Issue brief |

From Declarations to Action: Improving Access to Medicines

MSF briefing note to the G8 in Genoa

The challenge

HIV/AIDS has killed more than 21 million people since the beginning of the epidemic; it claimed three million victims in 2000 alone. Tuberculosis (TB) continues to kill two million people each year. Malaria kills one child every 30 seconds. In total, 14 million people die of infectious and parasitic diseases every year, and 90 % of them live in developing countries.

Many of the victims of these diseases die because they have no access to medicines that could cure them or extend and improve the quality of their lives. Life-saving drugs are either too expensive, they are fast becoming useless because of growing resistance, or they don't exist at all because there is virtually no research into some of the global killer diseases.

Treatment and prevention go hand in hand

Witnessing unnecessary deaths in its field missions every day and determined to act, Médecins Sans Frontières (MSF) is campaigning internationally to make life-saving medicines available to patients in developing countries immediately. We know that when medicines are available to patients, the dynamics in a community change: people will seek testing and counselling. This in turn boosts prevention efforts – a fact now widely recognised by the international community as well.

Extra money on the table needed

Despite recent initiatives, the unaffordable price of existing medicines remains a significant barrier to access. It is encouraging that the Declaration of Commitment adopted by all member states at the June UNGASS meeting on AIDS clearly acknowledges that the high cost of medicines must be addressed at all levels. International funding mechanisms are urgently needed to bridge the gap between the cost of life-saving drugs and the patients' ability to pay. Kofi Annan, UN Secretary General, has estimated that between $7-10 billion will be needed annually to fight AIDS alone. But in spite of general agreement about the urgency of the issue and promises made by political leaders, wealthy nations have yet to come up with sufficient pledges in order to make the proposed Global Health Fund a credible tool in combating infectious diseases. Clear ground rules as well as sufficient checks and balances must also be established to make such a global funding mechanism efficient and fully transparent.

TRIPS safeguards put to use

The WTO TRIPS Council members discussed the barriers caused by intellectual property protection on access to medicines in a special session in June 2001. A growing consensus is merging that the TRIPS Agreement should not stand in the way of countries' right to take measures to protect health. A flexible interpretation of the WTO TRIPS Agreement is particularly important now that additional funds are being allocated to fight infectious diseases.

Equitable pricing policy

Funding the fight against infectious diseases should be coupled with a commitment by governments and the pharmaceutical industry to an equitable pricing system ensuring that prices of medicines globally are sustainable and fair: poor nations should pay less for essential medicines and other health commodities. Such a system entails e.g. encouraging and stimulating generic competition, technology transfer and local production of medicines; differential pricing policies by pharmaceutical companies; using the TRIPS safeguards to the maximum; and implementing health exceptions to patent rights for goods purchased with financing from a global funding mechanism.

Need to stimulate research for neglected diseases

But price is by no means the only obstacle in ensuring access to treatment. Patients suffering from malaria and TB continue to be treated with medicines developed 30 years ago. For the most neglected diseases, such as visceral leishmaniasis, there is virtually no research and development because the conditions only affect the poor, who do not constitute a market. Of the 1393 new drugs approved between 1975 and 1999, less than one percent was for tropical diseases. MSF is demanding that the governments of the G8 countries, together with the leaders of developing countries, take responsibility for restarting research and development (R&D) for neglected diseases to compensate for the market failure. New vaccine initiatives and technical assistance for R&D for medicines are also needed. A potential solution is a global treaty, which would provide for mechanisms to stimulate R&D and share the financial burden to make drugs for neglected diseases global public goods.

In conclusion, Médecins Sans Frontières urges the G8 to:

  • stimulate generic competition in the production of essential medicines, encourage a differential (or tiered) pricing system and create economies of scale through regional or global procurement
  • encourage local production of life-saving drugs through voluntary licensing and technology transfer
  • support a flexible interpretation of the WTO TRIPS Agreement in national legislation
  • implement health exceptions to patent rights for goods purchased with financing from global funds
  • within global funding mechanisms, encourage purchasing medicines from lowest cost suppliers, including generic producers
  • create a database on drug prices, quality and patent status to help guide decisions of country purchases of medicines
  • take a leadership role in restarting research and development for neglected diseases by allocating funds domestically and internationally to compensate for the market failure in R&D
  • support new initiatives that are focusing on "unprofitable" disease vaccine and treatment research
  • provide technical assistance for researching, developing, and producing needed medicines in developing countries.