In 2019, MSF marks the 20th anniversary of founding its ‘Access Campaign,’ which has been working to secure access to affordable medicines, diagnostics and vaccines, including promoting their research and development, for people in MSF’s care and beyond. Marking this milestone provides an opportunity to reflect on what has been learned and accomplished – and what needs to be done going forward – in medical innovation and access for all people in need.
MSF launched the Access Campaign in 1999 against the backdrop of the HIV/AIDS epidemic that was raging in developing countries—while lifesaving HIV drug ‘cocktails’ transformed this deadly disease into a chronic and manageable condition in wealthy countries, they were priced out of reach for everyone else. At the same time, MSF medical staff lacked adequate treatments for neglected diseases such as tuberculosis, malaria and African sleeping sickness, because pharmaceutical corporations did not consider it profitable enough to develop drugs for people who could not afford to pay high prices.
Deciding we could not sit by idly and watch this injustice take the lives of so many people in front of us, MSF started the Access Campaign to overcome the many barriers that prevent people from getting the treatment they need to stay alive and healthy, focusing in particular on bringing down prices and ensuring medicines are available in countries that need them, and stimulating research into improved treatment options.
Over the last two decades, MSF and civil-society outrage and demands to put patient lives before patents and corporate profits have resulted in advancements in the affordability and availability of key lifesaving drugs and vaccines:
- For HIV medicines, the price ultimately came down by more than 99 percent, from over US$10,000 to treat one person for one year in 2000, to less than $100 per year today, by breaking down corporate monopolies to allow robust competition and the production of affordable generic drugs, primarily from India.
- In the early 2000s,MSF pushed for a switch to more effective treatment for malaria through its ‘ACT Now’ campaign, urging countries to switch to artemisinin-based combination therapy (ACT), which most countries in Africa did by 2008.
- In 2003, MSF co-founded the Drugs for Neglected Diseases initiative (DNDi), an innovative non-for-profit drug development model to develop treatments for neglected patients, which has delivered eight treatments for malaria, pediatric HIV, leishmaniasis, Chagas disease, and sleeping sickness, including the recently launched all-oral sleeping sickness treatment fexinidazole.
- In the late 2000s and early 2010s, MSF’s Access Campaign added nutrition and vaccines to its portfolio and achieved success in improving the quality of food aid provided to children facing malnutrition through its ‘Starved for Attention’ campaign, as well as achieving critical affordable access for humanitarian actors to the pneumonia vaccine for children in crisis through its ‘A Fair Shot’ campaign.
- With the introduction of new medicines to cure hepatitis C starting in 2013, the world was confronted with the $1,000 pill – a situation which, alongside the exorbitant and escalating prices of cancer drugs and insulin, put front and center the global crisis of high medicine prices. By supporting legal challenges to the monopoly held by corporations like Gilead Sciences in multiple countries, MSF, along with other civil society organisations, has contributed to price reductions of key hepatitis C medicines to roughly $1 per pill in selected countries. But tens of millions of people are still waiting for the cure.
“The medical innovation and access crisis is now becoming increasingly global, with people in developing and developed countries alike experiencing some of the same access challenges we have seen for decades in our work in over 70 countries,” said Dr. Els Torreele, Executive Director of MSF’s Access Campaign. “It’s time to acknowledge that the way drugs are developed and sold today is not delivering the treatments people around the world need at prices they can afford. We need to see governments and the research community standing up and proposing bold solutions to a problem that is truly global—simply put, business as usual will be deadly.”
Today, many new drugs, vaccines, and diagnostics remain out of reach due to high prices, while monopolies are more entrenched and pharmaceutical corporate powers more globalised. These obstacles are re-mobilising the “Access to Medicines” movement around the world to demand transformative changes centered on people’s health rather than profit – as a matter of justice, not charity.
The Access Campaign calls for:
- Seizing the global momentum for change: The current global outrage around expensive medicines, health systems collapsing under financial strain, and people dying from lack of treatment should be channelled, with alliances built with the growing numbers of people demanding change.
- Putting an end to pharma’s myths on high prices: The false narrative that medicines are and must be expensive should be put to rest once and for all. Pharmaceutical corporations must be transparent and accountable in terms of their price setting and research costs.
- Stopping patent abuse: The pharmaceutical industry should no longer be given new frivolous patents on already existing drugs, extending their monopolies and delaying access to affordable generic versions.
- Encouraging and protecting countries taking action for access: Countries wishing to exercise their legal right to access affordable medicines – including India, Thailand, Brazil, Colombia, Malaysia and others – must be allowed to produce or obtain affordable drugs and vaccines, without being bullied by pharmaceutical corporations or other countries.
- Promoting and organising R&D as a collective responsibility: Medical innovation must be fostered as a “social contract” of open, collective effort between the public and private sectors, delivering beneficial public health tools, not luxury commodities. Open, collaborative R&D in the public interest, in which knowledge and new treatments are shared, not privatised, must be embraced. Medical R&D must address people’s health needs no matter where they live, and must address priority areas including drug-resistant tuberculosis, antibiotic resistance, outbreak diseases, and neglected diseases.