World Health Assembly 2019: No universal health coverage without better access to medicines, health ministers say

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Science Speaks is in Geneva this week covering the 72nd session of the World Health Assembly, May 20-28.

GENEVA – The vision of universal health coverage dominates the discussions at the 72nd World Health Organization gathering, to the point that initials are considered sufficient — UHC — to argue its importance. Still, the goal remains far out of reach without greatly improved access to medicines, diagnostic tools and vaccines, health ministers said here today.

More than 100 million people fall into poverty every year due to high out-of-pocket costs for drugs and other healthcare services, Dr. Mariangela Simao, assistant director general of the WHO said. “We must not forget that medicines are public goods necessary for protecting health and promoting human rights,” she said, adding, “Promoting better health of people and communities should be the main motivator in the development of new drugs.”

Current market structures for drug development and sales are imbalanced, Dr. Armando Bartolazzi, Undersecretary of State for Health in Italy, said.

Between 30 and 40 percent of all financing for health research and development comes from the public sector, Bartolazzi said. That, he added, entitles taxpayers to better access to the commodities being developed with their tax money.

“Better access to generic drugs will be instrumental for universal health coverage,” he said, “especially in low- and middle-income countries where expenditures for medicines account for a huge share of health expenses.”

Affordability is not only a problem for low- and middle-income countries, Soonman Kwon of Seoul National University said. High-income countries are often forced to pay high prices for antiretrovirals for HIV treatment, drugs for cancer treatment and other chronic conditions, Kwon said.

Market withdrawal is another factor that impacts access, Kwon said. “Multinational companies often stop domestic drug supplies in a bid to raise prices, which endangers patients’ access to essential medicines,” he said.

Health ministers called for greater transparency from countries on how much they’re paying for drugs, with a first step of eliminating nondisclosure agreements pharmaceutical companies require countries to sign when they procure drugs.

Insufficient evidence of the benefits of some high-priced medicines is a huge issue, Kwon said, adding that research shows marginal or no additional therapeutic benefits to patients – especially when it comes to cancer and orphan disease drugs, he said. Lack of information and transparency on the effectiveness of new drugs forces countries to accept high prices for drugs with low benefits, Kwon said.

Even access to low-priced, but critically needed drugs is no longer a certainty, Bruno Bruins, Minister of Health in the Netherlands said. “Some antibiotics are manufactured at a single site,” he said. “It is worrisome that the entire world depends on one site for a needed antibiotic,” he said.

Rabita Aziz is senior global health policy specialist at the Infectious Diseases Society of America, which produces this blog.

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