What did the creation of the Access Campaign mean for MSF?
As a medical organization, MSF was not assessing the political or legal environment that governed access to medicines. We were logistically oriented and had made great progress in bringing medicines and vaccines to the ﬁeld—we knew how to purchase and deliver. But we needed to address the situations when we had nothing to purchase, and nothing to deliver.
Take HIV. It was obvious that intellectual property (IP) was a major challenge, pricing treatments out of reach. Addressing IP barriers was a priority. But for sleeping sickness or leishmaniasis, the issue was a lack of R&D. You cannot address both IP and R&D with the same tools and response. The campaign was the structure that developed a deep understanding of the problems, and then proposed solutions.
What were the Access Campaign’s ﬁrst achievements?
Getting rid of toxic sleeping sickness treatment was a ﬁrst success. On a trip to the United States, I suddenly saw an advertisement on TV for a hair removal cream containing eﬂornithine, the drug we had tried and failed to access for many years to treat sleeping sickness. So this lifesaving drug wasn’t available for people at risk of dying, but could be bought as a cosmetic product!
We took the story to The New York Times, and to [the CBS news program] 60 Minutes. This was the beginning of a long process that led to massive improvement in sleeping sickness treatment.
The campaign also led on malaria. In the 1990s, MSF programs were starting to observe that chloroquine [a drug introduced in the 1940s for the treatment of malaria] was not doing the job. But there was reluctance to change the status quo. MSF and Epicentre [MSF’s medical research arm] conducted a series of studies to document resistance to chloroquine, and on that basis the campaign came up with a strong message: “ACT NOW” to change treatment. [We wanted to] make artemisinin-based combination therapy [ACT]—newer, more effective malaria drugs—available, and do it everywhere. This campaign put pressure on the World Health Organization and led to the adoption of ACTs.
For HIV, the campaign also had a role in challenging the status quo. Publicly, [we led the] drive to reduce the price from $12,000 for a year’s treatment down to $1 a day. And within MSF, this contributed massively to overcome hesitancy to treat HIV, which previously was so expensive and complicated it seemed unfeasible.
And, by convening an expert group of idealists that thought we could do things better, the campaign also led to the creation of the Drugs for Neglected Diseases initiative [DNDi, a non-proﬁt drug research and development organization that develops drugs to treat neglected diseases]. After investigating the problems on the R&D side, we realized that to develop solutions we needed to create a separate initiative, one that could demonstrate a different model, a different way of doing R&D, and that could deliver. DNDi’s achievements are also the campaign’s.