Progress in the Access to Essential Quality Medicines in 2010

Positive developments

Looking back at what has happened in 2010 regarding access to medicines, vaccines and diagnostics, a number of positive developments have taken place, together with some negative trends. We offer you some of these meaningful events.

 

 

A Meningitis-A vaccine tailored
to the medical needs of
Africa

A new, highly-effective vaccine against one of the most fatal forms of meningitis in Africa was launched in 2010. It was developed not by a big pharmaceutical company, as most vaccines do, but thanks to a partnership between the non-profit organization PATH and the Serum Institute of India. Both institutions made sure that the vaccine would both meet the needs of people in Africa and be affordable for governments in the continent. This is a new avenue that could be used for other problems. By providing long-term protection against the disease being passed from person to person, the new meningitis A vaccine will effectively prevent epidemics to begin with.

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A new test for tuberculosis became available in 2010

A new test for tuberculosis that became available in 2010 will make possible diagnosing a curable disease that kills nearly two million people every year much faster, easier and more precise. This will help TB patients to have the right diagnosis and be able to be treated, instead of what is happening currently that many die untreated.

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The Medicines Patent Pool

The Medicines Patent Pool was created and received official backing in 2010. If medicine companies that own patents on key AIDS medicines are genuine about wanting to boost access to newer medicines, they must license the patents that are actually blocking generic production and put them on the pool. This will make a real difference to people’s lives.

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Improved treatment for severe malaria saves lives

Malaria research in 2010 in nine African countries has shown that treating children suffering from severe malaria with injections of artesunate instead of quinine could save many children’s lives.  High-quality artesunate is now available from reliable sources that have been validated by the World Health Organization (WHO). Artesunate should be used to treat both adults and children with severe malaria so that many more lives can be saved. Most countries have yet to recommend artesunate in place of quinine for either adults or children. And international donors have yet to put their full weight behind the latest evidence.

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New GPHF-Minilab in Cameroon,
a Protection Against Counterfeit Medicines

In December 2010, Difaem, the German Institute for Medical Mission , provided the Cameroon Baptist Church (CBC) with a new complete minilab system against counterfeit medicines. In many African countries more than 30% of the medicines on sale can be counterfeit of fake, and the number is increasing. This constitues a serious health risk as it poses a danger to human live.  Today drug quality control in the distribution systems of Africa has become more and more important for consumer protection. Pharmacopoeial analyses are very expensive and only a few centers of excellence in Africa are currently available to perform them. In order to bridge the capacity gap in medicines quality monitoring in African countries and in order to overcome limited access to regular medicine quality testing, the Global Pharma Health Fund (GPHF) set out to develop and supply inexpensive field test kits with simple test methods for rapid drug quality verification and counterfeit medicines detection. Cameroon disposes now of one of those minilab-kits.

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Light at the end of the tunnel of neglected tropical diseases

In 2010, southern Sudan and surrounding countries had the biggest visceral leishmaniasis (Kala azar) outbreak in eight years. This highlighted the urgent need for newer, better medicines to treat neglected tropical diseases in developing countries. The main challenge for pharmaceutical companies with producing new drugs for Neglected Tropical Diseases is the cost. Less than 1 % of the nearly 1,400 drugs registered between 1975 and 1999 were for tropical diseases. The good news is that there is growing awareness of the problem internationally, and an increased focus on eliminating the diseases.

Since 2003, the Neglected Diseases initiative (DNDi) has successfully delivered two antimalarial products in 2007 and 2008 and it intents to deliver six to eight new treatments for malaria, visceral leishmaniasis (VL), sleeping sickness (trypanosomiasis), and Chagas disease by 2014 and to establish a strong R&D portfolio. .In 2010 the WHO launched the first report on Neglected Tropical Diseases“ Working to overcome the global impact of neglected tropical diseases”

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Hindrances in access to quality medicines

HIV/AIDS progress blocked

New treatment recommendations for HIV patients reinforce the need to treat people earlier and with better medicines, both to prevent them from becoming severely ill, and to help reduce transmission of the virus among the population. Despite this evidence, donors are turning their back on AIDS diminishing HIV funding. This will mean treatment delays, deferral, or denials. The main funding organizations for HIV treatment (Global Fund and PEPFAR) in December 2010 rejected treatment proposals in high-burden countries, including Malawi, Swaziland, and Mozambique. This comes after a decade of progress, with five million people on treatment today.  As funding for global HIV/AIDS stagnates, and the price of needed newer drugs is on the rise, this very progress is at risk. A further ten million people are in urgent need of treatment and will die within the next several years if left untreated.

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Europe Threatens to Shut Down India’s Role as ‘Pharmacy of the Developing World’

Most medicines used to treat people in Africa are good quality generics from India. Most treatment programs paid for by international donors rely also on affordable Indian medicines. The European Union is pursuing a free trade agreement with India which will restrict Indian drug producers from making affordable and good quality generic medicines.  AEFJN has participated in MSF campaign ‘Europe! Hands Off Our Medicines’ with the goal of getting the EU to take out patents and data exclusivity for generic medicines.

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The Fight Against Fake Medicines deviates

The Fight Against Fake Medicines deviates in a fatal confusion between fake medicines and generics. Fake medicines, which make false claims about what they contain or where they are from, represent a real problem. In 2010, a number of initiatives that claim to deal with this problem have gone off course by taking a trade approach of enforcing Intellectual property rights, to what is first and foremost a public health problem. So instead of actually dealing with the danger of fake and substandard drugs, they end up by punishing access to quality generic medicines, as they equate generics with fake, what is completely wrong. These measures are not only an inadequate solution to fake drugs, but what is worse, they are detrimental to public health, making it more difficult for patients to have access to safe, quality and effective medicines. In many cases they

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The number of victims to counterfeit drugs increases

The World Health Organization (WHO) estimates that up to 30% of the medicines on sale in many African countries are counterfeit and have found that nearly half of the drugs sold in Angola, Burundi, and the Congo are substandard.

Fake tuberculosis and malaria drugs alone are estimated to kill 700,000 people a year. A large part of these victims are African.

 In 2003, Interpol, an international police organization, conducted a survey on the quality of drugs available in Lagos, sub-Saharan Africa's most populous city and found that 80 percent of the drugs available were fakes. In 2008, more than 80 children in Nigeria died after being given medicine for teething pain that was laced with antifreeze.

Fake medicines can be missing key ingredients, use the wrong ingredient, or have insufficient or too much of the active ingredient. In some cases, use of these medicines can increase drug resistance. When there is not enough of the active ingredient, the drug kills some of the parasites or viruses, but the pathogens that are not killed adapt. As time goes on, even if a patent was to be treated with the correct medication, he or she would not be cured.

The development of germs resistant to antibiotics and other treatments is a problem that affects all humanity, not just Africans. It is therefore in the best interest of all concerned that smuggling of counterfeit drugs be fought against.

Lack of progress in the 2010 year of Medicines

The 2010 review done Prescrire confirms the lack of medicinal evaluation that has left too many patients exposed to therapeutic regressions. Prescrire also deplores the lack of progress for patients and too many drugs to be avoided. In 2010, 97 new drugs or indications of existing drugs have been quoted by Prescrire. Of these, only 4 make a significant break-through in the care, while 19 others have been authorized despite an unfavorable risk-benefit balance. Firms recycle old materials in the form of fixed-dose combinations or new routes of administration. Their evaluation is often insufficient and the progress made is modest. Drug agencies are mandated to protect patients, but they are too often influenced firms, making their decisions timid in terms of withdrawal.

 

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