World Health Report 2012: No Health Without Research

It seems astonishing that in the 21st century decisions on health care can still be made without a solid grounding in research evidence. This is true even in clinical research, whether for simple or complex interventions, where systematic reviews time and time again conclude that the evidence base is inadequate. It is even more true in the areas of health policy and health systems, where quality research is hampered further by a lack of shared definitions, a lack of consensus on guiding principles, poor capacity (especially in low-resource regions), and methodological challenges. The WHR 2012 aims to provide impetus for a change to the problematic state of affairs of health research. Given the stated goals of the report, of particular importance is the documentation and sharing of real experiences from the countries where the research has been done.

The actual evidence on whether patents impede innovation or inventiveness in biomedicine is in a word, ambiguous. Yet firms clearly tend to avoid research projects for which there are many existing patents. Both the process of determining which potentially relevant patents are important to our search project and the negotiations for access to them candely, but less often kills, innovation. In industry and universities, researchers adopt strategies of ''licensing, inventing around patents, going offshore, the development tand use of public data base and research tools, court challenges and...using the technology without a license (i.e. infringement) to achieve their particular goals. This raises the question, what are the sevarious ''design around'' actions manifestations of, if not actual patent blockages or threats of the same? We act as if the anticommons block to innovation is real. Perception is reality.

Patents, or perhaps only the fear of their enforcement, inhibit biomedical innovation. If we knew how strong the inhibition really was, we would be having a different debate. The system must be reformed so that public goods-such as genuine innovation and access to HCTs-are not sacrifice on the altar of a private gain. This reform must prioritize the public good, use innovative policy tools to harness the private sector where it is possible to do so, and create public R&D capacity where market forces and actors are likely to continue to fail.