Spotlight on Access to essential drugs

You are in Malawi. A mother with a young child has made a long journey on foot to get to the nearest health centre. The child has tuberculosis and needs a course of antibiotics. But the clinic has run out. The nurse tells the mother to come back tomorrow. They have no medicine left today; the chance of there being any medicine tomorrow is small, perhaps nil.

The Commission for Africa, brought together by Tony Blair in 2004, identified the need for a predictable supply of affordable drugs and vaccines. A key recommendation was to give drug firms incentives to investigate diseases that affect Africa, where average spending on health per person in 2001 was no more than $21 (£11; €16).1 Just 10% of total spending on health research is on diseases that make up 90% of the global burden of disease.2 Drugs to be developed are chosen for possible future profit not concern for global public health. Between 1975 and 1997 only 13 new drugs were developed for neglected diseases. Peter Ringrose, chairman of the Biotechnology and Biological Sciences Research Council, says that there will always be a bias towards research for diseases found in countries that can afford to buy the drugs.

Marcia Angell, former editor in chief of the New England Journal of Medicine and currently at Harvard in the department of social medicine, has written a damning exposé of the industry, The Truth About the Drug Companies.3 In an interview she explains that “big pharma” does not make much money in the developing world: “Their major profit centre is the United States. Pharmaceutical companies are businesses and their fiduciary responsibility is to maximise the value of their shareholders' stock.” She …