HIP considers it essential to create the policy space at country level in which actors involved in health innovation can connect and shape their vision in this domain.

The idea of setting up a national implementation process responds to the logic of directly engaging most interested countries in this debate, so as to gain their policy angles and understanding of the existing challenges to overcome, and the potentials to positively build on. When engaging in discussions about the need for reconfiguring health innovation in international circles, contributions from the vast majority of countries located in the global south are hardly being heard.

How do countries innovate in health, and what are the conditions or the factors that can critically enable needs-driven innovation in regions with limited resources? What needs to be done to strengthen their scientific and research institutions, and implement the appropriate interventions aimed at reinforcing existing national policies to respond to health needs and expand access to healthcare? How can countries’ participation in health innovation be enhanced, using existing international instruments and south-south cooperation models, so as to determine a more decentralised landscape in health innovation and greater sustainability in tackling identified health problems?

Increasing evidence demonstrates that, in the particular context of development, innovation has to be understood not only as research on new products and approaches or the adaptation of existing ones for new local application and relevance, but also as the designing and provision of new strategies to use these products, based on new social, fiscal or economic policies that can create an enabling environment for knowledge application. Yet, this is not necessarily an approach that can be taken for granted: the main trend in international circles is to have innovation basically coincide with research and development (R&D).

The outcome is the little coherence in the way in which the international community deals with some of these issues. While the current innovation pipeline has never been so promising in many ways, priorities are often set by donors - public and private, including foundations – rather than by countries themselves. Coordination among the many new entities involved in R&D and access initiatives is very limited. The outcome is fragmentation and duplication of efforts, wasteful use of resources, and very poor accountability to societies in greatest need, the ones supposed to have a say on their access priorities and innovation policies.

In recent years, a number of low income nations have been able to take action in tackling their priority needs, and they have demonstrated they have a lot to offer in terms of essential health innovation. Adopting different approaches, countries have set up their own innovative initiatives, with the specific intent of becoming self-reliant on managing their health needs.

Some have been able to tailor innovation systems and actually become notable contributors in this area, integrating issues of research and development and production, financial investments, policy planning and access to medicines as a common good. Others are gradually emerging, responding with creative ideas to the vigorous global debate focusing on the need to reform the current model of innovation for health.

Empirical evidence shows that there is no separation of issues in the creation, dissemination and use of innovations in health and pharmaceuticals according to popular notions of intellectual property, access to medicines, drug quality and safety, access to knowledge and information. As analysts have pointed out, access to knowledge does not automatically translate into change, i.e. academic leadership and science application.

Similarly, access to medicines does not automatically translate into wider coverage and better health status. Ensuring the countries include more TRIPS flexibilities in their national legislations does not automatically mean that they can and will use them to promote local industries and delivery of cheaper drugs. At the same time, promoting a country’s clinical trial capacity and local pharmaceutical capacity does not guarantee that the people are assured better, easily available and more affordable health products. State capacity to enact rules, provide institutional support, and champion the cause of better health care and health access is key to enable an actively engaged and functioning local innovation system (Gehl Sampath, 2010).

Despite the availability of newly negotiated instruments, such as the WHO Global Strategy on Public Health, Innovation and Intellectual Property – adopted by the international community to address the associated issues of needs-based health innovation and access to essential medicines – international, regional and national factors seriously impinge on countries that make efforts to enhance their social wellbeing through health in the present landscape.

Working together with governments and local actors - specifically, those that are informed by ground realities of political, technological, social and organizational innovations within countries - to find solutions to these pressing issues of development calls for newer perspectives.

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