36 Gordon Square
London WC1H 0PD

T +44 (0) 20 7958 8251
admin@lidc.bloomsbury.ac.uk

New Research Group Dedicated to Transforming Access to Medicines

Lives are being lost in the developing world because the policy implications of new cures for neglected diseases are not properly understood. That was the message at the launch of Policy Cures – a new research group seeking to improve how policy-makers respond to deadly diseases. The London branch of Policy Cures – formerly part of the George Institute for Global Health – is based at LIDC's offices.
 
Failures of policy-making
Dr Mary Moran, Director of Policy Cures, explained how policy-making is lagging behind technical innovations, particularly regarding diagnostics, at the event hosted by LIDC on 16 September. She gave the example of tuberculosis – a disease which causes two million deaths a year. A new test for tuberculosis can now diagnose the disease within two hours, including multi-drug resistant tuberculosis (MDRTB). It is 98 per cent accurate, making it far superior to the commonly used smear microscopy test, which was first used 125 years ago. Moran claimed the new diagnostic has the potential to “revolutionise” MDRTB treatment, yet there is no funding to rollout the new testing equipment diagnostic on a large scale and not enough information about where and when it should be used.
 
She said these issues should already have been investigated by policy-makers, especially as the new diagnostic has been in the pipeline for five years. Her conclusion was clear: the treatment of MDRTB is now being delayed by the shortcomings of policy-makers. She said: “There is a tendency to focus on known problems rather than looking ahead. Policy is not keeping up with new tools and lives are lost. Good policy does make a difference.” Moran concluded by calling for applied health policy to take advantage of innovations, including mobile telephony, Information Technology, and Web 2.0 tools.
 
Sustainable solutions needed
Professor David Heymann, of the London School of Hygiene and Tropical Medicine and Chatham House, explained the recent history of access to health-related products and services and the challenges ahead. In his presentation he highlighted the cost of malaria – estimated at $12 billion per year – and how the donor community has shifted from the pursuit of only providing vaccines to providing medicines. However, Heymann said there are serious questions about the long-term future of initiatives set up after 2000, such as The Global Fund to Fight AIDS, Tuberculosis and Malaria. He added: “Today’s models are quick fixes, but they may not be sustainable. The answer is not yet there.”
 
Importance of behaviour
Professor Rob Horne, of The School of Pharmacy, continued the debate by introducing the often neglected issue of patient behaviour. He said effective treatment requires both the appropriate prescription of medicines, and their usage. Horne said access to medicines in the developed world is not a problem, but non-adherence to prescribed drugs is a barrier. World Health Organization research has shown that 50 per cent of all medicines for long-term conditions are not used as prescribed. Horne also cited his own work relating to anti-retroviral drug adherence among people living with HIV in Brighton; 27 per cent of people offered prescriptions refused to take the medicines. Such non-adherence was motivated by various factors, including doubts about personal need, concerns about side effects, and stigma associated with taking anti-retroviral drugs. Horne said it is necessary to make medicines acceptable and that there are many lessons to be learned from experiences in the developed world.
 
Diagnostics are undervalued
Professor Rosanna Peeling, of LSHTM, detailed the challenges facing diagnostics. She said there is a lack of investment by companies due to a perceived lack of return, governments do not value diagnostics, and there is a lack of regulatory transparency (certain tests are sold and used without evidence). In her presentation Peeling called for “fast-tracking” the translation of evidence to policy, and issued a stark warning relating to the use of the new tuberculosis diagnostic. She said: “How many tuberculosis patients will die while we wait for this new technology to be affordable and available?”
 
By Guy Collender, Senior Communications Officer at LIDC
 
Resources
 
Access to Health-related Products, Technologies and Services, Powerpoint delivered by Professor David Heymann,16 September
 
Improving Access to Diagnostics in the Developing World, Powerpoint delivered by Professor Rosanna Peeling,16 September