MSF statement in conjunction with the sixth BRICS Summit, being held in Fortaleza and Brasília, Brazil, from 14-16 July, 2014.
Fortaleza, Brazil, 15 July 2014 – Heads of state from Brazil, Russia, India, China and South Africa are convening in Brazil for the sixth BRICS Summit, during which they are expected to finalize the creation of a development bank, establish improved financial cooperation mechanisms, and emphasize their commitment to inclusive social policies. MSF welcomes the creation of joint funding initiatives and calls on heads of state to ensure that health will be a priority area to be supported.
As a medical humanitarian organization, MSF grapples daily with the fact that millions of patients are excluded from access to medical tools, in part because of gaps in today’s medical innovation system. MSF is increasingly responding to the unmet medical needs of patients living in countries classified as middle or high income; in more than 30 such countries, the organization runs programs that serve refugees and migrants, provide HIV and tuberculosis (TB) care, specialize in emergency obstetrics and trauma surgery, and respond to short-term emergencies.
MSF encourages increased BRICS funding for health that focuses on priority needs and applies these new mechanisms to ensure that innovation is made accessible and affordable to those in need.
The sixth BRICS Summit’s theme is "Inclusive growth: sustainable solutions", emphasizing the role of the BRICS countries in achieving the UN Millennium Development Goals as well as the recognized need for alternative frameworks for coordinating joint efforts. In health, the BRICS countries face common challenges, such as the burden of tuberculosis – already identified as a public health priority by BRICS health ministers -- for which sustainable solutions are urgently needed.
The BRICS countries account for 60 percent of all TB cases among high burden countries, and for 60 percent of the world’s cases of multidrug-resistant tuberculosis (MDR-TB). Despite investments in national TB initiatives and global awareness, existing medical tools have proven insufficient to deal with the growing MDR-TB crisis.
As one of the largest non-governmental providers of drug-resistant TB care, having treated 1,780 patients in 18 countries in 2012, MSF is concerned about increasing rates of DR-TB and the lack of effective treatments. Existing regimens, which are long, toxic and painful, have an unacceptably low success rate, with only 48% of patients being cured. In addition, diagnostic technologies are ill-suited to some of the resource-limited settings where MSF works, and medicines are not adapted for children.
These shortcomings are rooted in the way medical innovation works today. Diseases that mainly afflict populations that don’t represent an attractive commercial market, as is the case with TB, suffer from chronic under-investment and de-prioritisation of research and development (R&D) efforts by traditional biomedical investors and innovators.
For example, several commercial developers have recently announced a reduction in or a complete abandonment of TB drug R&D altogether. Moreover, for the few new products that have been developed, affordability remains a critical problem. Furthermore, new medicines have been developed without a view to how they should be incorporated into the multidrug combinations needed to treat the disease, significantly delaying benefits to patients.
These failures of the medical innovation system pose a threat to BRICS countries’ commitments to universal health coverage and will exacerbate numerous public health challenges faced by the BRICS countries, including communicable diseases like HIV, TB and Hepatitis C, and non-communicable diseases such as cancer.
BRICS Ministers of Health have expressed concern about the affordability of new medical tools and shown a willingness to cooperate in the area of drug discovery and development; importantly, they have acknowledged that cooperation around new mechanisms for innovation should prioritize affordability of medical products.
In this regard, the ongoing discussions on BRICS cooperation in science, technology and innovation should include support for innovative mechanisms to address gaps in health and medical research, particularly those that promote collaborative and needs-driven R&D and include provisions to ensure that sustainable funding goes towards disease areas characterized by market failure.
In the case of TB, for example, innovative approaches to financing and coordinating R&D are urgently needed to accelerate development of – and affordable access to – new treatment regimens critical to addressing the epidemic. In working to respond to the need for more effective TB regimens in MSF projects and beyond, MSF has put forth a proposal– the 3P Project – that aims to deliver new and more effective TB regimens that can be responsibly and affordably scaled up.
“The shortcomings in today’s medical innovation system are evident, and the BRICS countries are uniquely placed to play a role in changing the situation,” said Felipe de Carvalho, Advisor for the MSF Access Campaign in Brazil. “Having struggled for decades to ensure access to medicines and satisfy their public health needs, the BRICS countries can now use their research and production capacities to deliver long-term solutions to overcome these challenges. At this moment, when the BRICS countries are discussing cooperation initiatives and joint funding, the time is right to address health priorities through innovation models that are needs-driven and that result in medical innovations that are accessible and affordable to all who need them.”