‘There’s no point giving free cancer drugs to Africa’ a shocking headline, but not surprising when you realise it is propagated by the CEO of a BIG PHARMA company.
The BBC article published last week outlined how Pascal Soriot, CEO of AstraZeneca doesn’t see tackling the un-affordability of cancer medicines as the priority challenge to improving access to treatment on the continent.
Rather he feels it is a question of infrastructure, without the hospitals and doctors present these medicines would be wasted. It is certainly true that trained doctors and strong health systems are essential for the correct diagnosis and management of treatment for cancer which can be complex. But this is not an excuse for not challenging prohibitively high prices.
This situation is all too recognisant of the AIDS crisis in sub-Saharan Africa in the early 2000s. Back then the excuse for not addressing the $10,000 per person per year price tag for HIV treatment was that health infrastructure was too weak and since Africans ‘don’t have clocks or watches’ they wouldn’t be able to take their medication on time.
Fortunately activists were prepared to prove this argument- which came from the US Agency for International Development -wrong. The access to treatment movement, spear-headed by people living with HIV and their allies, lead to the development of generic anti-retrovirals that could be produced at a fraction of the cost. Today over 80% of people living in the developing world take generic ARVs, without them we wouldn’t have an AIDS response.
The fact is that improving access to medicines and strengthening health systems are not mutually exclusive endeavours, a holistic approach is required. According to Quartz Africa more than 20 countries on the continent don’t have access to a working radiotherapy machines, and 63% of cancer patients need radiation. On the other hand Faraja Cancer Support, an NGO that works with cancer patients in Kenya says that “the average [cost of] treatment ranges from $1,600 to $5,000, which is way beyond the reach of many Kenyans”. If this cost could be reduced and more radiotherapy machines could be purchased then this would have a significant impact on health outcomes for people living in Kenya.
The BBC article stated that access to treatment had been one of the leading themes at the annual meeting of the American Society of Clinical Oncology in Chicago, where the AstraZeneca boss was interviewed. With the persistent criticism of the industry for their high prices and the recent move from fellow pharma company GSK to extend access to its products for people in low and middle income countries, it is clear that AstraZeneca are on the defensive.
“If we give our products away, in five years, guess what? There are no new products” says Soriot, revealing his anxiety about what will happen to medical innovation if revenue from high price sales is reduced. It is common knowledge that the pharma industry invests most of its turn-over in marketing rather than R&D, never the less the money for R&D has to come from somewhere but funding it through high prices prohibits access. The answer is we need to come up with new incentives to high prices and fortunately there are civil society movements such as the Missing Medicines campaign as well as global initiatives such as the UN High Level Panel on Access to Medicines that have ideas for how a new model could work.
In direct reply to Pascal Soriot therefore, we could say that even if you had well trained doctors and effective health infrastructure, if drugs remain un-affordable a country’s health system will continue to fail. We need to address all these elements and governments should be encouraging industry to adapt its model for funding medical R&D to achieve better health outcomes as part of this effort.
The recommendations from the UN High Level Panel on Access to Medicines are set to come out late this summer and present us with an opportunity to set a plan in motion for transforming our medical innovation system to develop better, more affordable medicines for all.