Policy coherence for improved medical innovation and access.

Editorials 315 Public policy-making is an increasingly complex undertaking in a globalizing world, especially as policy domains formerly viewed in isolation become more intertwined. This complexity marks the interplay between health, intellectual property and trade policies. Can such interplay be managed so as to enhance the discovery, development and delivery of medical technologies for better health services and outcomes? This question is at the heart of a joint study on promoting access to medical technologies and innovation recently launched by the World Health Organization (WHO), the World Intellectual Property Organization (WIPO) and the World Trade Organization (WTO). 1 The study, conceived as a coherent, systematic and transparent information base for the capacity-building programmes run by the three agencies, is a practical compendium of useful policy information that showcases the value of multilateral interagency cooperation. This collaboration flows from a shared understanding that the protection of human health is the foundational rationale for international cooperation, and it provides a focus for analysing the interplay between intellectual property, trade and health policies. At the global political level, this focus is underpinned by WTO's Doha Declaration on the TRIPS Agreement and public health, 2 WHO's global strategy and plan of action on public health, innovation and intellectual property 3 and WIPO's development agenda. 4 This trilateral study maps the complex policy landscape affecting medical innovation and access and helps readers to navigate this territory through empirical data, practical examples and descriptions of current and emerging challenges. Although intellectual property and trade policy settings feature prominently in this landscape, their role and impact can only be assessed holistically, within a wider cluster of interacting policy domains that together determine health outcomes. Medical innovation and access to its products are mutually dependent. Universal health coverage cannot be achieved without continued needs-based medical innovation, alongside expanded access to essential technologies, now recognized as integral to the human right to health. 5 Policies surrounding universal health coverage require the careful integration of linked measures: prioritization of medical technologies, quality assurance through effective regulation, efficient procurement, reliable supply and product affordability through appropriate pricing policies. Innovation, research and development , and technology diffusion are costly and risky and falter without appropriate incentives. Policy on intellectual property aims to incentivize innovation in the public interest, and the patent system has spurred much medical product development. However, business models built entirely on commercial incentives and strong markets may not deliver …