[Ip-health] Doctors Without Borders "Alert" - The Cost of Medicine

Jennifer Reid Jennifer.Reid at newyork.msf.org
Tue Sep 29 13:49:48 PDT 2015

Dear colleagues,

We would like to share the most recent issue of Alert, the quarterly 
magazine from Doctors Without Borders/Médecins Sans Frontières (MSF-USA), 
available for download on our website: 

In this special report, "The Cost of Medicine," we explain some of the 
barriers that MSF faces in obtaining access to the medicines, vaccines and 
other medical tools we need, as well as the underlying causes of these 
challenges. The articles explore issues around expensive new treatments 
for hepatitis C, the ongoing lack of medical products to fight Ebola and 
antibiotic resistance, as well as the challenges of accessing high-priced 
vaccines and the lack of adaptation to ease use of these products in 
low-resource contexts. Also included is information on MSF's work in the 
United States and globally to improve today's broken biomedical innovation 
system, which limits innovation for - and affordable access to - the 
medical products we all need. 

The introductory letter by Dr. Deane Marchbein, president of MSF-USA, is 
available below:


September 23, 2015 

My first mission was in Ivory Coast. My boss was a 28-year-old 
French nurse who was serving as project coordinator, hospital manager, 
and medical coordinator, all at the same time. Her quiet, gentle manner 
belied a steely resolve. She knew every employee and many patients by 
name. Above all else, she was pragmatic, always seeking to do what was 
best for our patients, who were caught in a civil war.
I’ve always remembered her practical, patient-centered approach, because 
that’s really what this work is about—the patients. But even our most 
dedicated, skilled field workers can only do so much if they don’t have 
the right tools—the diagnostics, the medications, the vaccines—for the 
environments in which we work.
MSF’s Access Campaign was founded to prod others to develop or provide 
these essential medical tools and to make sure they work in remote 
locations with few resources. The work the Access Campaign does is 
directly tied to our field experience and has profound consequences for 
the people with whom we work. It brings much-needed attention to pricing, 
policies, the research and development system, and other crucial elements 
of the process by which medicines and medical tools make it to the 
field—or don’t, as the case may be.
And that’s what this issue of Alert is about, the cost of medicine,and the 
processes that drive the development of some medicines over others. Our 
special report consists of four interrelated sections, three of which 
highlight a different challenge our field teams face, while the fourth 
looks at the root causes of the dynamics at play. The first, focused on 
the $1,000-per-pill price tag of a new hepatitis C treatment, covers 
medications that are unaffordable because of how and why they’ve been 
developed and marketed. The second shows what happens when too many 
vaccines are unadapted to the settings in which we work (and, in some 
cases, unaffordable as well). The third looks at how the Ebola 
outbreak showed the frustrations of trying to respond to a crisis where 
good treatment options are unavailable. And then,to bring it all together, 
we look at the prevailing research and development system, which neglects 
huge swathes of people and leaves them vulnerable to health issues 
and diseases for which they should have better options.
My boss back on my first mission could make decisions at the field level 
that improved the picture for patients, but other things were far beyond 
her control, like the funding and incentive mechanisms for research and 
development,and the lack of attention paid to neglected diseases 
that primarily affect poorer patients. That’s why we think it’s 
so important to highlight the work that the Access Campaign is doing and 
to understand the issues we are raising here.
And as we talk about innovation, pragmatism, and effectiveness, we 
dedicate this issue of Alert to Jacques Pinel, a longtime MSF staffer who 
recently passed away. In his distinguished career with MSF, Jacques helped 
develop some of the most innovative and effective tools our field teams 
have, kits and protocols still in use that demonstrate the spirit, 
ingenuity, and attention to the needs of patients to which we all aspire. 
You will be missed, Jacques, but your impact will be felt every day in MSF 
projects—and by patients—around the world.
—Deane Marchbein, President, MSF-USA


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