[Column] Renan Ozyerli: Equitable access to healthcare should be a bigger priority as the world emerges from COVID-19
The World Health Organization (WHO) has said the world is at “the beginning of the end” of the COVID-19 pandemic with the numbers of deaths and cases slowing considerably. However, as the pandemic passes, it leaves behind severe effects on global health systems and economies, most worryingly the inability of people in many countries to access affordable healthcare products and services.
Renan Ozyerli, Regional President of biopharmaceutical company MSD, in Eastern Europe, the Middle East and Africa (EEMEA), believes that equitable access to healthcare should be a bigger priority on the global healthcare agenda, and that partners including the pharmaceutical industry, governments global health organizations and civil society need to think differently about how medicines and vaccines reach those who need them most and ensuring that they are affordable.
According to a WHO and World Bank report on Universal Health Coverage, an estimated 800 million people spend at least 10% of their household income on healthcare. For almost 100 million people, this spend is an out-of-pocket expense that is pushing them into extreme poverty – forcing them to live on $1.90 or less a day. It is estimated that 5.7 million people in low-and-middle income countries (LMICs) across the world die annually from poor quality healthcare, and 2.9 million people die from being unable to access care.The urgency to develop a COVID-19 vaccine, and the access challenges faced by millions of people during the COVID-19 pandemic further highlighted existing inequities.
As a company with a heritage spanning over 130 years, ensuring equitable access to our vaccines and medicines for the patients who need them is a priority that MSD has been actively pursuing. Heading MSD’s operations in a region mainly constituting low-middle-income-countries (LMICs) makes this priority especially important for our ability to improve and save lives throughout EEMEA. Adding to this challenge is the turmoil experienced in varying parts of the region that has resulted in the displacement of people – leaving them even more vulnerable to health challenges with no certain treatment path.
The pandemic was an untimely reminder of the need to invest in affordable and accessible health for all. At the moment of greatest need, many people in LMICs were unable to access vaccines, testing and treatment options for COVID-19 infection as procurement was dominated by wealthier states. But the pandemic also offers some lessons and solutions for the long-term access challenges the world faced even before it hit.
A Commitment to Collective Action
The global collective action to ensure access to health products and services during COVID-19 was unprecedented. Vaccines were developed faster than ever, with investment in research and development and manufacturing by the private sector, governments,
academia and non-profit organizations. Initiatives such as COVAX and the ACT-Accelerator quickly brought together multi-sector partners to get healthcare products to where they were needed. Retaining this momentum and building on the success of the multi-sector arrangements that helped to overcome the pandemic should be a priority at industry, sectoral, governmental and international level to ensure that access in healthcare becomes a challenge of the past.
Innovative Access Solutions
MSD’s COVID-19 therapeutic experience shows the promise of IP-grounded access partnerships, backed by the most comprehensive access strategy in healthcare history. MSD enabled access to its COVID-19 oral antiviral medicine, Molnupiravir in 107 LMIC’s. This was made possible through partnerships with eight voluntary license partners, the granting of over 20 sub-licenses to generics manufactures through the Medicines Patents Pool (MPP), as well as 3 million courses allocated to UNICEF. A further 2 million courses were availed to USAid at MSD’s best access price to increase access in LMICs.
We also had to think outside the box to ensure treatment access to displaced persons, wherever they find themselves as refugees. To this end, more than 100 000 courses of Molnupiravir were donated through the global NGO, Direct Relief to direct towards refugees in LMICs. An additional 50 000 courses were specifically directed to people affected by the invasion of Ukraine.
Beyond ensuring tangible access is the need to guarantee access through affordable pricing. MSD has remained focused on responsible pricing practices and the sustainable pricing of our medicines into the future. This is facilitated through the development of funding models to overcome access barriers by supporting the inclusion of alternative reimbursement through improved private insurance funding and universal health coverage (UHC).
A testament to this can be seen in Egypt where a memorandum of understanding (MOU) was concluded between MSD and the local Universal Health Insurance (UHIA). Through the MOU, the healthcare provider’s ability to serve patients is advanced while we also collaborate to raise awareness about the services of UHIA. It is through efforts like this, and others, that we have been able to treat over 1 million COVID-19 patients with Molnupiravir in less than a year since its first registration in late 2021, and treat nearly half a million cancer patients globally with our immuno-oncology therapy in clinical practice.
Harnessing the power of science
Ensuring we maintain the commitment to safe, high-quality and effective medicines and vaccines is crucial to solving the global access challenge, and this can only be achieved through a focus on scientific innovation. The biggest steps in addressing COVID-19 were made through the development of vaccines and therapeutic treatments faster than ever before. As the world moves on from the COVID-19 pandemic, it needs to continue to have access to innovative, life-saving medicines and vaccines which are only made possible through leading, cutting-edge research and development.
The truest value of an innovation in pharmaceuticals is its ability to generate improvements in patient health that were previously considered unattainable, and a premium placed on pharmaceutical innovation optimizes health outcomes and investment in R&D in areas that are of greatest value to society. Beyond making medicines and vaccines available and affordable, it is important to ensure that high-quality, safe and effective options reach all groups of people, regardless of race, age, geography or other demographics.
As we work continuously do our bit to address the healthcare access related inequalities that result in millions of unnecessary deaths each year, MSD and the organizations it partners with are pieces of an incomplete puzzle. The triple billion targets adopted by the World Health Assembly to see one billion more people benefiting from UHC by 2023 are still far from being realized. It is clear that the role of country governments across the region, and the globe at large, in establishing UHC is the missing piece towards accelerated radical changes in healthcare access.