Global Access to Medicines Initiative, disrupting the status quo

Person holding tablets
15th November 2019
Harriet Teare

It has just been announced[1] that 5000 children in England, Wales and Northern Ireland will be able to access a potentially life-saving drug for Cystic Fibrosis, following several years of negotiation between the NHS and the drug company, Vertex, to agree on an appropriate price (Scotland is involved in a separate negotiation process). The drug was first approved for use within the USA in 2015 and in Canada in 2016, but initially rejected by NICE in the UK, on grounds of cost-effectiveness and a lack of long-term data.

In February 2017 the National Institute for Health and Care Excellence (NICE) rejected use of the drug Palbociclib on the NHS in England. This breakthrough breast cancer treatment, which could have helped around 5,500 patients, was deemed too expensive for the NHS (at around £140 a pill)[2].

These are just two examples of a growing trend in drug development, which has become so expensive that patients are not able to benefit from the medicines they need.

Access to medicines is a global challenge; throughout the world current approaches to healthcare are failing as populations age and delivery becomes more expensive. While the expense associated with drugs is one major part of this challenge, accessibility extends beyond simply the question of affordability, and speaks to the economic, political, practical and ethical challenges associated with ensuring patients can realise their best possible health. The WHO estimates that 2 billion people across the world can’t access even the most essential medicines,[3] let alone benefiting from the advances in modern science described above. Access can be inhibited by gaps in local health systems and infrastructure, or interruptions in supply (including relating to war or natural disaster), or payment practices that force families to make impossible choices to fund health over other priorities (like food or education).

The Global Access to Medicines Initiative has been launched to help tackle this grand challenge, stimulating efforts in redressing drug discovery, drug repurposing and exploitation of new technology in translational medicine.

The Initiative aims to disrupt the current drug discovery process and accelerate medicinal developments. It will: 

  1. Support innovation by focusing on public interest, with the needs of patients at the core.
  2. Address inequality of access, and design inventive ways to effectively engage the underrepresented.
  3. Examine current bottlenecks, learn from good examples and share knowledge. 
  4. Translate and communicate generated knowledge into different contexts to allow these successes to be exploited.

The Initiative also intends to learn from best practice, and successes that are already in progress. For example, in response to questions of access, an innovative company in Rwanda, called Zipline (flyzipline.com), are delivering medicine, including urgent blood products, by drone. A large catapult launches these vital packages into the air, and their progress is tracked using GPS and WhatsApp messaging. This technology has enabled even the most remote communities to be reached. We have been talking to the founders of Zipline to learn about their experiences setting this project up and the challenges that they have faced.

Examples such as this demonstrate the opportunity to be creative, to disrupt traditional models and pathways, and learn from different sectors to achieve progress.

The Global Access to Medicines Initiative is currently working on several different activities in this area, for example considering how to encourage further opportunities for translation within the Oxford environment; exploring the opportunities for new technology to support open drug discovery; and developing a proposal to consider some of the ethical, legal and social implications of drug development that relies on growing volumes of individual-level patient data.

It is hoped that these activities will provide the foundation on which to establish a world leading research institute, to continue to tackle this important challenge.

Join us in helping to advance Global Access to Medicines.

For more information or to get in touch please visit our website: globalAMI.org