Drug Donations are Great, but Should Big Pharma be Calling the Shots? (The Guardian)
Director of Global Health Policy and Senior Fellow Amanda Glassman is quoted in The Guardian on financing pharmaceuticals and vaccines in the developing world.
In the early 2000s, pharmaceutical companies were high on activists' hit lists, prompted by Big Pharma's ill-advised attempt to sue the South African government for patent infringement on HIV drugs; an attempt to deal with the country's epidemic by allowing cheaper, generic copies to be sold.
Today, the discourse seems merrier. Charities and NGOs sit down with the same companies, discussing how best to confront public health challenges in the developing world. The talk is of partnerships and "win-wins". It isn't all idle chatter. Drug donations, reinvestment of profits in developing countries and a more flexible approach to intellectual property have all signalled a more collaborative approach, with the likes of GlaxoSmithKline, Sanofi, Johnson and Johnson and Merck all performing well in the 2012 Access to Medicine index.
But while talk of a new era of friendship is appealing (not least to the companies), there are still unresolved debates about the role that companies play in shaping the public health agenda in developing countries. Even the most seemingly charitable acts have come under scrutiny.
Some public health experts believe that "pull" (incentive) mechanisms might be a better way of bringing the private sector compared to "push" measures such as donation programmes. One example is the Advanced Market Commitment tool, where donors pledge to purchase developing country disease-focused vaccines or medicines, giving companies a commercial buyer and thus a reason to risk their R&D investment and product development. The mechanism "removes uncertainty for donors, governments, and vaccine manufacturers and improves availability and access", says Peter Shelby, associate director of communications at the International Federation of Pharmaceutical Manufacturers and Associations.
GSK's pneumococcal vaccine – introduced in Kenya's national immunisation programme in 2011 – benefited from this tool. But it was already a late-stage product, and the mechanism has not yet been used again. "Channelling such money should not be a problem from a [donor] Ministry of Finance or Treasury point of view, because they are such small amounts of money – you can't imagine the US or UK couldn't do that when the time comes," says Amanda Glassman at the Center for Global Development in Washington.
But for companies to believe the money is real rather than a mere pledge by aid ministers, it has to be locked away safely. In the current climate of austerity, the idea of unused public money is not appealing for western taxpayers, said Glassman. And some governments – notably the US and Japan – have trouble participating in multi-year commitments that represent a fiscal contingency.
