People’s right to benefit from scientific advances is part and parcel of medical development.
At the end of last year, a deadly outbreak in a remote part of the Democratic Republic of Congo sparked global panic when it was dubbed “Disease X.” The real culprit wasn’t a new mystery illness, but a severe form of a known killer: Malaria complicated by respiratory infections, malnutrition and a lack of access to primary health care services.
The headlines have since moved on, but malaria remains a relentless threat, killing nearly 600,000 people in 2023 — most of them children under 5. That is more than 1,000 young lives lost every day to a disease we know how to treat.
That means that lifesaving medicines still aren’t reaching those in need. To change that, considerations around access must be baked in from the beginning, starting with the R & D phase and through each stage of a medical products’ lifecycle.
The power of early access planning is highlighted in a recent report by Uniting Efforts for Innovation, Access and Delivery, a joint initiative of the Japanese government, the Access and Delivery Partnership led by the United Nations Development Program (UNDP) and the Japan-based Global Health Innovative Technology (GHIT) Fund. For a product to improve people’s health or save lives, R & D funders and innovators must consider its affordability, availability and acceptability. They must also commit to making information and know-how accessible to promote the dissemination of scientific knowledge as well as local manufacturing.
Funders have unique leverage and oversight to ensure innovations are affordable and acceptable. Exercising these privileges in the earliest stages, including by requiring developers to meet cost, ease of implementation and manufacturing standards, can help steer development decisions in a more equitable direction.
Beyond being affordable, medicines and medical technologies must be designed for real-world conditions — otherwise, they risk going unused. For example, cold chain requirements for vaccines have long hindered immunization efforts in places with limited resources, reducing coverage. To overcome this, innovations like solar-powered portable refrigerators and digital solutions can be adopted to ensure reliable vaccine storage in remote areas.
Target product profiles, which are designed to help guide the R & D process by outlining products’ desired characteristics, must address acceptability and affordability and push for innovations that countries can feasibly implement at scale. In this sense, meaningfully engaging communities in the design of such profiles is key.
Medicines should also be manufactured locally where possible, improving affordability and equitable distribution and helping build more resilient supply chains capable of weathering global crises. Innovators should plan from the start to support regional manufacturing by providing licenses through established entities, such as the U.N.-backed Medicines Patent Pool, and implementing technology transfers to enable local production, where appropriate.
A good example is the technology transfer for a new pediatric treatment option for schistosomiasis (caused by a parasitic worm) from German pharmaceutical company Merck to Farmanguinhos/Fiocruz, Brazil’s main drug tech laboratory, and more recently, to Kenyan manufacturer Universal. This medicine will soon become available to preschoolers, who are at high risk of contracting the neglected tropical illness, and the Access and Delivery Partnership, GHIT Fund and Pediatric Praziquantel Consortium, the partnership that developed this pediatric treatment option, are working together with other organizations to scale up access in affected countries.
Medical knowledge also needs to be available to all. Everyone, everywhere has the right to benefit from science. Ensuring that research is transparent and published in open-access journals, and enabling technology transfers and local or regional production can allow the broader scientific community to utilize, iterate and improve upon innovations.
We have seen how powerful open innovation can be, for example, in the case of the Corbevax COVID-19 vaccine, which was intentionally introduced as open-source and patent-free by the Texas Children’s Hospital Center for Vaccine Development and Baylor College of Medicine, also in Texas. The vaccine has been listed for emergency use by the World Health Organization and was approved in India, where at least 100 million doses have been administered so far.
Governments too can lead these efforts. At the Group of Seven Summit in 2023, Japan pledged an additional $200 million to support the partnership between the GHIT Fund and UNDP and its mission of investing in innovation, access and delivery of health technologies for neglected diseases. At November’s G20 summit, global leaders, including those of Japan, welcomed the establishment of a coalition for local and regional production, innovation and equitable access, offering another opportunity to connect the dots between technological advances, availability and delivery.
By championing these initiatives, Japan is leading the way in ensuring that R & D prioritizes access considerations as part of efforts to achieve universal health coverage and human security — a model for how nations can drive health equity on a global scale.
We know what needs to be done. Access cannot just be an afterthought once a product is ready for the market. If not, years pass before new innovations reach the people who need them and more lives are lost to preventable diseases like malaria. There’s no more time to waste.
Mandeep Dhaliwal is director of the HIV and Health Group, United Nations Development Program. Osamu Kunii is CEO of the Global Health Innovative Technology Fund.
This article was originally published in https://www.japantimes.co.jp