World Federation of Neurology
The revised daft roadmap for improved access to medicines and vaccines was developed through informal discussion with representatives of the United Nations and other international organizations and non-State actors in official relations with WHO, based on existing WHO mandates in key Health Assembly resolutions of the last 10 years for access to safe, effective and quality medicines, vaccines and health products. It also reflects burgeoning GBND and the Thirteenth Global Programme of Work. The draft Roadmap is comprehensive document based on a systems approach to two key overlapping areas:ensuring quality and safety and ensuring equitable access.The WFN believes that this may work for some MIC and HIC countries but not for LIC and LMIC where health system resources are inadequate. The WFN has specific concerns with three areas which it believes are significant contributors. The first is that there are competing forces at play which maintain the high cost of medications. The roadmap correctly deals with the quality and competence of regulation and of supply chains in LIC, it avoids the failure of distorted uncompetitive markets in UIC and MIC to drive down prices which facilitate high prices globally. The second is that in LIC the barriers are so many and varied that LIC governments struggle to overcome them and may even have difficulty in barrier prioritization. The third is the factor common to LIC which is inadequate financial resources. The overall Intent of the roadmap is supported strongly by the WFN while at the same time urging the WHO to undertake and publish case studies for the LIC and L/MIC, to advocate strongly for reform of HIC pharmaceutical markets and to consider the promotion of trials where aid to LIC is to tied to specified access programmes. The situation remains so critical that the WHO may need to extend its partnerships with NSA who see NCD as diseases like lay populations, rather than as health systems and thus generate more action.