The Access Campaign continues to work both on improving access to existing treatments and stimulating the development of newer and better medical tools that take into account the needs of people in poor countries. We push for continued improvements in medical practice. We also continue to support efforts to reshape the way medical research and development is funded so that medical innovation serves those most in need and is not simply market-driven as at present.
Key priorities currently include:
We continue to press international donors to recognise the specific nutritional needs of children and the need for products that are specially adapted to those needs in the provision of food aid.
Our advocacy continues to be underpinned by the successful results of MSF’s own nutrition programmes, using ready-to-use foods to ward off acute malnutrition in children. So too, we continue to use that evidence to convince governments to adopt new treatment guidelines for malnutrition as well as offer support and guidance to countries with high levels of malnutrition on implementing programmes to fight malnutrition.
We are also pushing to make sure that ready-to-use foods to treat malnutrition, are produced by a variety of manufacturers, using common specifications and as affordably as possible.
We contribute our medical, legal, pharmaceutical and operational expertise to identify ever simpler, more effective, and more affordable HIV/AIDS treatment, adapted to people’s real lives, that will help ease the burden of treatment for those already on antiretrovirals and also open the way for many more people to be put on treatment. This is a necessity if we are to reach the latest international target of putting 15 million people on treatment by 2015. We continue to search for and support ideas to bring down the costs of AIDS drugs, whether through the use of flexibilities contained in trade agreements, innovative mechanisms like the Medicines Patent Pool or public opposition to trade policies harmful to access to medicines.
We are keeping up the pressure on international donors and national governments to expand the provision of treatment for people with HIV/AIDS , grounded in the evidence that treating people with HIV saves lives and prevents the transmission of the virus, offering us a real stab at breaking the back of the pandemic.
Given the continuing vacuum of adequate treatment, the Campaign is focused on accelerating the introduction of new drugs to treat patients with drug-resistant TB and to expand treatment for drug-resistant TB. Building on an analysis of the quality, price and supply problems that plague existing drugs for drug resistant TB, we are currently developing strategies to overcome these difficulties.
In addition we are supporting a number of countries to allow promising new compounds – medicines that have passed through clinical trials but are not yet officially approved – to be used in the treatment of patients with the disease that have run out of treatment options. We are helping to support the pilot of a new molecular TB test in MSF projects that could mean many more people are correctly diagnosed with the disease. Meanwhile, we continue to promote the development of a true point-of-care TB test.
Responding to our teams in the field who are faced with increasing numbers of measles outbreaks, we are talking to governments and other international actors to boost coverage of traditional immunisation programmes for measles and other common childhood diseases.
While we support initiatives such as the GAVI Alliance that aim to get newer and more expensive vaccines to children in developing countries, we are calling for more aggressive policies to bring down prices, and to create a healthy distance with the vaccine industry to avoid conflicts of interest.
We are also active in promoting producers from developing countries to enter the market so that more affordable vaccines that are better suited to the needs of developing countries can be developed in places like India and China.
Following conclusive new scientific evidence, we are working to support the switch from the old drug quinine to artesunate injection to treat cases of severe malaria in adults and children. MSF projects have already adopted the new treatment guidelines and we are working to get national guidelines changed in the countries where we operate so many more lives can be saved. We also promote that clinical diagnosis of malaria should be confirmed through a rapid diagnostic test or microscopy.
Access & Innovation
Across the different areas where we work, there are common obstacles we encounter. Among these is the continuing and increasing pressure of the big pharmaceutical companies, often supported by trade policies of Western governments, to squeeze out more affordable generic products on which our medical teams rely to treat patients. As such, this is a priority area that sees us mobilising public campaigns against harmful trade deals that threaten generic production, supporting new initiatives such as the Medicines Patent Pool, publicly defending countries’ legitimate rights under international trade law to protect public health for their population against patent monopolies. At the same time, we need to tackle the huge gap in medical innovation to meet the needs of people in developing countries that MSF and others treat.
The present model for developing new drugs, vaccines, medicines is based on market incentives – which products will generate the most profits ? This is justified on the grounds that research costs are so high that only products that people in the developed world can buy, will find favour with shareholders. We need a different system of product development that prioritises medical research and innovation in line with real and urgent medical needs. This means de-linking the costs of research from the final price of the product. We are active in scoping out big new ideas in this area, supporting prize funds for instance or backing the creation of an international R&D treaty that would drive innovation through need not profits. Access to quality of medicines is an important concern for MSF.
While MSF has secured the quality of its own drug supply, there is a widespread problem of sub-standard medicines in developing countries. In addition to strengthening local regulatory authorities, a number of immediate measures can improve the situation, including a continued strong WHO pre-qualification programme and that donors as well as procurement centers supplying developing countries adhere to WHO quality assurance policies.
Despite some more interest over the last decade in the treatment of neglected diseases, the neglect of patients with these diseases is not overcome and there are still huge gaps in the availability of adequate medical tools for illnesses such as Kala Azar (Visceral Leishmaniasis), Chagas Disease and Sleeping Sickness (Human African Trypanomiasis) which MSF treats in significant numbers. For instance, as regards Kala Azar, better treatment options are needed, the supply of existing drugs needs to be secured and the price of the drug liposomal amphotericin B reduced. For sleeping sickness, there is a worrisome decrease in the numbers of organizations involved in treatment programmes and funding, putting at risk the progress in disease control that has been made over the past years. Newer drugs and new, simplified diagnosis are needed to help control the disease. For Chagas Disease MSF has advocated in Latin America for increased focus on diagnosis and treatment and not only vector control.
There are still major concerns regarding continued supply and access to the existing drug benznidazole. Newer drugs and a test of cure are needed to better diagnose and treat the disease.
Last updated: July 2011