Cost Shouldn’t be a Barrier for Access to Essential Medicines

Dave Ross, ScD, President and Chief Executive Officer, The Task Force for Global Health

Dave Ross, ScD, President and Chief Executive Officer, The Task Force for Global Health

By Dave Ross, ScD
President and Chief Executive Officer
The Task Force for Global Health

Most people in the world do not have access to medicines available to people in the United States and Europe. As many as 6 billion people cannot afford drugs that we take for granted in the United States such as beta blockers to control hypertension.

At The Task Force for Global Health, we seek social justice and health equity through our programs – that is, we believe all people should have access to the means for good health including essential medicines and vaccines. Our pharmaceutical partners also share in a commitment to access. While these values are important to us all, we must acknowledge that pharmaceutical companies are accountable to their shareholders and must be able to return a profit on their products.

Our programs to eliminate a group of infectious diseases called the neglected tropical diseases (NTDs) depend on significant drug donations from pharmaceutical companies. In 2016 alone, The Task Force received $3.2 billion in antibiotic and antiparasitic medicines for the elimination of three NTDs – trachoma, river blindness, and lymphatic filariasis – that currently burden hundreds of millions of people mostly in developing countries. These diseases will be eliminated within a decade because of these generous donations.

Drug donation models work well for diseases like those NTDs that can be eliminated through mass treatment of entire populations. People burdened by NTDs cannot afford to buy medicines that prevent and treat these infections. Pharmaceutical companies have recognized their moral and ethical imperatives to donate their products to NTD elimination programs. But these donations can end after these diseases have been eliminated, which ensure that companies don’t have to give away their products indefinitely.

The drug donation model, however, is not sustainable for chronic diseases such as hypertension that require people to take medicines for life. Different business models are needed that protect the financial interests of pharmaceutical companies while ensuring medicines are affordable to people who need them.

MDA photo

A child takes antibiotic during a mass drug administration in Malawi for the elimination of trachoma.

The Clinton Foundation successfully tackled the issue of access to HIV medicines, which were originally prohibitively expensive to most people outside of the United States and Europe. The foundation negotiated deep discounts on these drugs with pharmaceutical companies with the promise that they could make up for lower profit margins by selling more medicine than they might otherwise. From 2002 to ’10, the annual cost of HIV medicines dropped from $10,000 to $200 or less per person annually. This approach has helped ensure an estimated eight million people in developing countries have access to antiretroviral medications.

Gavi, The Vaccine Alliance, has used differential pricing models to increase access to vaccines for people in low- and middle-income countries. Gavi also negotiates deep discounts with pharmaceutical companies for vaccines, which they in turn sell to countries based on their abilities to pay. Pharmaceutical companies offset the costs of selling discounted vaccines by selling vaccines to high-income countries at market prices.

Differential pricing holds tremendous promise for ensuring people in developing countries can access medications for controlling hypertension, diabetes, and other chronic diseases. But there is need for more innovation in pricing approaches. This will become a more pressing issue over the coming years as the prevalence of chronic diseases continues to rise in developing countries and the corresponding need for these medicines increases.

The Task Force is committed to helping identify new approaches for increasing access to essential medicines. In the future, we plan to host a workshop of thought leaders from the global health community and pharmaceutical industry to discuss the state of this issue and begin to identify new approaches that could be useful going forward.

We must take steps to assure that cost is not an insurmountable barrier for people to access essential medicines. Health is a human right.

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One year later: Zika reflections and a look ahead

Lisa Splitlog (1)By Lisa Splitlog, director of communications at the CDC Foundation

Just over one year ago, the Centers for Disease Control and Prevention (CDC) activated its Emergency Operations Center to fight Zika, which is one of the most complex outbreak responses in the agency’s history. The World Health Organization ended Zika’s designation as a public health emergency of international concern in November 2016, announcing that Zika will require a longer-term approach to fight the virus. For CDC, which has assigned numerous disease detectives, mosquito control researchers and birth defects experts constantly since the outbreak began, the response shows no signs of slowing down. Continue reading

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Georgia Can Have An Even Greater Impact on Global Health

Russell M. Medford MD, PhD Vice-Chairman, Georgia Global Health Alliance Managing Partner, Salutramed Group

