14 April 2019: The World Health Organization (WHO) and the Government of South Africa held a global forum to discuss pricing of essential medicines, which highlighted the problems that governments and health authorities face in enabling access to affordable medicines. Participants called for greater transparency around the cost of research, development and production of medicines.
In SDG 3 (good health and well-being), countries commit to provide access to safe, effective, quality and affordable essential medicines and vaccines for all (SDG target 3.8), and to support research and development of vaccines and medicines for diseases that primarily affect developing countries (SDG target 3.b). This target references the Doha Declaration on the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement and Public Health, which affirms the right of developing countries to use provisions in TRIPS to protect public health and, in particular, to provide access to medicines for all.
Health authorities increasingly are rationing medicines for cancer, hepatitis C and other diseases due to cost considerations.
WHO estimates that 100 million people fall into poverty annually due to the prices they pay for medicines, and health authorities in high-income countries are increasingly having to “ration” medicines for cancer, hepatitis C and other diseases due to cost considerations, even with older medicines that are no longer have patent protection. WHO reports that pharmaceutical industry bodies have expressed support for the goal of access to medicines for all.
The WHO Forum on Medicines took place from 13-14 April 2019 in Johannesburg, South Africa. Delegates noted that some developing countries may pay higher prices for medicines that developed countries. Mariângela Simão, WHO, cited barriers to access as a global human rights issue.
Participants proposed strategies for reducing prices, including: sharing price information among countries so as to identify discrepancies; referring to WHO’s database on vaccine markets and shortages (MI4A); undertaking joint procurement of medicines by countries in the same region; and sharing national policies on expanding access to medicines.
WHO announced that it will soon begin consultations on what constitutes fair pricing of essential medicines. The Organization has already identified an Essential Medicines List, and a 2017 report commissioned by WHO and published in the British Medical Journal (BMJ) showed that many of them can be profitably manufactured at very low cost, yet most such medicines are sold in the UK and South Africa at significantly higher prices. The report indicates that estimating the costs of manufacturing generic medicines, adding a proposed 10% profit margin for the company and then making international price comparisons, could help governments negotiate for better prices. [WHO press release]