The 2024 Access to Medicine Index Report is out and reveals that only 43 per cent of new health innovations reach Africa. It highlights the pharmaceutical industry's efforts to address health disparities in low- and middle-income countries, focusing on challenges like voluntary licensing and regulatory frameworks. To unpack these key findings and discuss the industry's path forward, CNBC Africa is joined by Jayasree Iyer, CEO of the Access to Medicine Foundation.
The 2024 Access to Medicine Index Report is out and reveals that only 43 per cent of new health innovations reach Africa. It highlights the pharmaceutical industry's efforts to address health disparities in low- and middle-income countries, focusing on challenges like voluntary licensing and regulatory frameworks. To unpack these key findings and discuss the industry's path forward, we are now joined live by Jayasree Iyer, CEO of the Access to Medicine Foundation. Jayasree, thank you so much for joining us again on the show. So the report highlights that only 43 per cent of new health innovations reach Africa. From where you sit, what do you believe is the primary barrier to greater access in the region? Thanks again for having me in the show. I believe that the lack of infrastructure capacity, strong regulation and lack of sustained financing to buy medicines long-term are major barriers. But at the end of it, most of the big pharmaceutical companies are also mainly looking at profitable markets in the US and Europe, so they largely overlook many regions in Africa. Indeed. And also the report, Jayasree, here, it mentions that there's stagnation in voluntary licensing agreements. So what factors are we seeing contributing to this decline? And then how can companies be encouraged to increase some of these efforts? So voluntary licensing is a means to ensure that local generic manufacturers can make products that are under patent and deliver in the regions that they serve. It's been mostly used for HIV, hepatitis and during the COVID pandemic, where purchasing of the final medicines that are being made are also heavily driven by international donors, you know, paying for this. So we need to convince the pharmaceutical industry that African nations are willing and able to buy medicines, show a stable demand and also advocate for that local availability. And at the end of it, big pharmaceutical companies need to understand that they cannot sit on life-saving innovations and prevent access, especially in countries where they do not have a presence itself. African manufacturers need to also step up their efforts in ensuring that they're able to produce at capacity and quality needed, so that they can in-license these products from the big pharmaceutical companies. And that's the way we can sort of solve that gap. And Jess, we're also seeing that research and development was at the lowest performer here. So how can pharmaceutical companies better align the R&D to meet some of these specific health needs for low and middle income countries? Indeed, we found that the research and development pipeline, especially for areas where it's a high priority for low and middle income countries, is actually decreased in the last access to medicine index. So it's important for the pharmaceutical industry to invest in areas where there are gaps in treatment, prevention and diagnosis. They need to better design their products with global needs and usage in mind, and plan for access early so people all around the world do not have to wait years to receive access to products that are already approved in the United States or in Europe. And we are also seeing, or what role do we see here then for the African Medicines Agency, that is AMA playing when it comes to improving access to medicines? And at the same time, how can companies engage with this initiative? So the AMA can speed up registration and availability of medicines because at the end of it, if you don't have a product registered in a country, you don't have it sustainably available across the region itself. And AMA helps country governments and practitioners also fill the empty stocks of treatments and build a sort of a better resilient system to also monitoring the effects of the medicines in Africa itself. Companies need to engage with this initiative by ensuring that the products that they're developing and the products that they have on the market and elsewhere are also made available via the African Medicines Agency. So engaging and partnering with African manufacturers would really help here. And yes, looking at the biggest gap that you are also seeing when it comes to health product or innovations development, what can be done to expedite the product registration process for the new health innovations in Africa? Because there's a very huge gap that we are seeing here, so how best can we address it? So I think more harmonization between the African Medicines Agency, the European Medicines Agency and the US Food and Drug Administration can really help make sure that when there is a product that is approved, it is actually approved globally itself. And that way you can sort of prepare governments also to make sure that they are able to both finance, purchase and administer the medicines to patients that need them. Companies need to commit to lower their product prices to make sure that certain products are actually more affordable in regions, and they need to commit to register their products in more countries that have a high burden of disease and need. But we found that at the end of it, it follows where the clinical trials are actually running. And we've got a very low number of clinical trials running in Africa, so and the companies only register their products where the trials are. So there's a huge gap to fill in order to expedite the availability of medicines. And also as companies now shift to third party distribution models, what steps should they take to ensure reliable access to essential medicines here? So they should still take ownership in identifying the real needs and deliver according to that, you know, products need to be registered in countries with a high burden. And at the end of it, if you don't have the registration, the distributors cannot deliver in all the different regions, especially in smaller markets and, you know, countries that are where we have a very high poverty level. Companies need to be careful that they ensure that their prices are fair and people have the ability to pay for it. And they need to limit markups by working with reputed distributors that guarantee limits on markups that affect the end user and the patients that actually end up paying out of pocket. And this can actually be built into distribution contracts and companies can also use price caps to sort of monitor that eventual affordability. And yes, this third party question is alluding to the IBMs, that is the inclusive business models. So how are we likely to see them being effectively implemented to reach underserved populations? And also, as we move forward, what are we likely to see when it comes to access to medicine sector or industry performance? So the inclusive business models can be more tailored and targeted towards the needs of the populations. I mean, in a way, this is the main hope that we have for some of the lowest income countries and least developed countries. And especially in countries and regions where there's a high burden of disease, but there's a lot of people who pay out of pocket and live under the poverty line. So industry needs to make sure the patient reach approaches are more comprehensive and more ambitious, so they really reach the number of patients who need access. And there needs to be a strong will, a strong political will, to deliver alongside these long-term investments in these models by both companies and their private sector partners and public sector partners that they work with. So it can be done. We've shown multiple examples in the index on best practices and how this can be done in a more effective way. So it just means it just has to be done.
