MSF Access Campaign• Started in 1999

• Rooted in field experience

• Three Pillars:– Overcoming Barriers– Research and Development for Drugs for

Neglected Diseases– Effects of Globalisation (TRIPS, etc)

Access to Essential Medicines•75% of the world’s population live in developing countries

•They account for 8% of the pharmaceutical sales

•1/3 world’s population does not have access to essential medicines (> 50% in most impoverished areas of Africa and Asia)

Projected WorldPharmaceutical Market 2002

(around 400 billions USD)

Japan11%

North America42%Asia

7%

E. Europe & CIS

3%

Africa1%

Others4%

West Europe25%

Latin America7%

World Drugs Market

0

20

40

60

80

100

120

140

160

180

NorthAmerica

Europe Japan LatinAmerica

Africa/Asia Others

1993

1999

2002 Projected

Billions US$

Source: IMS Health, PNUD

Factors Affecting Access to Essential Medicines

R&D

ProductionApproval

Quality

Distribution

Drug information, rationale use

Diagnosis/prescription/monitoring

PriceCompliance

Pharmacovigilance

WH

O/C

DS

/CS

R

Evolution of Sleeping Sickness Throughout the

XXth Century

1995-2000

• Suramine et NifurtimoxBayer ends the production.

• Melarsoprol (Aventis)Production in danger

• Pentamidine (RPR-Aventis)Announces a progressive end to the

donation programme

• Eflornithine (HMR-Aventis)ends the production (exploitation is

offered to WHO)

2001• Bayer announces

production and donation re-

commencement

• Aventis annoncemaintenance of the production and donation programme for 5 years +

support to sleeping sickess programmes .

Drugs for sleeping sickness: Preliminary Results

Unaffordable Life-saving drugs

Anti-retroviralsSome treatments for opportunistic diseasesNew antibiotics or anti-malaria drugsNew vaccinesEtc.

Objective:Equitable Drug Prices

• The policy of assuring dramatically reduced drug prices so that they are truly affordable to the people who need them

• A policy that is – sustainable (not based on charity or donations)– Strengthens developing countries’ autonomy– Attracts donor funding– Not limited to HIV/AIDS medication only

Generic CompetitionSample AIDS triple-combination: lowest world prices

(stavudine (d4T) + lamivudine (3TC) + nevirapine)

0

2000

4000

6000

8000

10000

12000

US

$ Brand

Generic

Brand $10439

Brand $931Brand $727

Aurobindo $209Hetero $347

Cipla $350Cipla $800

Brazil $2767

Lack of Research and Development for Neglected Diseases

Defining the problems and searching for solutions

Global investment in R&D

• Estimated that between $70 - 90 billion per year spent on health R&D – 50% public funding (of which 80% is G8)– 50% private funding (for profit and non-profit)

Less than 10% is devoted to 90% of the world’s health problems

Lack of R&D for Neglected Diseases1975 – 1999

Among 1393 new chemical entities, 435 (31.2%) therapeutic innovations

New chemical entities69%

Therapeutic Innovations for Tropical Diseases 1%

Therapeutic Innovations for Other

Diseases 30%

Who can play a role in defining solutions

• NGO's commitment• The role of the pharmaceutical industry• Public support, • political will and funding