20 Years On

The fight for access to medicines is going global

MSF activists protest for affordable medicines at the European Patent Office.
Germany 2018 © Peter Bauza
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By Els Torreele, Executive Director, MSF Access Campaign

When I first joined the Access Campaign in 1999, I understood both the enormous medical needs and intense frustration that led to its creation. MSF staff in the field were facing multiple challenges, unable to provide adequate treatment to people dying from HIV/AIDS, tuberculosis, malaria, and neglected tropical diseases because drugs were too expensive, ineffective, toxic—or simply did not exist at all.

I used my expertise as a biomedical researcher to coordinate a working group analyzing the lack of research and development (R&D) for neglected tropical diseases. Across the board, it was clear that these deficiencies were not solely due to scientific or technical limitations. They were the result of conscious political choices about how medical innovation and access to health tools are organized and financed globally. The multinational pharmaceutical industry, rooted in the economic and political systems of the richest countries on earth, decides which diseases merit R&D effort and wields unchecked power over the pricing and distribution of essential medicines and vaccines everywhere. Big Pharma routinely prioritizes profits over people’s health.

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“Medicines Shouldn’t Be a Luxury” was an early rallying cry for the campaign, and it remains a powerful message today. Over the past 20 years, we have achieved incredible victories. Working together with patient activists, MSF was part of a coalition that helped overcome the barriers to accessing lifesaving HIV antiretroviral drugs. Thanks to intensive advocacy as well as competition from generic producers, the price of these drugs dropped from more than $10,000 per person per year to less than $100. As a result, we’ve seen the massive scaling up of treatment for people living with HIV/AIDS to over 22 million at the end of 2018. 

1999-2019:

MSF Access Campaign

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MSF demonstrators deliver a petition at Pfizer headquarters in New York City to drop the price of pneumonia vaccine to $5 per child in developing countries.

Other campaign successes followed, from increasing access to rapid diagnostic tests and artemisinin-based combination treatments for malaria, to decreasing the prices of the pneumococcal conjugate vaccine and hepatitis C drugs, to fostering R&D for the most neglected diseases. A major outcome of the campaign was the creation in 2003 of the Drugs for Neglected Diseases initiative (DNDi), which I joined as a founding member. DNDi is a collaborative, non-profit drug development organization driven by patients’ needs, with which MSF continues to partner. Earlier this year, we celebrated the launch of fexinidazole, a new all-oral cure for African sleeping sickness developed with partners by DNDi. This landmark achievement shows that it is possible to develop new drugs outside the commercial pharmaceutical business model. 

Indian activists protest in New Delhi against a challenge to the country's patent law by Swiss pharmaceutical giant Novartis.
India 2007 © Michel Lotrowska

Despite some major wins, today the challenges for access to lifesaving medicines are greater than ever. Many new drugs, diagnostics, and vaccines are marketed at increasingly high prices. Drug corporation monopolies are even more entrenched, and their powers are more global. At the same time, we are missing the tools we need to control some of the major public health challenges of our time, such as the spread of antibiotic resistance and outbreaks of epidemic diseases like Ebola.

MSF: Johnson & Johnson should make TB drug available for all at $1/day
In April 2019, MSF staff demonstrated outside a shareholders meeting at Johnson & Johnson’s headquarters in New Brunswick, New Jersey, calling on the company to lower the cost of the tuberculosis drug bedaquiline to $1 per day.
United States 2019 © Melissa Pracht/MSF

The crisis of access to medicines and medical innovation is truly global now, which presents enormous hurdles as well as opportunities for greater solidarity and coalition building. Finding solutions for exorbitant drug prices while fostering medical innovation is a topic of public and political debate in high- and low-income countries alike.

We are advocating for health needs-driven medical R&D and access to medicines as a collective responsibility. Given that medical R&D is largely financed by public funds, it is unacceptable that the fruits of these collective efforts are captured by unchecked monopolies that mainly enrich pharmaceutical corporations and their shareholders. Meanwhile, health systems collapse under financial burdens and people die for lack of medicines.

Together we must drastically step up efforts to expand people’s access to lifesaving health tools. Across the international community, all of us must continue to demand justice, not charity.

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Together we must: 

Seize the global momentum for change 

  • We must channel global outrage over the high cost of medicines and unnecessary deaths, build alliances with the growing numbers of people demanding reform, and build on past successes to ensure sustainable, systemic changes that ensure greater access.

Bust pharma's myths on high prices

  • Pharmaceutical companies must be transparent and accountable in terms of their product pricing, R&D costs, and research data. We must counter the false narrative that medicines must be expensive.

Stop patient abuse 

  • The pharma industry should no longer be given new frivolous patents on existing drugs. Patent abuse only enables companies to unfairly extend their monopolies and delay access to affordable generic medicines.

Challenge and transform the medical research system 

  • The economic model behind the development and distribution of medicines and other essential health technologies must change. Profit-maximizing business strategies are failing sick people and do not deliver the affordable medicines we need. We must explore more sustainable ways forward that center on people’s needs, including treatments for drug resistant TB, antibiotic resistance, outbreak diseases, and neglected diseases. We must embrace open and collaborative models of R&D in the public interest, through which knowledge and new treatments are shared, not privatized. Medical innovation must deliver goods supporting greater public health, not luxury commodities.

Support countries taking action for access

  • We should all defend countries exercising their legal right to put people before patents, such as India, Thailand, Brazil, Colombia, and Malaysia. Countries must be allowed to produce or obtain affordable versions of lifesaving drugs and vaccines without being bullied by pharmaceutical corporations or other countries.

Demand justice, not charity 

  • Pharmaceutical corporations and governments in wealthy countries should not get to decide if and when lifesaving drugs, vaccines, and diagnostics are affordable or available to the people who need them. We must work together to ensure that people’s right to health and equitable access are put first.