As an international medical humanitarian organisation providing life-saving medical care in more than 70 countries around the world, Medecins Sans Frontieres knows well what it means to not be able to treat people in our care because a needed medicine is too expensive or simply not available.
In the context of this unprecedented crisis, it is high time we stop pretending that the market mechanisms can provide medical care and health tools to all those who need them.
Since its creation MSF has experienced the gaps and barriers such a model creates– the AC has worked to tackle them for more than 20 years now.
With Covid-19, right now, every single person on the planet can experience first-hand the failure of the current pharmaceutical system. For each of us, it can mean no diagnostic, no treatment, no ventilator, no vaccine; for society as a whole, it is a disaster.
The number of people who are excluded from access is growing in every country, including in the most wealthy ones.
- People lack access to new life saving treatments: 7 years ago, obvious rationing started with Hepatitis C, and since then problems became obvious in many disease areas (diabetes, cancers, rare diseases, and so on).
- But countries also experience increasing shortages of old products that are not of interest for pharmaceutical companies, because there is too little money to make with them. In recent years the stress for many countries was the lack of basic antibiotics such as penicillin, products like insulin, adrenaline, atropine, lidocaine, etc.
Right now, in the context of the covid pandemic, key antibiotics such as amoxicillin, or doxycycline, as well as morphine, or reagents for diagnostic, are missing. Even if you can to buy them, these are simply not available – or have been already sold to the highest bidder. As it is the case with some vaccines, like the one against HPV, the issue is often a limited number of companies controlling the market (through monopolies, or oligopolies) and relying on a limited number of API manufacturers.
As a consequence of limited availability, public health policies based on rationing are now spreading globally – and the right to health care and access to essential health tools is eroding for many people. The fact that diagnostic is not part of the confinement policy, in many countries right now, is only the case because these countries, such as France, do not have the capacity to generalize testing. Basic equipment to prevent the spread of this pandemic, equipment such as face masks, gloves and other basic protection material, or life-saving equipment such as ventilators are missing. This is a result of local capacities dwindling or disappearing because governments decided to count on a globalized supply, in the belief that the market would provide these tools as and when needed. In fact, States relinquished their power to exert “health sovereignty” which is their power to protect and promote health and health services.
But we can change the current trend and redesign the organization of our health systems in ways that really are about improving health for all people.
The funding of the vaccine against covid-19 is for instance an opportunity: to put the resources on health priorities, but also to think of and plan the conditions of access from day one: simple questions need to be asked and answered publicly: what do we need? How much do things cost exactly? Who is paying? How do we guaranty access for all in need? The answers to these questions must dictate the terms of collaboration between the stakeholders. They must define a social contract that ensures transparent and fair use of public resources and a collective governance of essential health tools as a common good. This is not only because the pharmaceutical economy is deeply subsidized by public money and insurance systems, but also because, as is made obvious right now, in New York, in Madrid, and elsewhere, the health of the public should be a matter of public concern.
MSF is deeply concerned about access to tests and to any forthcoming drugs and vaccines for COVID-19 in places where MSF works and in other countries affected by this pandemic. Unless we build a public health system based on global solidarity in which every life counts, no-one will be safe from this or other illnesses. This is why we are urging governments to change the rules: put health before profits, access before patents, transparency of prices and costs before trade secrets, organize a collective governance instead of the unilateral control over knowledge and resources by large companies. This is required to ensure that we have the health tools we need, available in every continent, and affordable.
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