Even though I have worked in the public health sector for almost 20 years and I know from personal experience how slowly things change, I am still astonished that nearly 2 billion people don’t have access to essential medicines and basic health technologies and that every single year 100 million people are driven into poverty because they are forced to spend far more than they can afford on healthcare. The need for universal health coverage (UHC) could not be clearer.
The challenge is, of course, the cost. Can countries afford it, particularly those that need it most? The answer, at least in theory, is yes they can. Governments have spending choices. But in order to choose health as a priority they need to have the political will to do so. The UN High Level Meeting on Universal Health Coverage, taking place on 23 September in New York, is a critical opportunity to generate the political commitment to UHC. Once the will is there, the financial commitment is much more likely to follow.
However, if governments are going to commit to UHC, they have got to feel that it’s within reach. That means that the necessary ingredients have to be in place such as adequate health facilities, enough trained staff, logistics infrastructure as well as diagnostics and medicines. And they have to be cheap enough to be affordable. Many stakeholders need to contribute to make that happen and one of them is the Medicines Patent Pool (MPP). By getting licences from the companies that develop new drugs, we are able to facilitate the manufacture and sale of high quality but much cheaper and therefore affordable versions for low- and middle-income countries. Affordable drugs are only one part of UHC but I’m happy to stick my neck out and say they are an absolutely necessary part. In fact, I’d go so far as to say that without affordable drugs, UHC is impossible.
I am a passionate believer in the need to ensure access to essential medicines for everyone, regardless of where they live or what their financial and social situation is. This is why I decided to join the Medicines Patent Pool a year ago, as it was established by Unitaid at the request of the United Nations precisely to offer an innovative model for addressing the issue of access to affordable medicines through voluntary public health-oriented licensing and patent pooling.
What the MPP has achieved in less than 10 years is still a source of wonder to me. Through MPP licences, 8 billion HIV and hepatitis C pills have been supplied at affordable prices to those who need them the most and governments have paid USD 1 billion less than they would have had to pay without the MPP, freeing up money to treat more people. This includes enabling access to best-in-class HIV treatments like new WHO-recommended dolutegravir (DTG) for more than 90% of people living with HIV. Our model – which gives generic manufacturers the freedom to innovate – has led to the development of exciting, novel, highly efficacious fixed-dose formulations like TLD (tenofovir disoproxil fumarate, lamivudine and DTG) – sold at reasonable prices in developing countries, as well as special formulations for children.
So far our contribution has been limited to HIV, TB and hepatitis C but now we have a new mandate to bring our model to essential medicines right across health. We’re delighted with the opportunity this gives us to make a greater range of quality drugs available at affordable prices and play our small but important part in the achievement – so essential if we really mean we won’t leave anyone behind – of universal health coverage.