Russell M. Medford MD, PhD
Vice-Chairman, Georgia Global Health Alliance
Managing Partner, Salutramed Group

Georgia has a rich constellation of organizations working to solve large-scale health problems around the world. With the support of the new Georgia Global Health Alliance (GGHA), these organizations are now poised to have an even greater impact on global health. Continue reading

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One treatment at a time…

Dale Hanson Bourke

Dale Hanson Bourke

By: Dale Hanson Bourke

Mafraq, Jordan-The clinic waiting room was already filling up when the young woman walked in, carrying a baby in one arm and holding the hand of a little girl. She looked exhausted and the baby was whimpering as the little girl coughed heavily. Clearly, the entire family was very ill.

A volunteer from the Syrian American Medical Society (SAMS) took the woman’s information and found her a seat, then let the pediatrician know about the baby. As the woman waited I tried to entertain the little girl.

_D3_5861-2I had come to Jordan with medications from MAP International for Syrian refugees—the $6 billionth donation of medicines to those in need since MAP’s founding. Working with the doctors from SAMS, we set up the pharmacy in a small clinic in Mafraq, Jordan, a border town that had doubled in size because of the refugee population. As the doctors saw patients, I did my best to assist them as I could.

As I played with the little girl, another volunteer filled out more background information. The woman explained that she had been a kindergarten teacher in Syria and had also been studying for an advanced degree when the war broke out.  She and her husband fled with their little girl over the border to Jordan but by the time they arrived the refugee camps were full. They were doing their best to survive, but her husband couldn’t find work so had left to find a job in another part of Jordan, leaving her with the children.

_P5R3970The pediatrician was finally able to examine the baby and found, in addition to her cold and ear infection, she was suffering from severe diaper rash. The young mother explained that she had little money to buy diapers so she could only change the baby once during the day and again at night. It was a common story among the refugees who brought their babies in to the clinic. Diapers had become a luxury.

Examining the little girl, the pediatrician diagnosed a respiratory infection and said she needed both cold medication and antibiotics. Then the pediatrician told the woman that she, too, needed to be examined. She seemed hesitant until I gestured that I would hold her baby and play with her little girl. She thanked me and handed over her baby.

After an internist examined the woman she noted that the entire family had a respiratory infection and all needed medications. I was grateful that we had stocked the pharmacy with both children and adult cold medications as well as antibiotics.

_D3_5780When I handed her baby back to the woman, I saw that she had prescriptions for every member of the family. But instead of walking toward the pharmacy, she began to walk out the door. Thinking she was confused, I pointed at the prescription forms and then to the pharmacy.

She looked at me sadly and shook her head, holding out her hand as if to say, “I have no money.” I quickly grabbed a volunteer who could explain the medicine was donated and was free. As the volunteer spoke to the young mother, her eyes widened. She looked at me as if to confirm what she had been told. Then she grabbed me and kissed me on both cheeks. “Shukran! Shukran!” she said, with tears in her eyes.

As she left the clinic, the young mother was smiling. While the medicines were part of MAP’s historic $6 billion donation, for this woman, the medicine represented health and hope for her family.

 

Click to donate to MAP International’s Syrian Refugee campaign: https://www.map.org/refugees

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CDC Foundation Honors Outgoing CDC Director Dr. Tom Frieden

Doug Nelson, chair of the CDC Foundation’s board of directors and the retired president and CEO of the Annie E. Casey Foundation

Doug Nelson

By Doug Nelson, chair of the CDC Foundation’s board of directors and the retired president and CEO of the Annie E. Casey Foundation

Inspiring leaders are essential to the success of organizations, but they are hard to find, especially those able to run a complex organization with responsibility for the health, safety and security of all Americans. During the past eight years, the Centers for Disease Control and Prevention (CDC) has been fortunate to benefit from an outstanding leader, Tom Frieden, who left the agency last week with the transition of presidential administrations.

True leaders have many attributes, with characteristics like intelligence, experience, vision, commitment and drive coming to mind. But leaders also require the courage to take difficult stands on issues and tell people news they need to have but may not want to hear. These conversations become more challenging when topics are personal, and perhaps nothing is more personal than the health of our families and friends or ourselves.

