Why is it crucial to improve access to essential medicines? Better health is a necessary step to alleviate poverty and break “The Poverty Trap”, as d

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Why is it crucial to improve access to essential medicines?

Better health is a necessary step to alleviate poverty and break “The Poverty Trap”, as described by Professor Jeff Sachs.

On May 13th, WHO released their 2011 World Health Statistics. According to this report, an increasing number of countries are facing a “double burden of disease” as the prevalence of risk factors for Non Communicable Diseases (NCDs) such as diabetes, heart diseases and cancers increases, while many countries still struggle to reduce maternal and child death caused by infectious diseases. Pneumonia, diarrhea and malaria are most likely to kill children under the age of five. In 2009, 40% of all child deaths were among newborns (aged 28 days or less). Overall, the report indicates that health expenditures as a % of GDP slightly increased from 2000 to 2008 (8.3% to 8.5%), but for “low income and lower-medium income populations”, out-of-pocket payments still represent around 85% of private health expenditures.

In the upcoming issues of the PPP newsletter, we will explore some sustainable solutions in improving global health, particularly in relation to Global Partnerships, as stated in the Millennium Development Goal number 8:
• “In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries”
• “In cooperation with the private sector, make available benefits of new technologies, especially information and communications”

When Sustainability demands Profits

Such cooperation requires a long term commitment. Although Official Development Assistance (ODA) plays a significant role in alleviating poverty, private sector corporations will be able to sustain their commitment only if they show a profit.

The late Professor C.K. Prahalad highlighted in “The Fortune at The Bottom of the Pyramid” how new for-profit business models are emerging, relying on “relatively simple, convenient and low-cost innovations”. Many of these innovations are already found in the healthcare industry. Jaipur Foot (prostheses) or The Aravind Eye Care System (eye surgery) invented new business models to serve the poor while making a profit. Consultants at 3xBL helped several pharmaceutical companies redesign their business models with the same goal.

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Indeed, pharmaceutical companies are fast expanding in emerging markets and they begin to adopt new business models to serve a less affluent population. Essential medicines involve mostly off-patent compounds, and are usually available in generic form, branded or not. Their price (frequently regulated) and how they are packaged makes them affordable to most of the 4 billion living just above absolute poverty.

Low prices are not sufficient

Affordability is just the first step. Other conditions are indispensable.
• Awareness. Individuals do not understand their symptoms or fear visiting a healthcare professional (HCP). In many countries, undiagnosed diabetes represents up to 85% of cases.. Often, HCPs are eager to receive education materials refreshing their notions about standard treatments.
• Appeal. A medicine by itself will not solve a problem. Relevant, integrated health solutions are required.
• Availability. Soda or soap may reach remote places but making medicines available requires professional and compliant handling.

We will come back to these topics over time in future issues of this newsletter, and address questions such as: Is there a simpler way to start? Could NCD and infectious diseases be addressed in the same way? How to deal with different kinds of countries? How to make a field force successful? How to enforce compliance?

Feel free to circulate this newsletter, but always in its entirety. To subscribe or unsubscribe, please use the links at the bottom of this page.

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Olivier Jarry

With the contribution of Ms. Mais Najib. Sources: www.who.int/whosis/whostat/2011/en/index.html. www.un.org/millenniumgoals/. www.worlddiabetesfoundation.org/composite-35.htm. Prahalad, C.K. The Fortune at the Bottom of the Pyramid. Wharton School Publishing, 2005. Sachs, J.D. The End of Poverty. Penguin Books, 2006.

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