[Ip-health] Seminar "Drugs: cure or curse", Brussels (Belgium Network-MSF-B), December 3 2007

[Alexandra HEUMBER]

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Dear all,=0D
=0D
Please find below the agenda of a seminar organised in Brussels on=0D
December 3rd, by the belgium network Be-Cause Health. The seminar focuses=
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on 3 main issues:=0D
=0D
Research and Development- with a special focus on the WHO IGWG on Public=0D
health, Innovation and Intellectual Property=0D
Quality of medicines=0D
Appropriate delivery corresponding to the patients=E2=80=99 needs=0D
Cost of medicines and financial access:=0D
=0D
Best regards=0D
=0D
Regards,=0D
Alexandra=0D
=0D
=0D
=0D
Please find below the description of a seminar organised by Be-Cause=0D
Health in Brussels on December 3.=0D
More information available at:=0D
http://www.be-causehealth.be/becausehealth/Site/Default.asp?WPID=3D181&MIID=
=3D163&L=3DE=0D
=0D
Note that the amount of places is limited and that registration should be=
=0D
done by writing to:=0D
Ellen Coeck : ecoeck@itg.be or Fiona Robertson : frobertson@itg.be=0D
=0D
(please indicate name / organisation / function)=0D
=0D
Participation: 15 euro to be paid on the spot=0D
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                        Access to Quality Medicines for Patients in=0D
Developing Countries=0D
                                        =E2=80=9CDrugs: Cure or Curse?=E2=
=80=9D=0D
                                December 3, 2007 - Brussels=0D
=0D
=0D
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Seminar description:=0D
=0D
The issue of access to medicines of quality for patients in developing=0D
countries has been discussed on numerous opportunities these last years:=0D
high prices of drugs in the context of HIV/Aids, the need for Research and=
=0D
Development (R&D) to address neglected diseases and tuberculosis, the=0D
problem of counterfeiting of essential medicines and the question of how=0D
much money is needed and who should pay for it all. Meanwhile, new R&D=0D
=E2=80=9Cprivate public partnerships=E2=80=9D and international initiatives=
 for funding=0D
and procuring medicines for the =E2=80=9Cbig three diseases=E2=80=9D HIV/Ai=
ds, malaria and=0D
tuberculosis have been created, as well as the WHO pre-qualification=0D
project. The last two have a concrete impact on procurement systems.=0D
Many steps and factors will determine whether a patient eventually has=0D
access to the medicine he needs and looking into all of them in detail=0D
would require several days. Some factors in this process have seen a=0D
certain evolution these last years though, and are at the centre of=0D
political debates that look into new ways to address them. The annual=0D
seminar of Be-cause Health1 intends to address a selection of these=0D
topics.=0D
=0D
Objectives of the seminar=0D
o To present some of the persistent bottlenecks in the field of medicines=
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taking into account the evolution of the recent years and present=0D
potential new ways forward=0D
o to discuss the challenges ahead=0D
o to sensitise Belgian and international policymakers as well as other=0D
stakeholders=0D
o to favour interaction between existing networks=0D
=0D
Expected results=0D
o the participants have a clearer global understanding of the issues at=0D
stake=0D
o the actors involved in access to quality drugs in developing countries=0D
are sensitised on the issues=0D
o the discussions and conclusions will feed the work agenda of the=0D
Be-cause Health platform.=0D
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The programme of the seminar=0D
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=E2=80=A2 Research and Development:=0D
Before anything else, drugs first need to be discovered. It is now=0D
recognised that there is a lack of R&D answering in an adapted way to the=
=0D
specific needs of the patients of the South. Only one percent of the=0D
medicines put on the market these last decennia are for tropical diseases.=
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A specific inter-governmental working group (IGWG) has been set at the WHO=
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to propose a =E2=80=9Cglobal strategy on public health, innovation and=0D
intellectual property aiming at providing a medium-term framework for an=0D
enhanced and sustainable basis for needs-driven, essential R&D relevant to=
=0D
the diseases that disproportionately affect the developing countries=E2=80=
=9D=0D
=0D
Questions to be addressed:=0D
- What needs to be done concretely about the lack of appropriate R&D?=0D
- What is the role of the states?=0D
- Is the concept of new public private partnerships the answer?=0D
- What are the alternatives?=0D
=0D
Panel:=0D
- A representative from the Belgian government will talk about the IGWG=0D
process at the WHO.=0D
- A representative from a PPP will present her/his view=0D
- The debate will be triggered by a representative from civil society=0D
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=E2=80=A2 Quality of medicines:=0D
Once drugs exist, they may be available from different sources, and the=0D
issue of selection arises. The pharmaceutical sector is a very profitable=
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one and - old or new - medicines are now being produced all over the world=
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to answer to the needs of the markets. Regulation regarding these products=
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vary greatly though, and the complicated production process of medicines=0D
means that important technical and financial means are necessary in order=
=0D
to assess the quality of products as required. Since 2001, the WHO has set=
=0D
up the WHO pre-qualification project which ensures the evaluation of=0D
quality, safety and efficacy of medical products for HIV/AIDS, malaria and=
=0D
tuberculosis. It is used as a reference for numerous international funding=
