Statement by South Africa
Item 15.5 Access to Essential Medicines
Chairperson, Honourable Representatives of Member States, distinguished delegates, South Africa is pleased to a speak on behalf of the 47 members of the African region.
We thank the secretariat for preparing this report on Access to Essential Medicines and the WHO Medicines Strategy as reflected in the Twelfth general Programme of Work: 2014-2019.
Progress towards achieving the MDGs will not be realised if there are still barriers to access medicines. While countries have made considerable progress in achieving MDGs, particularly with respect to accessing medicines to fight HIV, malaria and TB. Access to other drugs such as vaccines and anti-cancer drugs remain out of reach of millions of people in both developed and developing countries.
Access to medicines implies continuously available and affordable medicines at health facilities which are close to where people live. Barriers to access can be due to several factors such as inadequate financing, high-priced products, procurement of originator brands, and inefficiencies in the supply and distribution chain.
The high price of medicines, particularly in the private sector, is a key barrier to affordable essential medicines in developing countries. While affordable prices are a key determinant in improving access to medicines, we should not forget that adequate, sustainable and equitable financing of medicines is also required. The WHO essential medicines committee may consider producing a list of medicines that are essential for public health however they are at an unaffordable price. This would direct other low cost manufacturers to focus on their product portfolio.
Chair, public sector availability of medicines is low in many developing countries. In a survey of 27 developing countries found the average public sector availability was only 35 per cent. When medicines are not available in the public sector, patients will have to purchase these medicines from the higher-priced private sector, or forgo treatment altogether. Low availability of medicines is therefore another barrier to access.
Generically equivalent products are usually priced at a substantially lower level than the originator brand. Increasing the use of quality-assured generic medicines through competition is therefore a key strategy for improving the affordability of medicine. A range of policy options is available to promote the use of generics.
Patents also have a dramatic impact on access to medicines when they are used to prevent competition. When life-saving treatments for diseases such as HIV/AIDS, cancer and Hepatitis become unaffordable to those that need them, the consequences can be – and are – devastating. Yesterday we were discussing limited access to Hepatitis treatment at the Assembly. In developing countries, where people pay for drugs out of their own pockets and very seldom have health insurance, the high price of medicines becomes a question of life and death.
Communities in Africa have insufficient access to essential medicines, a situation compounded by fragmented medicines regulatory systems. The medicines regulatory harmonisation was approved by the AU Conference of Ministers of Health in 2007 (under the pharmaceutical manufacturing plan for Africa and launched in 2009) and aims to enable African countries to fulfil their national obligations to provide all citizens with safe, quality and efficacious essential medicines.
Chair, in conclusion:
We would like to recognise that there are several factors that affect access to medicines. These include :
• The purchase price of the medicine from the manufacturer is a key factor that influences access. This can be best addressed through a price regulatory system.
• Utilisation of the TRIPS flexibilities to promote access to medicines that impact on public health.
• A system to track the availability of medicines through the medicine supply chain.
• A simplified, harmonised, efficient and transparent regulatory approval process particularly for generic medicines.
• A generic substitution policy that is effectively implemented.
All of these interventions must be implemented in a integrated system to improve access to essential medicines. The member states of Africa support the resolution on Access to Medicine as key to improving people’s lives and fundamental to realising the right to health. Thank you