Frieden-FundCDC is our nation’s health protection agency, and CDC’s scientists and disease detectives work in this country and around the globe to track diseases, research outbreaks and respond to emergencies of all kinds. From what they learn in this work, CDC’s team promotes health policies that strengthen America′s health and security. CDC’s pronouncements, including those of its director, carry considerable weight. Tom has fully embraced this responsibility, leading CDC with determination and conviction backed by the agency’s outstanding scientists and professionals.

I’ve had the privilege to get to know Tom personally through my involvement at the CDC Foundation, first as a board member for many years and now as board chair. It has been an honor for the CDC Foundation to work with CDC during Tom’s tenure on scores of programs aimed at extending the agency’s life-saving work to protect the health of all Americans. These efforts cover health threats as diverse as Ebola and Zika to smoking use and birth defects.

I saw firsthand the many gifts Tom brought to his role as director of CDC. The contribution I most admire has been his ability to inspire those around him, including all of us at the CDC Foundation, with his conviction and faith that public health, when executed properly, is a powerful and essential tool to ameliorate human suffering, build stronger communities and save lives. The accomplishments of CDC during the past eight years have validated Tom’s faith and belief in the critical importance of sustaining a robust public health capability in this country. Furthermore, those achievements have increased public awareness of CDC and the importance of its core mission. While Tom’s tenure at CDC has come to an end, the example of his leadership in defending the health and safety of Americans will live on beyond his time at the agency.

One of Tom’s greatest passions at CDC has been his support for activities to grow and strengthen the public health infrastructure and the next generation of its leaders. This is a critically important objective. In fact, the United States is in the midst of a public health workforce crisis. By some estimates, more than 250,000 additional public health workers are needed to maintain current capacity. The CDC programs with the most profound impact related to meeting this challenge are the Public Health Associate Program (PHAP), the Epidemic Intelligence Service (EIS), and the Laboratory Leadership Service (LLS) fellowship program, all of which are pipelines into the field of protecting the public’s health.

DrFriedenCDCOn behalf of the board of directors and staff of the CDC Foundation, we thank Tom for his leadership guiding the agency and the nation’s response to threats, and I’m pleased to announce that we will honor his work and legacy through the creation of the Tom Frieden Future Leaders Fund. This fund will raise support to extend and strengthen the PHAP, EIS and LLS programs, with donations being used to help enhance program curricula and recruitment efforts; enable involvement in emerging outbreaks for EIS teams; engage additional expert faculty; and increase partnerships to connect graduates with public health job needs.

Also, the Foundation is providing what we hope will accelerate this fund with an initial $20,000 contribution. More funds are needed, and we hope to bring in support from individuals, philanthropies and the private sector to help extend these programs.

Please join us in congratulating Dr. Tom Frieden and thanking him for his remarkable service to our nation. You can honor Tom with a donation to the fund or leave him a personal message.

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Reflections on a Journey to Liberia

By Steve Stirling, President & CEO of MAP International

MONROVIA, Liberia — I’ve been to a number of countries in Africa over the past 15 years, but this was my first visit to Liberia.  Liberians are resilient and gracious people.  They have prevailed against more than 12 years of civil war which tore apart the country, including the health systems.  In 2005, Liberians elected their first woman president, Ellen Johnson Sirleaf. She has dedicated herself to rebuilding the country. Continue reading

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Reflecting on 2016

Dr. Judy Monroe is president and CEO of the CDC Foundation.

Dr. Judy Monroe is president and CEO of the CDC Foundation.

By Dr. Judy Monroe, president & CEO of the CDC Foundation

December is a great time to reflect on the past year. By almost any measure, 2016 was eventful, with triumph as seen in the Summer Olympic Games and tragedy in the form of terrorist attacks in the United States and around the globe. But as I reflect on the past year and my first 10 months leading the CDC Foundation, I think about all I am thankful for. Continue reading

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After Divisive Election, Charity can Play Unifying Role

Tolli Love, CARE’s vice president of fundraising and marketing

Tolli Love, CARE’s vice president of fundraising and marketing

By Tolli Love, CARE’s vice president of fundraising and marketing.

