GHF2006 – LS01- Improving Access to Quality Medicines: Health Partnerships for the Developing World and the Fight against Counterfeiting

Session Outline

Lunch Session LS01, Wednesday, August 30 2006, 16:00-17:30
Chair(s): Eric Noehrenberg, International Federation of Pharmaceutical Manufacturers and Associations, Geneva, Switzerland
Anna Wang, Medicine for Malaria Venture, Geneva, Switzerland
Dirk Engels, Department of Neglected Diseases, World Health Organization, Geneva, Switzerland
Julian Morris, International Policy Network
Tesfamicael Ghebrehiwet, International Council of Nurses, Geneva, Switzerland

Session Report

Submitted by: Caroline Rheiner (ICVolunteers); Contributors: Martin Elling (ICVolunteers), Marie Mac Gehee (ICVolunteers), Tatjana Schwabe (ICVolunteers)

Image: Jorge Garbino, ICVolunteers.org

The availability of quality and non-counterfeit drugs is an essential part of any health care delivery service. This session presented the audience with information related to the expansion of private-public partnerships (PPPs) for the development of safe drugs and of drugs for neglected diseases. The speakers also pointed out the danger of counterfeit drugs and the efforts undertaken to combat this serious and life threatening menace.

Dr. Eric Noehrenberg, Director, International Trade & Market Policy, Partnerships and Public Health Advocacy, of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), opened the symposium with a presentation on neglected diseases.

Dr. Noehrenberg reminded the audience that today, more than 65 million people are infected with HIV/AIDS and that 95% of them live in developing nations. Although 23 drugs have been developed since 1987, HIV/AIDS, TB and Malaria together kill more than 20,000 people each day. The research-based pharmaceutical industry has recognized the issue and has developed a business model with the following key elements:

Preferential pricing, such as "not-for-profit" pricing, and also major donation programs for drugs in well over 100 countries as well as community investment, in many countries. Commitment to innovative partnerships that include for example voluntary licensing granted for medication for HIV/AIDS or multi-drug resistant TB. IFPMA Members also promote research and development (R&D) into vaccines for neglected diseases through Public-Private Partnerships (PPPs). Today, an unprecedented level of research has been stimulated to develop badly needed new drugs for diseases such as Chagas' disease, African trypanosomiasis, onchocerciasis, leishmaniasis, schistosomiasis, leprosy, lymphatic filiriasis, Dengue fever, Guinea worm and blinding tracoma. According to the London School of Economics (LSE), the PPP model is working and the landscape of R&D into these diseases has been transformed. Today, there are already 63 new drug projects for neglected diseases, excluding HIV/AIDS.

Dr. Noehrenberg concluded that PPPs are successful but require additional resources. Well funded PPPs can bring the expertise of a range of partners together and create an innovative environment well beyond what individual partners would be capable of alone.

Ms. Anna Wang of the Medicine for Malaria Venture (MMV) addressed the positive impact PPPs can have on the fight against malaria. For example, MMV's mission is to discover, develop and deliver safe, effective and affordable anti-malaria drugs. Other PPPs can also play a catalytic and innovative role in the development of affordable drugs. For most local communities, the biggest obstacle is not the lacunae of medication, but political commitment and funding. The pooling of collective knowledge, talent and resources can improve the situation and consequently save millions of lives (http://www.mmv.org/rubrique.php3?id_rubrique=11).

Dr. Dirk Engels, from the Department of Neglected Diseases at the WHO, explained how the best applicable tools for use in the field were those that were simple to detect and administer, and that were cheap and safe. Drugs for most neglected diseases were increasingly available through public-private partnerships, access programmes and donations from pharmaceutical companies and generics but that certain diseases, such as leishmaniasis, African trypanosomiasis, and the bureli ulcer were still lagging behind due to increased drug resistance and the cost or complexity of diagnosing and treating these illnesses. The key to treating neglected diseases lies in a long-term commitment by all stakeholders, especially governments, and through mass interventions like vaccination campaigns, community directed care and door-to-door interventions. This also implies sustained funding and breaking the cycle of insufficient generic production which was caused the lack of market opportunities for this group of diseases. Supplementary information on this subject by Dr. Engels and his colleagues can be found at the following website: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10%2E1371%2Fjournal%2Epmed%2E0030283.

The symposium continued with a presentation by Dr. Julian Morris from the International Policy Network on the dangers posed by counterfeit medicines. Counterfeit medicines are a n important and growing threat to patients' safety. This problem is not restricted to lower income countries, although it is more pronounced there: the percentage of counterfeit and substandard drugs can reach 25% in low and middle income countries (and even 40% in certain Chinese cities). The impact is devastating. For example, the WHO reported that in 1995 more than 2,500 deaths were caused by counterfeit meningitis vaccines. Other risks concern the hazard of increased drug resistance and the increased cost of treatment. A trend is for local communities to return to their traditional medicines as they lose faith in modern drugs.

Dr. Tesfamicael Ghebrehiwet, Consultant, Nursing & Health Policy of the International Council of Nurses (ICN) in Geneva, Switzerland, made a presentation on ICN's efforts to raise awareness of the dangers of counterfeiting in many countries. The ICN takes this issue very seriously. As nurses are the largest group of health care providers who, in addition, are also close to the patient, they are often the first to recognize treatment failure.

It is clear that there is an urgent need to raise public awareness regarding the dangers of counterfeit drugs. This will not only require the education of the general public and the dissemination of information, but will also include the lobbying for fair prices for authorized drugs and the monitoring and reporting of the occurrence of counterfeit drugs. Dr. Ghebrehiwet proposed greater collaboration between a wide range of technical and law-enforcement agencies including the International Federation of Pharmaceutical Manufactures and Associations (IFPMA), Population Services International (PSI) in Washington, the International Alliance of Patients' Organization (IAPO), Interpol and the World Health Professions Alliance (WHPA).

Dr. Eric Noehrenberg, wrapped up the presentations by stating that the IFPMA was working in collaboration with the WHO in order to raise awareness among policy makers, criminalize the production and distribution of counterfeit goods, allocate greater resources to curb the threat caused by such deleterious activities, tighten the screening and control of the supply chain, and increase interdisciplinary and international collaboration in the sustained fight against piracy, which has become a "public health emergency". IFPMA is collaborating with WHO in the IMPACT (International Medical Products Anti-counterfeiting Task Force) initiative and co-sponsored an international meeting in Rome to launch IMPACT. Details can be found at the WHO web site: http://mednet3.who.int/cft/.

Additional information can be found on the following websites: http://www.ifpma.org/pdf/IFPMA_counterfeit_conference_16Feb06.ppt#256,1 and http://www.who.int/bulletin/volumes/84/9/06-010906/en/index.html

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