=0D
initiatives. Nevertheless, ensuring access to quality medicines in=0D
developing countries still often implies a conscious way of assuming a=0D
certain risk management.=0D
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Questions to be addressed:=0D
- What have been the main evolutions of the pharmaceutical market?=0D
- What challenges and problems does it raise?=0D
- How can authorities from developing countries ensure the quality of the=
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products on their markets?=0D
- What do they need for that?=0D
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Panel:=0D
- AEDES will present a summary of the evolution of the pharmaceutical=0D
market and its consequences=0D
- A representative of a drug regulatory agency of the South will share=0D
her/his approach and the challenges faced=0D
- A representative of the EMEA will explain the role that this institution=
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can play in supporting developing countries=0D
- The debate will be triggered by a representative from the WHO=0D
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=E2=80=A2 Appropriate delivery corresponding to the patients=E2=80=99 needs=
:=0D
Ensuring the drugs are in the country is only a part of the process.=0D
Procuring medicines corresponding to the needs of the population is a=0D
complicated step in the process that leads to different situations on the=
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ground: international funding has created situations where too many drugs=
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are procured by too many sources for HIV/Aids, lack of appropriate needs=0D
calculation and /or funding leads to stock outs of ACT for malaria, etc.=0D
International agencies are also often involved in procuring medicines in=0D
developing countries which brings up other challenges. At last, the=0D
rational use or not of the medicines at health structure level itself will=
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in turn impact the predictability of needs in calculation and procurement.=
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Questions to be addressed:=0D
- What problems do national and regional pharmacies face when distributing=
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drugs and equipment to the health centre network?=0D
- How to address the challenges of needs in calculation and of rational=0D
use of medicines at service delivery?=0D
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Panel:=0D
- A representative of a procurement agency from a developing country will=
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present the challenges of efficient procurement from a national=0D
perspective=0D
- An international agency representative will discuss the challenges of=0D
efficient drug procurement from its perspective=0D
- The rational use of medicine=E2=80=99s today will be presented by the Ant=
werp=0D
Tropical Institute=0D
- The discussion will be triggered by a representative from WHO=0D
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=E2=80=A2 Cost of medicines and financial access:=0D
Whatever medicines are selected and distributed, they need to be paid for,=
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at one level or the other. The latest drugs that have been brought on the=
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market and that are needed as well in developed as in developing=0D
countries, present an important problem: they are very expensive. The=0D
HIV/Aids epidemic has acted as a magnifying glass and illustrates the=0D
difficulties in accessing new medicines. Several approaches are being=0D
implemented to ensure that new and vital medicines are affordable: the=0D
review in interpretation of trade agreements, voluntary programmes by the=
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pharmaceutical industry, increased and new international funding, public=0D
tenders. For some medicines, prices have dropped drastically or they are=0D
on the market on what can be considered a =E2=80=9Creasonable price=E2=80=
=9D. But if the=0D
prices seem affordable for governments and health implementers it does not=
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mean that they are affordable for the patients...=0D
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Questions to be addressed:=0D
- Are the approaches to ensure the affordability of medicines sufficient?=
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- How well do they work in reality?=0D
- What are the main limits and what should happen to ensure that new=0D
needed medicines are made available in developing countries?=0D
- Who should pay for the costs?=0D
- What impact does asking the patient to pay for access to medicines have=
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on the efficiency of health programmes?=0D
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Panel:=0D
- MSF will review and share its experience on the use of the different=0D
alternatives to access new quality medicines and make it available for the=
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patients.=0D
- A donor representative will explain her/his approach on ensuring access=
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to affordable medicines for developing countries and for the population=0D
- A representative from a developing country will present the challenges=0D
they are faced with=0D
- The debate will be triggered by a representative from a Southern country=
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civil society group working on these issues=0D
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A final debate with representatives from the Belgian government, the donor=
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community, a representative of a developing country and of the Be-cause=0D
Health group on medicines will conclude the day.=0D
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