Access to Medicine Report 2024

The Access to Medicine Foundation released its latest Index Report on November 19, 2024. This report evaluates the efforts of 20 leading pharmaceutical companies in improving access to medicines in low- and middle-income countries (LMICs). Published biennially since 2008, the report marks ongoing challenges in accessing life-saving pharmaceuticals. The evaluation focuses on three main areas – Governance of access, research and development (R&D), and product delivery.

Key Findings from the 2024 Index

The 2024 Index reveals important gaps in access to medicines. While some pharmaceutical companies are adopting inclusive business models, these initiatives have mixed results. Many companies still lack transparent reporting on patient reach. The report indicates that equitable access strategies are often skewed towards upper-middle-income countries. Alarmingly, 61% of assessed products lack access strategies for low-income countries.

Clinical Trials Exclusion

Another critical finding is the exclusion of patients in LMICs from clinical trials. Only 43% of clinical trials are conducted in the 113 LMICs analysed, despite these countries hosting 80% of the global population. This exclusion limits the availability of new treatments for millions.

Limited Local Availability Efforts

Efforts to enhance local availability of medicines through voluntary licensing and technology transfers are also limited. While some companies have made progress, areas like sub-Saharan Africa remain largely overlooked. Most initiatives are concentrated in Brazil, China, and India, leaving many regions without adequate access to essential medicines.

Declining Focus on Priority Diseases

The report raises concerns about the declining focus on R&D for diseases like malaria and tuberculosis. These diseases disproportionately affect LMICs. Companies are increasingly diverting resources away from addressing these priority health issues. This trend poses challenge to health equity and the well-being of billions globally.

Opportunities for Improvement

The report suggests that there are substantial opportunities to improve access to medicines. By leveraging innovative approaches and local partnerships, pharmaceutical companies can enhance their efforts. This could help bridge the health equity gap and ensure that life-saving treatments reach those in need.

Questions for UPSC:

1. Critically analyse the impact of inclusive business models on access to medicines in low-income countries.
2. Estimate the significance of clinical trial inclusion for patients in low- and middle-income countries.
3. Point out the challenges faced by pharmaceutical companies in addressing priority diseases in LMICs.
4. What are the implications of limited technology transfers for local medicine availability in sub-Saharan Africa?

Answer Hints:

1. Critically analyse the impact of inclusive business models on access to medicines in low-income countries.

1. Inclusive business models aim to prioritize low-income countries, potentially increasing access to essential medicines.
2. Mixed outcomes reported; some companies show improved patient reach, while others lack transparency in reporting.
3. 61% of assessed products still lack access strategies specifically targeting low-income countries.
4. Upper-middle-income countries receive more focus, denoting inequity in access strategies.
5. Success depends on sustained commitment and effective implementation of these models.

2. Estimate the significance of clinical trial inclusion for patients in low- and middle-income countries.

1. Only 43% of clinical trials occur in LMICs, despite these regions housing 80% of the global population.
2. Exclusion limits access to new treatments, compromising health outcomes for millions.
3. Inclusion in trials can lead to tailored treatments that address specific local health challenges.
4. Increased trial participation can enhance trust and engagement in healthcare systems.
5. Addressing this gap is crucial for equitable health advancements and improved patient care.

3. Point out the challenges faced by pharmaceutical companies in addressing priority diseases in LMICs.

1. Declining focus on R&D for diseases like malaria and tuberculosis, which predominantly affect LMICs.
2. Resource allocation often shifts towards more profitable markets, neglecting critical health needs.
3. Limited collaboration with local stakeholders can hinder effective responses to these diseases.
4. Regulatory and logistical barriers in LMICs complicate drug development and distribution.
5. Need for innovative funding models and partnerships to tackle these priority health issues effectively.

4. What are the implications of limited technology transfers for local medicine availability in sub-Saharan Africa?

1. Limited technology transfers restrict local production capabilities, leading to shortages of essential medicines.
2. Sub-Saharan Africa remains largely overlooked, increasing reliance on imports and affecting affordability.
3. Local manufacturing could enhance access and reduce costs, improving health outcomes.
4. Technology transfers can encourage innovation and capacity building in local healthcare systems.
5. Addressing this limitation is essential for achieving health equity and improving access to care.