I have been at the Medicines Patent Pool (MPP) now for 18 months and, although we are definitely making progress in getting MPP better known, I’m still surprised by the number of people who misunderstand what we’re about. They think we’re about licences, or making drugs cheaper, or saving money for the public health community. We’re not. We’re about people and helping to ensure they have access to medicines and that those medicines are affordable. Signing licences, reducing the price of drugs and saving money are just methods to achieve the goal of improving people’s health and lives.
To make this possible we need to be working with those people, to make sure we are really addressing what they need and want. We do this in a number of ways. The staff who work at MPP, our Governance Board, our Expert Advisory Group and our Scientific Advisory Panel all have people from affected communities. That means their perspective informs all we do. In addition, we regularly take part in Community Advisory Boards that exist to promote the views of affected communities but also in many other consultations. But equally we need their help. This is not a one-way relationship. On the contrary, it’s very symbiotic. The affected communities and the broader civil society that works hand-in-hand with them are vital in advocating for the licences that will deliver the drugs they need and then with governments to ensure that those drugs are made available once our licences have made them affordable.
Traditionally we have measured our impact in terms of the numbers of people getting access to drugs and the savings that have resulted from the lower prices our licences have made possible. Now we want to broaden our impact measures to look at how the affordability of these medicines changes people’s lives. We are working with experts to find ways of capturing this (it’s not easy!). We are starting with daclatasvir (being used together with sofosbuvir) and dolutegravir but will extend the methodology to the other drugs we licence. And, of course, the input of those living with HIV or hepatitis is critical to understanding what it means to be able to switch from efavirenz to dolutegravir or to be cured of hepatitis C.
But we want to do more with the people we serve. So, we have started doing field trips that allow us to spend more time on the ground with them. We did the first one this year to India where we had the opportunity to meet a whole range of stakeholders – government, doctors, NGOs, academics and, critically, people who have personally benefitted from our licences or are hoping to in the very near future. You can watch the trailer to the video we made about the trip here. The full video will be up on our site in the new year. We will be doing two more field trips next year – to one or two countries in Eastern Europe/Central Asia and to South Africa. These field trips also allow us to capture better the impact of what we do in human terms.
Our relationship with affected communities is only going to become more important as we move into new disease areas, where there is no external funding and countries need to pay for the drugs out of their own resources. Our model breaks down if there is no demand. We can have the cheapest drug in the world but if governments are not willing to buy it and people are unable to pay for them (whether through insurance, out of pocket or otherwise) and it just sits in warehouses, our generic partners will simply stop making it. People from the affected communities are critical in keeping governments informed that affordable generic versions of patented essential medicines are available and ensuring that governments include them in their programmes.
Which brings us to Universal Health Coverage (UHC). UHC has been a dominant theme in 2019, not least because of the United Nations High Level Meeting in New York in September. As countries try to increase the number of people covered by UHC and the number of medicines and services included while decreasing the financial contribution from those covered, it is clear that in low- and middle-income countries (LMICs) this absolutely requires that the medicines are affordable, especially since medicines comprise over a quarter of total healthcare spend on average and up to 67% in some LMICs. Otherwise the global goal of the expansion of UHC will not be possible.
We were delighted that not only do LMICs understand this but so do the most developed countries. In 2019 the health ministers of both the G7 group of countries and the G20 explicitly supported our expansion into essential medicines and we are hoping that this will encourage the originator companies to work with us in 2020 to bring their innovative medicines to the millions of people in LMICs who need them but currently do not have affordable access. We will be 10 years old in 2020 and we want to mark it by showing that our model, which has worked so well in HIV and hepatitis C, can work equally well in other areas like cancer, cardiovascular disease or diabetes.
I wish all of you a very happy holiday period, in particular our partners, and would especially like to thank Unitaid, the Swiss Agency for Development and Cooperation and the Wellcome Trust for their financial support. But most of all I wish it for all those people we help but who equally help us.