The adversity of access to medicine

Is a life-saving medicine really saving lives if it is not accessible and affordable?

Imagine you are a person living in a village in Kenya. You have a disease that will require you to take a pill every day for the rest of your life. Then you find out that a new medicine is being produced, which you only need to take once every six months —much easier to manage and access. You are filled with hope… until you find out that the medicine will be priced at $40,000 per year. Disappointment? Devastation?

That’s how many people living with HIV are feeling right now. Gilead is producing a new HIV/AIDS medicine called Lenacapavir, but they are planning to sell it at more than $40,000 for a year’s dose. This leaves me with one question: is a life-saving medicine really saving lives if it is not accessible and affordable for the people who need it most?

Activists marching at #AIDS2024 demanding access to Lenacapavir

Over the last few days, I have taken some time to reflect on my career —on my work with the Peoples’ Medicine Alliance (previously the Peoples’ Vaccine Alliance). I started as an intern and immediately after worked as a junior campaigner. One of the things I learnt is that there are deep inequalities in access to medicines between rich and poorer countries. For example, as I was joining the vaccine campaign at the start of March 2022, high-income countries had fully vaccinated almost three-quarters of their population against COVID-19, while only 1 in every 10 people were fully vaccinated in Africa.

As the world’s rich countries were scrambling for vaccines, big pharmaceutical corporations were busy selecting the highest bidders and totally disregarding the lives and livelihoods of millions of people living in low-income countries who didn’t have access to the vaccines. This prioritizing of profits over people allowed pharmaceutical companies to amass profits to tune of $1,000 per second between Pfizer-BioNTech and Moderna. Last year, analysis by SOMO and the People’s Medicine Alliance found that, every five minutes during the COVID-19 pandemic, more than $1 million was paid to shareholders and executives.

If you are new to this, as I was then, you would think this is a one-time challenge and that once people protest, then these countries and corporations would change. But I came to realize that this was a very naive thought. The greed of pharmaceutical corporations and the selfishness of rich countries continued… as it has always. Rich countries cared only for themselves, donating near-to-expiry doses to wash off the guilt.

And that was not all. As we were still navigating the COVID-19 pandemic, Monkeypox (Mpox) hit, spreading for the first time to rich countries. The EU, US and other rich countries, again, were racing to purchase available doses of Mpox vaccines for themselves. As always, the vaccines were not accessible in African countries despite the fact that, as a continent, we have been facing Mpox challenge for decades. In recent weeks, Mpox has again been spreading fast in African countries, and has been declared as a Global Health Emergency by World Health Organization. Yet only 200,000 vaccine doses out of the 10 million that are needed are available, despite millions of vaccines doses being held in stockpiles in rich countries.

It would be easier for pharmaceutical corporations and their sympathizers to say, “they took a risk by investing in medicines/vaccines, and so they are entitled to get profits.” But if you look at COVID-19 vaccines, you realize that the research was funded by public money. One of the US government officials who engaged in procuring the vaccine complained that calling it Pfizer’s vaccine is ‘the biggest marketing coup in the history of American pharmaceuticals.” How did we then get to a point where this pharmaceutical corporation owns the patents to the research, enjoys the monopoly and charges exorbitant prices while it was primarily ordinary people who paid for the vaccine through their taxes?

In the EQUALS podcast episode with Nick Dearden, he likens Big Pharma to hedge funds in that they buy up research and enjoy the monopoly using the patents.

"They are not pharmaceutical research and development companies at all, they are essentially hedge funds. They buy other people's research and squeeze it for all it's worth," he said.

While editing Nick Dearden’s podcast interview, I realized that one of the reasons we are in this mess is because we have let pharmaceutical corporations control the prices of medicines, and to whom and where they want to sell them. But I believe that we can do better.

As it is highlighted in the ‘The people’s prescription’:

“Continuing with business as usual is not an option, as our current health innovation model is expensive, inefficient and unsustainable.”

Here a few ways we could create a pharmaceutical system fit for the twenty-first century, to ensure equitable access to medical tools and save lives in future pandemics and health emergencies:

• More state-ownership. In Brazil, state-owned pharmaceutical companies compete with private corporations, and state-owned laboratories manufacture 80% of the vaccines procured by public health systems.

• Diverse ways to incentivize innovation. US Senator Bernie Sanders proposed a Medical Innovation Prize Fund —a government-created fund to reward researchers who reach agreed health objectives, as an alternative for patents.

• More Global South innovation and South-South cooperation. Vaccine inequity highlighted the need for Africa to revolutionize its vaccine manufacturing sector, and the MRNA Technology Transfer Program is a prime example of South-South cooperation.

• Supporting pandemic treaty. A binding treaty with equity at its heart will make sure that when the next pandemic hits, we will not have a repeat of the terrible failure during COVID-19.

These changes will not happen by default. It will entail multi-sectoral engagement. Governments around the world must be willing to challenge the Big Pharma model. Pharmaceutical corporations need to put accessibility and affordability in their distribution strategies and health advocates must keep pushing for a system that ensure access for everyone, everywhere.

End.

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Author: Simon Maina is the EQUALS Podcast & Blog Project Manager and the producer of EQUALS and Sick Development podcasts.

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