develop
a Delphi analysis to identify major barriers to the implementation of the
HIF (Frewer L J, Ruto E, Coles D, Stakeholder views regarding the
objectives and implementation of a Health Impact Fund (HIF) to incentivise
pharmaceutical innovation relevant to diseases of poverty (accepted for
publication in Global Health Governance)).
Details of external colleagues involved in Professor Pogge's work (a
selection): Aidan Hollis, Professor of Economics, Calgary University,
Canada; Peter Singer, Professor of Philosophy, Princeton University, US;
Lynn Frewer, Professor of Food and Society, Newcastle University, UK;
Harvey Rubin, Professor of Medicine and Director of the Institute for
Strategic Threat Analysis and Response (with Consultative Status at the
UN), University of Pennsylvania, US.
HIF Advisory Board members (a small selection): Sir Michael Rawlins
(former Chairman of NICE, UK); Baroness Onora O'Neill (President of the
British Academy); Prof. Amartya Sen (Nobel Laureate); Prof. Kenneth Arrow
(Nobel Laureate); Paul Martin (former Canadian PM).
References to the research
1. Banerjee, A., Hollis, A., Pogge, T. 2010. The Health Impact
Fund: incentives for improving access to medicines, Lancet
2. Pogge, T. 2009. The Health Impact Fund and Its Justification
by Appeal to Human Rights" in Human Rights: Normative Requirements and
Institutional Constraints, Journal of Social Philosophy,
3. Pogge, T. 2010. Politics as Usual: What Lies behind the
Pro-Poor Rhetoric. Cambridge: Polity Press
4. Schroeder, D., Singer, P. 2011. Access to Life-Saving
Medicines and Intellectual Property Rights — An Ethical Assessment, Cambridge
Quarterly of Healthcare Ethics, 20:2, 279-289
5. Schroeder, D. 2011 Does the Pharmaceutical Sector have a
Co-Responsibility to Secure the Human Right to Health? Cambridge
Quarterly of Healthcare Ethics, in 20:2, 298-308
6. Pogge, T. 2011. Are We Violating the Human Rights of the
World's Poor? Yale Human Rights & Development L.J. 14(2) 1-33.
Grants and fellowships that supported this work:
The work has been supported at UCLan, Yale University and the Australian
National University. UCLan holds the largest single grant supporting the
co-development of the HIF. The consortium, led202fby Pogge, included the
Chinese Ministry of Science and Technology and the main New Delhi
think-tank of the Indian Ministry of External Affairs (RIS).
Who the grant
was awarded to:
Thomas Pogge, UCLan
Pharma-Innovation – Patent-2
Period of the grant (with
1 June 2008 – 31 May 2011
|Value of the grant:
The funding was provided to: advance knowledge and ethical insight into
reform plans for the current IPR system; finalise an existing plan to amend
the current IPR system in the area of pharmaceutical innovation; provide a
reality check for the new system from the world's two most powerful
developing countries (India and China); promote urgent policy developments
on IPR by forging a consensus for the new system and providing a policy
Details of the impact
During the REF period 2008-2013, our research has stimulated and informed
policy and public debates, influenced international agencies and
organisations and made a significant contribution to202fresearch-informed
policy at the global level.
In 2008, Pogge made a submission to the WHO's Expert Working Group on
Research and Development Financing (EWG, WHA61.21), which summarised
research on the HIF, especially evidence of problems with the current
patent system and ways of overcoming them. In December 2009 the EWG
delivered its report, recommending that "efforts should be made to examine
other promising proposals in their local contexts, such as open source
products; patent pools; Health Impact Fund; priority review voucher
scheme; and orphan drug legislation." Given that all other named
mechanisms were already being tried, it is most encouraging that the HIF
was included in this policy advice to the WHO Director General. [A]
A later WHO working group "considered that the ideas underpinning the HIF
were of interest and that, if successfully implemented, it would address
many of our criteria." However, currently "a sufficiently reliable
measurement of health impact" is not available in developing countries and
pilot studies are needed (2012 Report, and see below for planning). [B]
The HIF reform plan directly addresses intellectual property management
issues by seeking to incentivize R&D relevant to the disease burden in
developing countries, while also facilitating access by de-linking the
price of relevant products from the cost of R&D. As a result, the HIF
would have a favourable distributive effect and202fboost the availability
and affordability of important medicines in developing countries while
also202fincentivizing firms to promote wide and optimal use. The proposal
was considered a useful complement to the existing set of intellectual
property incentives in that firms can choose whether to register their
product with the HIF or use the patent system as they do now.
