Speech of Mike Foster, UK Minister for International Development at launch of Industry Government Forum on Access to Medicines

On October 12, 2009, the “Industry Government Forum on Access to Medicines” (IGFAM) was launched. The UK Minister for International Development, MP Mike Foster made a a speech to launch this initiative which is reproduced below.

Presentations were also made by Pfizer (Ponni Subbiah), GSK (Abbas Hussain), Rajiv Venkayya (Gates Foundation), Prashant Yadav (Massachusetts Institute of Technology) and Suerie Moon (Research Fellow and Doctoral Candidate, Kennedy School of Government, Harvard University).


Nearly 30,000 children die every day from diseases which could easily be treated if they had access to a basic range of essential medicines.

In Africa, about 700,000 children under 5 die every year from malaria.

1.8 million children die every year from pneumonia.

Diarrhoea kills 1.5 million children every year.

Each year more than 3.8 million people die from diabetes-related causes, one death every 10 seconds – more than the death toll from AIDS.

These statistics are even more tragic when compared with the situation in developed countries.

In the UK the debates over access to medicines concern cancer drugs costing tens of thousands of pounds annually. In much of Africa life-saving drugs for malaria or antibiotics for infections costing pennies or pounds are either not available, or not affordable.

The causes of poor health outcomes in developing countries are complex – but the inability to access life-saving medicines plays a major role. And price is, of course, a major factor. Most poor people in developing countries rely on their own resources to purchase medicines.

Every day around the world, children are dying from things as simple to treat as diarrohea and dyssentry. It is not only morally unacceptable that this degree of suffering and inequity persists, it also increases the global risks that the spread of disease creates.

The purpose of this forum – which I’m very pleased to be launching today – is to look at how we can ensure that poor citizens in developing countries are not denied access to the essential life-saving medicines which most of us here take for granted.

Through this forum we can begin a dialogue about the new business models we need in order to deliver better access to medicines across the board in developing countries.

Of course, price and availability of medicines are determined by many factors outside the control of the pharmaceutical industry. And we know that the most effective way to improve health is by supporting stronger national health systems – so that more people can visit a health clinic and medicines reach the people who need them.

Developing country governments must lead the way – by investing more of their own money in health systems, and meeting the Abuja target of directing 15% of government spending towards health care.

To support them, the UK is investing £6 billion up to 2015 to improve health systems in developing countries. Our support is helping to provide health care to about 60 million people in developing countries.

In order to raise additional funding for health – to pay for more nurses and doctors and to equip health clinics – we set up the High Level Taskforce, chaired by Gordon Brown and Robert Zoellick of the World Bank. The Taskforce reported this year and helped to secure $5.3 billion to radically improve health services across the developing world.

The agreement announced in New York last month saw six developing countries commit to expanding access to health services, giving ten million more people access to free health care. Burundi will provide free health care to all children under five and pregnant women. Malawi will extend free health services to nearly a million more people. Ghana, Nepal, Sierra Leone and Liberia also made far reaching commitments to expand access to free services.

We are providing long term funding to purchase medicines – £1 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria up to 2015, and £790 million over 20 years to UNITAID.

Gordon Brown also personally led the way in setting up the International Finance Facility for Immunisation – which is raising $4 billion to provide life-saving vaccines for millions of children, and could save 10 million children’s lives between now and 2015.

Measures like these are crucial – and are making a difference to the lives of millions of people around the world.

But at the same time, decisions made by pharmaceutical companies about which products to market and promote, how much to invest in research and development and which diseases to focus on make a huge difference to people in developing countries.

In the case of antiretrovirals, we all know that prices in developing countries have fallen dramatically since 2000, partly as a result of initiatives by brand name companies, but particularly because of the presence of generic competition from producers in India.

But as new antiretrovirals are developed, as first line treatment recommendations change, and as more people need to be moved to second line treatments – the price of treatment is once again going up.

Improved first line treatments for AIDS recommended by the World Health Organisation are now over twice the price of the most common treatment used to date. The cheapest second line treatments are over six times that price.

That is why we are supporting UNITAID’s efforts to create a global patent pool for antiretrovirals to address the urgent need for cost reduction and to help create new fixed dose combinations needed in developing countries. And we are encouraging industry to work with UNITAID to develop a business plan to present to the UNITAID board later this year.

The example of antiretrovirals has shown what can be achieved in improving accessibility.

But the evidence suggests that for the great majority of drugs differential pricing to reach the poor is not very effective. Companies, both brandname and generic, concentrate their efforts on the better off in those countries and often sell at prices little different from those in developed countries.

That is why we see the need to make further progress in making medicines for all diseases more accessible to poor people. I believe industry also wants this – if only they could identify suitable business models.

Many pharmaceutical companies are already sensitive to the need to find better models.

Earlier this year GSK announced new initiatives on pricing, research and investment in health systems, including a patent pool to promote research on neglected diseases, emphasising the need for a new way of thinking in the industry.

Andrew Witty, the CEO of GSK, talking about the need to improve access to medicines in developing countries said, and I quote:

“We need to adopt a new mindset… our business model is not written into any country’s constitution.”

Pfizer has set up a Global Access Strategy unit which is headed by our speaker today, Ponni Subbiah. The unit is dedicated to exploring and developing new business models that will improve access to quality medicines in a way that is both commercially viable and socially responsible. I look forward to hearing more about Pfizer’s plans in this area.

To help drive progress on access to medicines, we have recently made a commitment, along with the Bill and Melinda Gates Foundation, to the Access to Medicines Index which ranks companies on the quality of their policies on access to medicines.

The Index will be an impartial measure of how well companies are doing at making their products available in developing countries – and it aims to encourage good practice across the board. I would like to congratulate Wim Leereveld on his sterling efforts in getting this off the ground.

Of course, industry doesn’t need the government to tell them that developing countries and emerging markets have the potential to be major sources of future growth. By 2020 sales in emerging markets are likely to exceed current sales in the USA and Europe combined.

Our challenge is to ensure that the poor as well as the rich benefit as the pharmaceutical market expands.

That is why we have selected “differential pricing” as the forum’s first topic for dialogue. Professor Yadav from MIT will today initiate the discussion – which we hope will result in new ideas and lead to concrete outcomes in improving access to medicines.

Today’s event is only the beginning of a process. But by working together – industry and government, along with stakeholders from across civil society – this forum can help us to change the way we do business and make a real difference to the lives of millions of poor people around the world.

Thank you and I look forward to hearing your views.