In News:

• Recently, Access to Medicine Index Report 2024 was released by the Access to Medicine Foundation. The report evaluates 20 leading pharmaceutical companies on their efforts to expand access to medicines in low- and middle-income countries (LMICs).The biennial report has been published since 2008.
• Key Highlights:
  • Key Areas of Evaluation
    • Governance of Access: Companies’ leadership in addressing access issues.
    • Research & Development (R&D): Focus on innovations for diseases prevalent in LMICs.
    • Product Delivery: Efforts to ensure medicines and vaccines are accessible.
  • Findings from the 2024 Report
    • Gaps in Access for Low-Income Countries:
      • Many pharmaceutical companies are adopting ‘inclusive business models,’ but outcomes are mixed, with transparent reporting still lacking.
      • 61% of products lack specific access strategies for low-income countries.
    • Exclusion from Clinical Trials:Only 43% of clinical trials take place in LMICs, despite these countries representing 80% of the global population.
    • Limited Technology Transfers & Local Availability:
      • Technology transfers and voluntary licensing are concentrated in countries like Brazil, China, and India.
      • Sub-Saharan Africa (excluding South Africa) remains largely overlooked.
    • Decline in R&D for Priority Diseases:
      • Pharmaceutical companies are moving away from diseases like malaria, tuberculosis, and neglected tropical diseases, which disproportionately affect LMICs.
  • Key Issues in Accessing Medicines in LMICs
    • Economic Barriers:
      • High costs of essential medicines, including patented drugs, limit access for patients in LMICs with low purchasing power.
      • Out-of-pocket expenditures lead to catastrophic financial consequences for families.
    • Infrastructure Challenges:
      • Poor transportation and cold chain infrastructure hamper the efficient distribution of medicines, especially in rural areas.
      • Disruptions in supply chains (e.g., during pandemics) exacerbate medicine shortages.
    • Regulatory Issues:Weak enforcement of regulatory frameworks results in the proliferation of substandard and counterfeit medicines, compromising treatment efficacy.
    • Workforce Limitations:
      • A shortage of trained healthcare professionals restricts appropriate prescription and management of medicines.
      • Cultural beliefs and low health literacy further complicate adherence to treatments.
  • Challenges Specific to LMICs
    • Dual Burden of Diseases:
      • LMICs face both infectious diseases and non-communicable diseases (NCDs), putting strain on fragile healthcare systems.
      • 17 million people die from NCDs before age 70 annually, with 86% of these deaths occurring in LMICs.
    • Need for Local Manufacturing:
      • Strengthening local pharmaceutical manufacturing and distribution networks is crucial to ensure a reliable supply of essential medicines and reduce dependence on imports.
  • Recommendations for Improving Access
    • Companies should scale up efforts to bridge the health equity gap and use innovative approaches and local partnerships to improve access.
    • Focus on increasing transparency in access reporting and addressing the lack of strategies for low-income countries.
    • Pharmaceutical companies should refocus on diseases prevalent in LMICs, such as malaria and tuberculosis, and ensure that their R&D addresses the needs of these regions.