"Starting on antiretrovirals was quite difficult - I didn't have very bad side effects, but I lost appetite. But after four months I started feeling a change. I became strong. I could now stand for long hours. I went out to look for work and got a job as a social worker at a school for children orphaned by the HIV epidemic, 2005, Kenya. Photograph by Charles
Feature story |

5 portraits 2013

5 min
Photograph by Charles
"Starting on antiretrovirals was quite difficult - I didn't have very bad side effects, but I lost appetite. But after four months I started feeling a change. I became strong. I could now stand for long hours. I went out to look for work and got a job as a social worker at a school for children orphaned by the HIV epidemic, 2005, Kenya. Photograph by Charles

What if the medicines that could save your life cost a hundred times what you earn in a year?

Many people in developing countries can’t get hold of the treatment they need to stay alive and healthy.

That’s why Médecins Sans Frontières launched the MSF Access Campaign in 1999 to find ways of ensuring that medicines could be made available for all our patients and others in developing countries.

Our mission is to increase access to – and the development of – affordable, practical and effective drugs, vaccines and diagnostic tests for diseases that affect people in places where we work.

We are a multi-disciplinary team that includes doctors, pharmacists, scientists, lawyers, as well as advocacy and communications experts. We also work with patient groups and other civil society organisations in response to their concerns over access to treatment.

"Some of the reasons that people die from diseases like AIDS, TB, sleeping sickness and other tropical diseases are that life-saving, essential medicines are either too expensive, are not available because they are not seen as financially viable, or because there is virtually no new research and development for priority tropical diseases. What we as a civil society movement demand is change, not charity."

- Dr James Orbinski, President of MSF’s International Council, accepting the Nobel Peace Prize in 1999.


"As a person living with HIV/ AIDS, the most fearful thing is when you hear you might not be able to get hold of your medicines. It feels like a rope is being tied around your neck."

Charles Sako is 41 and lives with his partner and three-year old daughter in Kibera, a deprived area of the Kenyan capital, Nairobi. Charles is HIV positive and is being treated at an MSF clinic in Kibera. Six years ago, after he had started antiretroviral treatment, Charles documented his life in pictures in a project called ‘My Life with HIV’. Now, in 2011, Charles is a healthy and active individual, working as a receptionist in a health centre to support his family. Photograph by Sven Torfinn
Photograph by Sven Torfinn

Charles Sako lives in Kenya with his family – partner Noel, and young daughter, Gift. He started antiretroviral therapy with MSF in 2003 and is doing very well on treatment. Over the last ten years, the price of HIV drugs fell steeply, allowing people like Charles access to life-saving treatment. But prices for newer medicines are now climbing rapidly, threatening to block access to treatment once more for people in developing countries

The MSF Access Campaign is working to ensure the flow of affordable, quality-assured, generic medicines continues to patients in the places where we work.


"My husband made a coffin for me. He prepared everything for the occasion of my possible death while he was away working in Russia and left things so I could be buried decently."

MDR-TB patient Rohatay Abdullaeva at her home with a grandson Atabek and daughter Nadira, town of Hojeily, Karakalpakstan (Uzbekistan). Photograph by Natalia Sergeeva
Photograph by Natalia Sergeeva

Rohatav Abdullaeva, a former nurse from Uzbekistan, thought tuberculosis (TB) would end her life. She is now responding well to treatment for a drug-resistant form of the disease, provided by MSF and the Ministry of Health. Drug-resistant TB is very difficult to diagnose and cure with the tests and drugs available today. Patients also often experience very severe and sometimes irreversible side effects from the lengthy two-year treatment.

The MSF Access Campaign is pushing for the development of more accurate tests for TB and more effective medicines for people with drug-resistant strains of the disease, so that many more people can be put on life-saving treatment.


"I know how important the vaccines are for my babies to be healthy, but I was unable to travel the long distance to hospital for my twins to get their further vaccinations." 

Aquil Bol Mallien, mother of twins at an MSF clinic in South Sudan.
Photograph by MSF

Aquil Bol Mallien at an MSF clinic in South Sudan explains the challenges she faces in getting her children adequately protected through vaccination. In fact, at a minimum, five visits to a clinic are required in the first year of life to get a child fully vaccinated. This is difficult for caregivers, who may live far away and can’t afford transport, or to leave their families and work for the time of a clinic visit. Vaccines which were originally developed for use in wealthy countries are often impractical to use in places where MSF works, requiring refrigeration for instance.

The MSF Access Campaign is calling for simpler vaccines to be produced to reach the 22 million children born each year that are left unprotected from basic childhood killers.

Neglected tropical diseases

"I couldn’t pay the cost of the medicines back, so I had to mortgage my two pieces of land. I am a sick person, yet we do not have enough food to eat." 

Since July 2007, MSF has been running a kala azar diagnostic and treatment project in Vaishali district, in the centre of the Indian state of Bihar. Photograph by Anna Surinyach
Photograph by Anna Surinyach

Kamil could not afford the medicines for visceral leishmaniasis, a deadly parasitic disease also known as kala azar, transmitted through the bite of a sandfly. She is now receiving free treatment with MSF in India. But other people with kala azar cannot currently access the best treatment for the disease in South Asia because it is too expensive. For other neglected tropical diseases, such as Chagas or sleeping sickness, the existing medicines and tests are very often not practical or effective in the places where we work.

The MSF Access Campaign raises the alarm about the need for more effective drugs, vaccines and tests for all neglected tropical diseases that affect people where we work and others in developing countries.

Fighting for access

"Whether we live or die should not be up to trade negotiators. We watched family and friends sicken and die ten years ago because pharma companies put patents and profits before people. Don’t trade away our lives now."

Thousands of demonstrators took to the streets in Delhi once again on 2 March in protest over the planned Free Trade Agreement between India and the European Union (EU) which will restrict access to life-saving medicines. Photograph by Rico Gustav
Photograph by Rico Gustav

Loon Gangte of the Delhi Network of Positive People (DNP+) took to the streets along with MSF and others in Delhi to protest against harmful provisions included in trade negotiations between Europe and India that could stifle the production of affordable generic medicines and restrict the flow of those medicines to patients in developing countries. India is the source of 80% of the HIV medicines used in MSF projects and without these life-saving, affordable medicines, it would have been impossible to scale up treatment to the levels seen today.

The MSF Access Campaign works with patient groups and other civil society organisations to identify and campaign against trade and drug company policies that could harm access to affordable, life-saving medicines.