[Ip-health] MSF: PharmaLetter - UN High Level Panel report is good prescription for change in access to medicines

Joanna Keenan joanna.l.keenan at gmail.com
Tue Oct 18 06:17:05 PDT 2016

UN High Level Panel report is good prescription for change in access to
By Rohit Malpani
17-10-2016 Comments (0)Print

In our weekly expert view piece, Rohit Malpani, director of policy and
analysis for Mèdecins Sans Frontiéres Access Campaign, discusses the UN
Secretary General's High-Level Panel report on Access to Medicines and
looks at the responsibilities it places on industry.

During the UN General Assembly in New York last month, the UN Secretary
General’s High-Level Panel on Access to Medicines released its
much-anticipated report, containing recommendations for governments and the
pharmaceutical industry on how to enable better access to medicines and
vaccines and how to ensure medical research and development (R&D) addresses
unmet priority health needs.

As a medical humanitarian organization, we confront the effects of a lack
of innovation for many diseases affecting patients on a daily basis, and we
and our patients continually struggle to overcome barriers, like high
prices, that prevent widespread access to needed medical tools.

"Pharmaceutical corporations must stop pursuing harmful pricing and access
policies and ensure their drugs are registered, for whatever treatment
indication is needed, in each country"

We’re encouraged that Panel Members representing government, industry,
civil society and academia presented a set of strong recommendations that,
if implemented, can improve health outcomes worldwide.

Now the UN Secretary General, governments, and industry must transform
these recommendations into action. Whether it’s the sky-high prices of
medicines to treat hepatitis C, or a lack of innovation on new tools to
treat emerging infections like Ebola, which took more than 11,000 lives
during the last outbreak, the cost of continued inaction is deadly.

Each day, MSF staff see small children who are gravely ill with pneumonia
because the vaccine that could prevent it is too expensive for their
government or for MSF to afford.

We see the emergence of drug-resistant bacteria in war-wounded, burn
patients and newborns in places like Iraq, Pakistan and Haiti, including
infections that can only be treated with the very last lines of
antibiotics. Drug-resistant infections already kill 700,000 people globally
each year, yet it has been more than 30 years since a new class of
antibiotics was introduced, and the pipeline for critically needed new
antibiotics is nearly empty.

Report does 'not go far enough'
The cost is not only in human lives and a public health disaster that
causes unnecessary suffering for millions, but it’s also increasingly
viewed as an economic challenge – drug-resistant infections are forecast to
have lost the world’s economy US$100 trillion by 2050. MSF broadly welcomes
the panel’s recommendations on the need for new incentives for R&D and for
greater transparency, but in some cases we wish the report had gone further.

For example, the report did not go far enough in supporting essential
government and civil society efforts to increase access to existing
medicines. While the report does caution against damaging intellectual
property rules included in trade agreements, it could have more strongly
urged countries to stop pursuing longer monopolies on life-saving medicines
through trade agreements like the Trans Pacific Partnership Agreement
(TPP), a US-led trade agreement that is the worst-ever trade agreement for
access to medicines.

Nevertheless, we recognize the report is a product of a compromise, given
the diverse interests of the panel members. On the positive side, the
report suggests some measures that governments can already take now to
improve access to existing medicines, including taking advantage of legal
provisions called ‘TRIPS flexibilities’ to their fullest extent, reforming
patent laws if need be, and empowering governments and civil society to use
these provisions.

The report also pointed out that the World Trade Organization could employ
its trade policy review process to enable greater transparency and action
against countries that seek to undermine the use of TRIPS flexibilities.
The call for greater transparency of R&D investments, patenting and pricing
decisions, and the recognition that there is a need to reform incentives
for innovation are perhaps some of the strongest recommendations.

The panel’s strong recommendation to implement new approaches to R&D that
de-link, or separate, the financing of R&D from the end product price
aligns with the approach governments have endorsed for R&D into new
antibiotics to tackle antimicrobial resistance – including in a recent UN
Political Declaration on AMR. Linking investments in R&D to the expectation
of high sales prices through granting patent monopolies is the key driver
of drug development today. This means that corporations make R&D
investments based on whether high prices can be expected in return, while
ignoring the pressing health needs of millions of people who are considered
too poor.

The concept of de-linkage breaks the dependence on high prices and
monopolies to enable R&D driven by health priorities. The report concludes
that government action and regulation are urgently needed, as governments
are ultimately responsible for managing medical needs for people.
Governments around the world, including in the US and Europe, are becoming
more acutely aware of the challenges posed by the rising prices of
medicines and yet they continue to grant often unwarranted patent
monopolies that allow pharmaceutical corporations to charge those high
prices in the first place.
Protecting and promoting health and well-being

Governments face a tremendous challenge to create an environment that
balances innovation rewards with public health needs. But pharmaceutical
corporations can also implement some of the recommendations today, for
example by reducing the price of medicines and vaccines for countries and
for organisations serving the world’s most vulnerable people – such as
humanitarian organisations working with refugees.

Pharmaceutical corporations can also stop pursuing harmful pricing and
access policies and ensure their drugs are registered, for whatever
treatment indication is needed, in each country. Most importantly,
pharmaceutical companies must not stand in the way of governments that seek
to take steps to ensure that people have access to affordable medicines and
vaccines, both now and in the future.

Ultimately governments are responsible for protecting and promoting health
and well-being, and must demonstrate leadership and take action to
implement the report’s recommendations. Whether we work for a government, a
non-profit organisation or a pharmaceutical company, the net effect is the
same; if we can’t afford the medical tools we need, or if they simply don’t
exist, then who does medical R&D actually benefit?

Joanna Keenan
Press Officer
Médecins Sans Frontières - Access Campaign
P: +41 22 849 87 45
M: +41 79 203 13 02
E: joanna.keenan[at]geneva.msf.org
T: @joanna_keenan


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