Getting life-saving medicines to the poorest communities: what needs to change?

This blog post is by Morel Naim, from our Partnerships and Philanthropy team, and Kirsten Mathieson, Senior Health Policy and Research Adviser. It discusses a conference we hosted with the International Federation of Pharmaceutical Manufacturers and Associations.

It’s a life-and-death issue affecting millions of children and adults today. How can we improve access to medicines – particularly for the world’s poorest communities?

In relation to this, in January a rare event took place. Or at least, rare until now. Pharmaceutical companies, governments, NGOs and multilateral organisations sat together in the same room to discuss how we can increase access to medicines for low- and middle-income countries.

Improving access to medicines is a complex problem. And pharmaceutical R&D – how we decide what medicines to research to treat which illnesses, and how they are made available and at what price – is at its heart.

There are many different debates going on separately in different places, including about whether the current model of R&D needs to change, and how diverse sectors coordinate and collaborate effectively. This event – a one-day conference hosted by Save the Children and the International Federation of Pharmaceutical Manufacturers and Associations – sought to bring some of those debates and players together. We focused on what action the private sector needs to take, in collaboration with other key players such as governments and civil society.

From the moment attendees arrived, you could feel the sense of anticipation for a stimulating debate. No doubt in part because the topics at play were often the most contentious ones:

• How can we improve affordability and availability of medicines when there is limited transparency in pricing information and R&D costs?
• Can we be brave enough to pilot new R&D models to help develop new medicines?
• How can we ensure access issues are factored in at the onset of the R&D process?
• How can such diverse sectors coordinate and collaborate effectively?

Opening a dialogue on these often-taboo questions was a key achievement of the conference. Read our conference report.

How does the private sector measure up?

The Access to Medicines Foundation kicked off the day’s discussions by presenting findings from their recent Access to Medicines Index 2016.

The Index reveals a mixed bag of success. For example, while there is an increase in collaborative models of R&D, companies are still only addressing 31 of 84 high-priority, low-incentive product gaps.

An even bigger challenge, arguably, is that good practice in improving affordability and, in particular, availability of products is limited. While companies are increasingly considering affordability, only 5% of medicines in the Index (ie, 44 products) considered socio-economic factors when deciding price points.

From ranking to action

The Index aims to be more than just a ranking. It aspires to serve as a model for change – stimulating a ‘race to do well’ by diffusing best practices. The shared goal of the conference we hosted with IFPMA was to help drive this agenda forward by identifying tangible initiatives to extend good practice in access to medicines and opening the door to future discussions.

At the conference, breakout sessions aimed to bring this goal to life. We looked at critical access issues around:

1. collaborative R&D
2. improving affordability and availability
3. health system strengthening
4. better coordination amongst private sector initiatives.

A number of concrete actions emerged from discussions, including:

• increasing transparency in pricing and pricing strategies, as well as on R&D costs
• transparency about where companies file for patents
• developing guiding principles for companies engaged in advocacy, public policy and public partnerships
• furthering product development partnerships
• improving access strategies for middle-income countries and intra-country tiered pricing
• expanding the scope of the Access to Medicines Index.

The full list of actions is set out in our conference report.

Driving the agenda forward

It was clear from the conference that there’s a lot to do.

But it was also clear that there’s a lot of energy to act. And to collaborate – a key achievement of the conference was finding agreement on critical areas of work for industry and partners to take forward.

The message from the conference was clear. It’s time to drive this agenda forward and address very real issues that affect the everyday lives – and survival – of millions of people.