Following the publication of Nathan, Carl (2007) `Aligning pharmaceutical
innovation with medical need', Nature Medicine, 13:301-308, which
compared IPR reform plans and selected the HIF as the only one without
detrimental medium- or long-term consequences, Prof. Harvey Rubin
contacted Pogge. After briefing him on the details of the HIF, an OECD
project report written by Rubin endorsed the reform plan. [C]
From 2007, Pogge gave various prominent lectures for the German Social
Democrats (SPD), in the Willy Brandt Haus, at the Hannah Arendt Days and
three times with Heidemarie Wieczorek Zeul [former German Minister for
Economic Cooperation and Development] as partner. As a result, Karin Roth,
a member of the German Parliament, invited him to a conversation. After
deliberations with a range of German SPD politicians, the HIF was included
- in 2011 - in the platform of the German Social Democratic Party's (SPD)
parliamentary delegation (the SPD is one of two main parties in Germany,
comparable to the British Labour Party).
Pogge and his global team have been working with leading health care
assessment organizations such as the George Institute for International
Health, PolicyCures, NICE International, PATH and the Institute for Health
Metrics and Evaluation, to conduct a pilot, evaluating the health impact
of products in various countries. A UCLan-based proposal (€1,924,989) has
been submitted to the European Research Council (ERC) to provide further
funding for the research preceding the pilot. (At the time of writing,
Pogge has been invited to grant negotiations for the full amount with the
new project to commence in 2014).
Influence on Public Debates
Our high-level programme of knowledge exchange has enabled our new
theoretical insights to enter the public domain and to shape public
opinion. Significant media coverage of the HIF has been achieved on all
continents. The following are selections from almost 100 items between
2005 and 2013, all attesting to contributions to and influence on public
- Suhrith Parthasarathy, "Adverse reaction: India's radical challenge to
the global patent regime," The Caravan, June 1, 2013.
- Carl Nathan, Let's gang up on killer bugs, New York Times,
December 9, 2012 www.nytimes.com/2012/12/10/opinion/teaming-up-to-make-new-antibiotics.html?_r=1&.
- TED is a non-profit company "devoted to Ideas Worth Spreading", T
Pogge, Ted Talk, September 2011, www.ted.com/talks/lang/en/thomas_pogge_medicine_for_the_99_percent.html
(watched over 200,000 times).
- Pogge interviewed on Austrian television (political talk show: Talk im
Hangar-7, June 10, 2010), www.servustv.com/cs/Satellite/Article/Talk-im-Hangar-7-011259276607980.
- Thomas Pogge, "Rettferdig medisin." Morganbladet, May 7-13,
2010. [In Norwegian, Norway's first daily newspaper, since 1819], online
copy in addition to print copy: http://morgenbladet.no/ideer/2010/rettferdig_medisin
- Thomas Assheuer, "Der Weltverändererdenker." T Pogge featured by
German newspaper Die Zeit [national weekly with a readership of
2 million]. April 23, 2009 www.zeit.de/2009/18/PD-Thomas-Pogge
- Peter Singer, "Tuberculosis or Hairloss". Guardian. September
16, 2008, http://www.guardian.co.uk/commentisfree/2008/sep/16/health.pharmaceuticals
Sources to corroborate the impact
A. Expert Working Group on Research and Development Financing. Public
Health, Innovation and Intellectual Property: Report of the Expert
Working Group on Research and Development Financing. Geneva: World
Health Organization; 2009, at p. 19. This WHO report recommends the HIF,
which attests to the influence on policy claimed in this case study.
B. Expert Working Group. Research and Development to Meet Health Needs in
Developing Countries: Strengthening Global Financing and Coordination
Geneva: World Health Organization; 2012, at p. 55f.This WHO report
recommends further action needed to refine the plan for tailored use in
C. Rubin, Harvey (2011) Future Global Shocks: Pandemics, OECD
IFP/WKP/FGS(2011)2, available at: www.oecd.org/dataoecd/58/1/46889985.pdf,
page 62. OECD report endorsement: `In this regard, we strongly support
the work on the Health Impact Fund as one of the creative and practical
solutions to the problem of incentivizing the discovery and distribution
of new drugs and vaccines'.
D. Deutscher Bundestag. Drucksache 17/2135, 16.6.2010, SPD motion to
German parliament on 16.6.2010 endorses HIF. http://dip21.bundestag.de/dip21/btd/17/021/1702135.pdf
An equally promising plan is the Health Impact Fund (HIF), which links
financial incentives with impact. The HIF is also included in the WHO's
Global Strategy and Plan of Action.Our translation from: Ein
ebenfalls vielversprechender Ansatz ist der Health Impact Fund (HIF),
der finanzielle Anreize mit dem Nachweis der Wirksamkeit verbindet. Auch
der HIF wird im GSPA der WHO aufgeführt.
E. Working Group on Economic Cooperation and Development of the SPD
parliamentary group in the Bundestag, One world, one future — for a
sustainable and progressive social democratic development policy, p.
12: "One solution that promises to benefit people in developing countries
and serve the interests of pharmaceutical companies is the Health Impact
Fund, which would encourage research into neglected diseases and
substantially improve access to effective drugs worldwide."
Contact 1: Baroness O'Neill of Bengarve, Former President of the British