Developments

Interim Report of Task Force 5 Working Group on Access to Essential Medicines

Coordinator Paula Munderi, Lead Author Graham Dukes - February, 2004

Interim Report - Task Force 5 Working Group on Access to Essential Medicines

The Millennium Project commissioned by the UN Secretary General as independent advisory body to United Nations

"......The fact that a very large part of the world's population has inadequate access or none to essential and often life-saving medicines is of grave concern. It results in a vast loss of life and much suffering, more particularly among the poor and underprivileged.. It is in blatant contradiction to the fundamental principles of human rights. And, even if one were to set humanitarian considerations side, it results in serious damage to the economy and to the functioning of society."

Report 2004 available online as PDF file [120p.] at: http://www.unmillenniumproject.org/documents/tf5ateminterim.pdf

Background paper 2003 online as PDF file [85p.] at: http://www.unmillenniumproject.org/documents/tf05atemapr18.pdf

The extent of the problem can be illustrated in various ways, both globally and in individual countries. It has been estimated that one third of the world's population lacks access to the most basic essential medicinal remedies, while in the poorest part of Africa and Asia this figure climbs to one half. Bearing in mind that medicines are society's primary instrument in curing and alleviating disease and that they are a prominent tool for its prevention, it is clear that the world cannot hope to attain its Medium term Development Goals in the area of health so long as this situation persists. A high proportion of deaths in the developing world are due to illnesses which are in principle curable with medicines which currently exist; this is the case, for example, with tuberculosis, pneumonia and malaria. Many other deaths result from diseases for which medicinal treatments could, with due effort, be developed using knowledge already available.

The problem of impaired drug access can be solved, and the world has the resources needed to solve it. Three main areas for action can be recognized:

• Firstly, the medicines , which are needed by poor populations, must be available:
• The research and discovery process must and can be reoriented to place more emphasis on creating and identifying the medicines needed to treat major diseases of poor populations, such as HIV/AIDS, malaria and tuberculosis. The private sector can be given incentives to do it, but contributions can also be made in the public sector and in developing countries.
• By using public, private and non-profit channels in parallel, procurement and supply systems in developing countries can be made more effective and reliable
• Unsafe medicines and situations of special risk can and should be more rapidly identified and eliminated than is the case at present in much of the world; information sharing can accelerate the process of containing risk. Where users are unnecessarily injured by medicines, redress must be provided

Secondly, the medicines so urgently needed must be affordable:

• A basic supply of medicines should be based on giving priority to a list of "essential drugs" secured from reliable suppliers
• Within a country, a flexible combination of state financing of drugs and pre-payment systems can ensure that financial barriers to drug access are progressively eliminated. Appropriate donations (and in exceptional cases loans), though they can only be a temporary means of ensuring drug supplies, are for countries at a low level of development likely to be needed for many years to come; the level of such financing will for many countries need to be raised substantially if progress is to be achieved.
• Imposition of user fees on poor populations should be avoided wherever possible; those already in force should be progressively phased out.
• Prices of medicines must be reduced to the minimum sustainable level, particularly by promoting greater competition, eliminating tax burdens and making full use of the exceptions and flexibilities built into the TRIPS agreement. An open exchange of pricing and cost information must be developed.

Thirdly, medicines must be more appropriately used:

• Prescribing must be based on "essential drugs" principles and these principles must be as fundamental part of basic and follow-up training for health workers at all levels, backed by reliable and impartial information services in the field
• Prescribers should be protected from temptations to over-prescribe, such as may arise if they also dispense products for profit, or if they are subject to irresponsible advertising and promotion.
• Prescribing and usage of medicines should be carefully monitored and policies adjusted to take account of the findings
• To ensure well-informed use of medicines in the home, understandable information on their use must be made available through appropriate channels..."

The recommendations presented herein are preliminary and circulated for public discussion. The Task Force will be revising the contents of this document in preparation of its Final Task Force report, due December 2004. The Final Task Force report will feed into the Millennium Project's Final Synthesis Report, due to the Secretary-General by June 30, 2005.

July 2002
New joint report released by Oxfam, Save the Children and VSO: Beyond Philanthropy; the pharmaceutical industry, corporate social responsibility and the developing world. Beyond Philanthropy argues that the pharmaceutical industry should do more to actively consider the needs of poor people in developing countries in their core business activities. PDF-version;
HTML version Link Broken or moved

21 May 2002
IBFAN distributes press release on PPIs at WHA.

17 May 2002
Two key public-private interactions discussed at 55th World Health Assembly:
Note by the Director General on the Global Fund (PDF file)
Note by the Secretariat on the Global Fund (PDF file)
Report by the Secretariat on GAVI
*** all links broken

29 January 2002
HAI Europe and members of the Alliance for a Corporate-Free UN send letter to UN Secretary General Kofi Annan
*** link broken calling for major changes to the Global Compact.

14 January 2002
HAI/CI/IBFAN criticise WHO's promotion of public-private interactions at 109th Executive Board Meeting.
Click here for statement