1. Access to Medicines: NCDs & NTDS: INSULIN VS PRAZIQUANTEL
Shiffman “Four Challenges that Global Health Networks Face” Framework as a tool to contrast the challenges in access to medicines for NCDS & NTDs: Insulin versus Praziquantel
Access to Medicines: NCDs & NTDS: INSULIN VS PRAZIQUANTEL
LMICs are facing a growing double burden of disease: NTDs and NCDs
80% of 35 million NCD deaths are in LMICs (WHO) and two of every three years lived with disability, NTD mortality up to 1 million per year and 56 million DALYs
Effective long extant medicines exist but affordability and availability continue to be challenging
Global health community treats NTD and NCD challenges differently and there is little comparative literature
Framing and coalitions around medicines impact access for the poorest populations
Study Design/Methodology
Methodology
Chose to compare a long extant medicine from each field – insulin vs praziquantel Comparative design: assess success of the global health networks around these medicines using Shiffman’s approach Shiffman’s research: governance mechanisms, framing and resulting coalitions ultimately impact the level of support for achieving access success Objective to establish successful strategies that could be applied from one field to another
WHO frameworks on NCDs and NTDs explored for core guidelines
WHA resolutions examined
Relevant literature reviewed systematically
Online searches for each disease group and each medicine as they relate to Shiffman eg ‘NTD + governance’, ‘schistosomiasis + coalition’, ‘insulin + priority’
Websites of identified coalitions searched
Key results analysed to explore best practice
Results
Problem definition/positioning
Coalition Building
Governance
Level of Global Priority
Shiffman Framework
NTD governance places praziquantel at core, NCD framework around prevention Both diseases need both medicine and prevention Pharmaceutical firms need to be at the core of the access path but with incentives to deliver affordable medicine Expansion of NTD medicine delivery programmes to include chronic NCDs Benefit from global health implementation partners and economies of scale Increasingly HIC problem too -> amplify need for change Innovative business models built around affordability and access and financial sustainability
Nadya Wells, Research Fellow, IHEID,
Conclusions: Best Practice
Problem def/Positioning
Coalition Building
Governance
Level of global Priority
Incorporate access pathways
Not about R&D, medicine and pricing
Transdisciplinary approach
Transdisciplinary structures eg GSA WASH
Pharmaceutical producers core
Financial incentive
Integrated approach
NCD/NTD framing divisive
Systems thinking
Population based approach
Ensure affordable formulations
New business models