Following a divisive presidential campaign, many Americans are answering the election negativity in a very positive way: by increasing their charitable support. The campaign surfaced the passions of many Americans, on issues ranging from immigration and refugees to the status of women and America’s role in the world. We immediately saw news reports on donations pouring into some groups, particularly those focused on the environment or women’s issues.

A new CARE survey indicates this is more than a small, fleeting trend. One in four Americans either already has increased or plans to increase support for nonprofits and charities as a result of the U.S. presidential election, according to the online survey of 2,054 adults conducted for CARE Nov. 28-30 by Harris Poll.

Among those ramping up their support, more than half (52 percent) say they  are doing so because it’s one way they can effect change after the election. Many (41 percent) see increased charitable support as a way to assure the U.S. remains engaged in the world. And 40 percent say they believe their favorite nonprofit or charity is under threat.  Whatever the reasons, channeling all that passion and energy into charities and nonprofits is a really positive way to move forward on the issues people care deeply about.

The survey indicates that the largest share of increased support is going to children’s charities, followed by groups supporting women’s reproductive rights/family planning, environmental protection and women’s empowerment and women’s rights. Groups focused on health care, LGBTQ rights, race relations and international humanitarian aid/global poverty also were high on the list.

CARE’s work to empower women and girls around the world overlaps with a lot of these issues, and, though it’s still early, we’ve seen signs of increased support this giving season, including through a new campaign called #DreamWithHer. It fosters a personal connection by linking people here via social media with girls in Malawi who benefit from CARE’s poverty-fighting work. By “dreaming with her,” supporters have interacted with the girls — Evelesi, Maliyana and Alinafe — asking questions about their life in Malawi and learning of their dreams for a brighter future in southern Africa. “Their energy, hope and optimism inspire me,” said CARE President and CEO Michelle Nunn after meeting the girls in person during a recent trip to Malawi. Our donors apparently feel the same, as many have enriched that connection by purchasing items from an associated gift catalog, whose proceeds support programs that help girls like Evelesi, Maliyana and Alinafe.  

Yet, as our survey indicates, it’s not just financial gifts that Americans say they are increasing; it’s also time volunteering or advocating for a cause. And we’re seeing this at CARE, too. Our advocacy network of more than 270,000 people, called CARE Action, is currently advocating for policies that empower women globally and has seen a surge of interest and engagement in this issue since the election. The number of “likes” on the network’s Facebook page has jumped by more than 20,000 since the election.

Perhaps the most encouraging revelation in the survey is that Millennials and younger GenXers are leading the trend in increased charitable support. Although young adults have been criticized for not playing a larger role in the political process, our survey indicates that the election has spurred them into action, via charitable giving, volunteerism and time spent advocating for causes they care passionately about. Even more importantly, Millennials were twice as likely as those 35 and older to say they want to work with those of different political views to solve the world’s most pressing problems. And that bodes well for our country’s future.

Starting with the delivery of more than 100 million CARE Packages after World War II, CARE has always united Americans behind the cause of helping those most in need around the world. And, at a time when the U.S. is so divided, we are ready to play that role again.

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Campaign Empowers Puerto Rican Women, Communities to Stop Zika

Lisa Splitlog, Director of Communications for the CDC Foundation

Lisa Splitlog, Director of Communications for the CDC Foundation

By Lisa Splitlog, Director of Communications for the CDC Foundation

Dr. Christine Prue spent 75 days on the ground in Puerto Rico earlier this year, leading a team that interviewed hundreds of pregnant women to gain insights into their perspectives about Zika. Christine, associate director for behavioral science for the National Center for Emerging and Zoonotic Infectious Diseases at the Centers for Disease Control and Prevention (CDC), discovered that while many Puerto Rican women are challenged by their difficult circumstances, they remain resilient, strong and optimistic. Continue reading

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Partnering to Save Lives

By Jodi Allison

At MAP International, we concentrate much of our efforts on medicines that benefit those without access to the most needed life-saving drugs, such as antibiotics and oral rehydration salts. But for those living in resource-poor countries who suffer from more rare diseases, we also work directly with pharmaceutical partners to meet specific needs. One example of this is the Jimenez family. Continue reading

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