Jan 05, 2016
MSF Access Campaign• Started in 1999
• Rooted in field experience
• Three Pillars:– Overcoming Barriers– Research and Development for Drugs for
Neglected Diseases– Effects of Globalisation (TRIPS, etc)
Access to Essential Medicines•75% of the world’s population live in developing countries
•They account for 8% of the pharmaceutical sales
•1/3 world’s population does not have access to essential medicines (> 50% in most impoverished areas of Africa and Asia)
Projected WorldPharmaceutical Market 2002
(around 400 billions USD)
Japan11%
North America42%Asia
7%
E. Europe & CIS
3%
Africa1%
Others4%
West Europe25%
Latin America7%
World Drugs Market
0
20
40
60
80
100
120
140
160
180
NorthAmerica
Europe Japan LatinAmerica
Africa/Asia Others
1993
1999
2002 Projected
Billions US$
Source: IMS Health, PNUD
Factors Affecting Access to Essential Medicines
R&D
ProductionApproval
Quality
Distribution
Drug information, rationale use
Diagnosis/prescription/monitoring
PriceCompliance
Pharmacovigilance
WH
O/C
DS
/CS
R
Evolution of Sleeping Sickness Throughout the
XXth Century
1995-2000
• Suramine et NifurtimoxBayer ends the production.
• Melarsoprol (Aventis)Production in danger
• Pentamidine (RPR-Aventis)Announces a progressive end to the
donation programme
• Eflornithine (HMR-Aventis)ends the production (exploitation is
offered to WHO)
2001• Bayer announces
production and donation re-
commencement
• Aventis annoncemaintenance of the production and donation programme for 5 years +
support to sleeping sickess programmes .
Drugs for sleeping sickness: Preliminary Results
Unaffordable Life-saving drugs
Anti-retroviralsSome treatments for opportunistic diseasesNew antibiotics or anti-malaria drugsNew vaccinesEtc.
Objective:Equitable Drug Prices
• The policy of assuring dramatically reduced drug prices so that they are truly affordable to the people who need them
• A policy that is – sustainable (not based on charity or donations)– Strengthens developing countries’ autonomy– Attracts donor funding– Not limited to HIV/AIDS medication only
Generic CompetitionSample AIDS triple-combination: lowest world prices
(stavudine (d4T) + lamivudine (3TC) + nevirapine)
0
2000
4000
6000
8000
10000
12000
US
$ Brand
Generic
Brand $10439
Brand $931Brand $727
Aurobindo $209Hetero $347
Cipla $350Cipla $800
Brazil $2767
Lack of Research and Development for Neglected Diseases
Defining the problems and searching for solutions
Global investment in R&D
• Estimated that between $70 - 90 billion per year spent on health R&D – 50% public funding (of which 80% is G8)– 50% private funding (for profit and non-profit)
Less than 10% is devoted to 90% of the world’s health problems
Lack of R&D for Neglected Diseases1975 – 1999
Among 1393 new chemical entities, 435 (31.2%) therapeutic innovations
New chemical entities69%
Therapeutic Innovations for Tropical Diseases 1%
Therapeutic Innovations for Other
Diseases 30%
Who can play a role in defining solutions
• NGO's commitment• The role of the pharmaceutical industry• Public support, • political will and funding