Theme: Transforming Pharmaceutical Industry Strategies for Africa's Health Needs
The 2024 Access to Medicine Index Report has shed light on a concerning statistic - only 43 per cent of new health innovations reach Africa. This revelation underscores the stark disparity in access to vital healthcare solutions for low- and middle-income countries. The report emphasizes the uphill battle faced by the pharmaceutical industry in bridging the healthcare gap, citing challenges such as voluntary licensing agreements and regulatory frameworks. To delve into the core findings and navigate the industry's trajectory, CNBC Africa engaged in a riveting discussion with Jayasree Iyer, the CEO of the Access to Medicine Foundation. Iyer elucidated on the primary barriers hindering greater access to innovative health solutions in Africa, citing lack of infrastructure capacity, stringent regulation, and insufficient financing as major roadblocks. Moreover, the CEO highlighted the industry's propensity to prioritize lucrative markets in the US and Europe, often sidelining regions like Africa. One of the critical points raised during the interview pertained to the stagnation in voluntary licensing agreements, a pivotal mechanism for enabling local manufacturers to produce patented products and cater to regional demands. Iyer stressed the importance of incentivizing pharmaceutical companies to bolster their efforts in this realm by showcasing the purchasing capacity and stable demand within African nations. Additionally, she underscored the imperative for African manufacturers to enhance production capabilities and quality standards to facilitate collaboration with major pharmaceutical entities. Another pressing issue broached in the conversation was the dwindling focus on research and development tailored to meet the unique healthcare needs of low and middle-income countries. The imperative for pharmaceutical companies to recalibrate their R&D endeavors towards addressing treatment gaps, preventative measures, and diagnostic tools for marginalized populations was underscored. It was emphasized that the industry must design products with global utility in mind, ensuring timely access to approved medications worldwide. The discourse also delved into the role of the African Medicines Agency (AMA) in bolstering access to essential medications by expediting product registration processes. Iyer underscored the agency's role in enhancing medication availability, streamlining monitoring mechanisms, and fortifying treatment supply chains across the region. Additionally, she advocated for increased collaboration between pharmaceutical companies and the AMA to streamline access initiatives. The need for harmonization between regulatory bodies like the AMA, European Medicines Agency, and US Food and Drug Administration was highlighted as a pivotal step to accelerate product approval globally and enhance funding and distribution mechanisms for life-saving medications. Furthermore, Iyer accentuated the necessity for fair pricing strategies, expedited registration processes, and reliable distribution channels in reaching underserved populations effectively. She underscored the significance of inclusive business models tailored to cater to the unique needs of marginalized communities, emphasizing a collective effort from private and public sector stakeholders in steering the industry towards equitable healthcare access. As the industry grapples with transforming its strategies to meet Africa's burgeoning health needs, a concerted effort from all stakeholders is imperative to drive positive change and ensure universal access to essential medications.
"It's important for the pharmaceutical industry to invest in areas where there are gaps in treatment, prevention and diagnosis. They need to better design their products with global needs and usage in mind, and plan for access early so people all around the world do not have to wait years to receive access to products that are already approved in the United States or in Europe."
['Pharmaceutical Industry', 'Access to Medicine', 'Africa', 'Health Innovation', 'Regulatory Frameworks', 'Medication Access']