E-DRUG: Seminar "Drugs: cure or curse", Brussels, December 3 2007
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Please find below the description of a seminar organised by Be-Cause
Health in Brussels on December 3.
More information available at:
http://www.be-causehealth.be/becausehealth/Site/Default.asp?WPID=181&MIID=163&L=E [Pls repair link]
Note that the amount of places is limited and that registration should be
done by writing to:
Ellen Coeck : ecoeck@itg.be or
Fiona Robertson : frobertson@itg.be
(please indicate name / organisation / function)
Participation: 15 euro to be paid on the spot
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Access to Quality Medicines for Patients in Developing Countries 'Drugs: Cure or Curse?'
December 3, 2007 - Brussels
Seminar description:
The issue of access to medicines of quality for patients in developing
countries has been discussed on numerous opportunities these last years:
high prices of drugs in the context of HIV/Aids, the need for Research and
Development (R&D) to address neglected diseases and tuberculosis, the
problem of counterfeiting of essential medicines and the question of how
much money is needed and who should pay for it all. Meanwhile, new R&D
'private public partnerships' and international initiatives for funding
and procuring medicines for the 'big three diseases' HIV/Aids, malaria and
tuberculosis have been created, as well as the WHO pre-qualification
project. The last two have a concrete impact on procurement systems.
Many steps and factors will determine whether a patient eventually has
access to the medicine he needs and looking into all of them in detail
would require several days. Some factors in this process have seen a
certain evolution these last years though, and are at the centre of
political debates that look into new ways to address them. The annual
seminar of Be-cause Health1 intends to address a selection of these
topics.
Objectives of the seminar
o To present some of the persistent bottlenecks in the field of medicines
taking into account the evolution of the recent years and present
potential new ways forward
o to discuss the challenges ahead
o to sensitise Belgian and international policymakers as well as other
stakeholders
o to favour interaction between existing networks
Expected results
o the participants have a clearer global understanding of the issues at
stake
o the actors involved in access to quality drugs in developing countries
are sensitised on the issues
o the discussions and conclusions will feed the work agenda of the
Be-cause Health platform.
The programme of the seminar
- Research and Development:
Before anything else, drugs first need to be discovered. It is now
recognised that there is a lack of R&D answering in an adapted way to the
specific needs of the patients of the South. Only one percent of the
medicines put on the market these last decennia are for tropical diseases.
A specific inter-governmental working group (IGWG) has been set at the WHO
to propose a 'global strategy on public health, innovation and
intellectual property aiming at providing a medium-term framework for an
enhanced and sustainable basis for needs-driven, essential R&D relevant to
the diseases that disproportionately affect the developing countries'.
Questions to be addressed:
- What needs to be done concretely about the lack of appropriate R&D?
- What is the role of the states?
- Is the concept of new public private partnerships the answer?
- What are the alternatives?
Panel:
- A representative from the Belgian government will talk about the IGWG
process at the WHO.
- A representative from a PPP will present her/his view
- The debate will be triggered by a representative from civil society
- Quality of medicines:
Once drugs exist, they may be available from different sources, and the
issue of selection arises. The pharmaceutical sector is a very profitable
one and - old or new - medicines are now being produced all over the world
to answer to the needs of the markets. Regulation regarding these products
vary greatly though, and the complicated production process of medicines
means that important technical and financial means are necessary in order
to assess the quality of products as required. Since 2001, the WHO has set
up the WHO pre-qualification project which ensures the evaluation of
quality, safety and efficacy of medical products for HIV/AIDS, malaria and
tuberculosis. It is used as a reference for numerous international funding
initiatives. Nevertheless, ensuring access to quality medicines in
developing countries still often implies a conscious way of assuming a
certain risk management.
Questions to be addressed:
- What have been the main evolutions of the pharmaceutical market?
- What challenges and problems does it raise?
- How can authorities from developing countries ensure the quality of the
products on their markets?
- What do they need for that?
Panel:
- AEDES will present a summary of the evolution of the pharmaceutical
market and its consequences
- A representative of a drug regulatory agency of the South will share
her/his approach and the challenges faced
- A representative of the EMEA will explain the role that this institution
can play in supporting developing countries
- The debate will be triggered by a representative from the WHO
- Appropriate delivery corresponding to the patients' needs:
Ensuring the drugs are in the country is only a part of the process.
Procuring medicines corresponding to the needs of the population is a
complicated step in the process that leads to different situations on the
ground: international funding has created situations where too many drugs
are procured by too many sources for HIV/Aids, lack of appropriate needs
calculation and /or funding leads to stock outs of ACT for malaria, etc.
International agencies are also often involved in procuring medicines in
developing countries which brings up other challenges. At last, the
rational use or not of the medicines at health structure level itself will
in turn impact the predictability of needs in calculation and procurement.
Questions to be addressed:
- What problems do national and regional pharmacies face when distributing
drugs and equipment to the health centre network?
- How to address the challenges of needs in calculation and of rational
use of medicines at service delivery?
Panel:
- A representative of a procurement agency from a developing country will
present the challenges of efficient procurement from a national
perspective
- An international agency representative will discuss the challenges of
efficient drug procurement from its perspective
- The rational use of medicine's today will be presented by the Antwerp
Tropical Institute
- The discussion will be triggered by a representative from WHO
- Cost of medicines and financial access:
Whatever medicines are selected and distributed, they need to be paid for,
at one level or the other. The latest drugs that have been brought on the
market and that are needed as well in developed as in developing
countries, present an important problem: they are very expensive. The
HIV/Aids epidemic has acted as a magnifying glass and illustrates the
difficulties in accessing new medicines. Several approaches are being
implemented to ensure that new and vital medicines are affordable: the
review in interpretation of trade agreements, voluntary programmes by the
pharmaceutical industry, increased and new international funding, public
tenders. For some medicines, prices have dropped drastically or they are
on the market on what can be considered a 'reasonable price'. But if the
prices seem affordable for governments and health implementers it does not
mean that they are affordable for the patients...
Questions to be addressed:
- Are the approaches to ensure the affordability of medicines sufficient?
- How well do they work in reality?
- What are the main limits and what should happen to ensure that new
needed medicines are made available in developing countries?
- Who should pay for the costs?
- What impact does asking the patient to pay for access to medicines have
on the efficiency of health programmes?
Panel:
- MSF will review and share its experience on the use of the different
alternatives to access new quality medicines and make it available for the
patients.
- A donor representative will explain her/his approach on ensuring access
to affordable medicines for developing countries and for the population
- A representative from a developing country will present the challenges
they are faced with
- The debate will be triggered by a representative from a Southern country
civil society group working on these issues
A final debate with representatives from the Belgian government, the donor
community, a representative of a developing country and of the Be-cause
Health group on medicines will conclude the day.
Seco GERARD
Advisor, Analysis and Advocacy Unit, Gen Dir.
MSF
Rue Dupre 94
1090 Brussels
32 2 475 36 34 (dir off)
seco.gerard@msf.org