2. MSF Access Campaign Started in 1999 Rooted in field experience Three Pillars: –Overcoming Barriers –Research and Development for Drugs for Neglected Diseases –Effects of Globalisation (TRIPS, etc)

3. Access to Essential Medicines 75% of the world’s population live in developing countries They account for 8% of the pharmaceutical sales 1/3 world’s population does not have access to essential medicines (> 50% in most impoverished areas of Africa and Asia)

4. Projected World Pharmaceutical Market 2002 (around 400 billions USD)

5. World Drugs Market Billions US$ Source: IMS Health, PNUD

6. Factors Affecting Access to Essential Medicines R&D Production Approval Quality Distribution Drug information, rationale use Diagnosis/prescription/monitoring Price Compliance Pharmacovigilance

7. WHO/CDS/CSR Evolution of Sleeping Sickness Throughout the XXth Century

8. 1995-2000 Suramine et Nifurtimox Bayer ends the production. Melarsoprol (Aventis) Production in danger Pentamidine (RPR-Aventis) Announces a progressive end to the donation programme Eflornithine (HMR-Aventis) ends the production (exploitation is offered to WHO) 2001 Bayer announces production and donation re- commencement Aventis annonce maintenance of the production and donation programme for 5 years + support to sleeping sickess programmes. Drugs for sleeping sickness: Preliminary Results

9. Unaffordable Life-saving drugs  Anti-retrovirals  Some treatments for opportunistic diseases  New antibiotics or anti-malaria drugs  New vaccines  Etc.

10. Objective: Equitable Drug Prices The policy of assuring dramatically reduced drug prices so that they are truly affordable to the people who need them A policy that is –sustainable (not based on charity or donations) –Strengthens developing countries’ autonomy –Attracts donor funding –Not limited to HIV/AIDS medication only

11. Generic Competition Sample AIDS triple-combination: lowest world prices (stavudine (d4T) + lamivudine (3TC) + nevirapine)

12. Lack of Research and Development for Neglected Diseases Defining the problems and searching for solutions

13. Global investment in R&D Estimated that between $70 - 90 billion per year spent on health R&D –50% public funding (of which 80% is G8) –50% private funding (for profit and non-profit) Less than 10% is devoted to 90% of the world’s health problems

14. Lack of R&D for Neglected Diseases 1975 – 1999 Among 1393 new chemical entities, 435 (31.2%) therapeutic innovations New chemical entities 69% Therapeutic Innovations for Tropical Diseases 1% Therapeutic Innovations for Other Diseases 30%

15. Who can play a role in defining solutions NGO's commitment The role of the pharmaceutical industry Public support, political will and funding