matrix of essential drugs

MDG Gap Task Force

Access to Affordable Essential Medicines

Indicator 8.13 under Target 8.E seeks to measure the proportion of the population in each country with access to affordable essential drugs on a sustainable basis, although data availability is a significant problem. The ‘access’, ‘affordability’ and ‘sustainability’ components of the indicator will depend on both domestic and international factors, and the Target also seeks to capture the extent to which the pharmaceutical sector is contributing to providing access.

It is difficult to measure the “delivery gap” of essential medicines not only because of the lack of data but also because of the lack of numerical targets and commitments. While Target 8.E also intends to track the contribution of pharmaceutical companies to increase access to affordable medicines in developing countries, there are no quantitative targets and indicators in the MDG framework.

Commitment/Initiative	Target & indicators	Gap
Millennium Summit, New York, 6-8 September 2000 —MDG-8	Target 8.E: In cooperation with pharmaceutical companies, provide access to affordable drugs in developing countries Indicator: 8.13. Proportion of the population with access to affordable essential drugs on a sustainable basis	Lack of numerical targets prevents proper monitoring of global commitments. Availability of medicines in developing countries is low, 42% in the public sector and 64% in the private sector (in countries with available information). Prices of medicines remain high. Median prices of generic medicines are, on average, between 2.7 and 6.3 times higher than international reference prices, in the public and private sectors, respectively. Essential medicines are unaffordable to large segments of population in developing countries. Monthly costs of medicines to treat chronic diseases are often equivalent to several days’ salary of the lowest paid government worker. Originator branded medicines are even more unaffordable.
UNITAID international drug purchase facility, September 2006	Target: Provide additional predictable funding to scale up access to essential medicines and diagnostics at a sustainable cost.	No numerical targets have been set for patients or medicine prices.
International Finance Facility for Immunization, January 2006	Target: 500 million children vaccinated and at least 5 million lives to be saved by 2015.	As of 30 September 2009, IFFIm had approved programmes of $2 billion (since inception). Of that amount, more than $1.2 billion has already been disbursed to support vaccine purchase and delivery to 70 developing countries.
Advanced Market Commitments, February 2007	Target: 1.5 billion dollars to create incentives to develop vaccines to treat the pneumococcal disease.	In March 2010, GlaxoSmithKline (GSK) and Pfizer Inc. were the first companies that committed to supply millions of doses of life-saving vaccines for 10 years at an affordable price. Supply of the vaccine has not started yet, but may start in 2010.
OECD High Level Forum on Medicines for Neglected and Emerging Infectious Disease: Noordwijk Medicines Agenda, Recommendations of June 2007	Target: OECD countries to support developing countries-led efforts in strengthening their own health, local production and research systems. Indicator: Taking steps to strengthen the capability of developing countries to manage issues of intellectual property (IP), including using available flexibilities to the fullest extent, and to build sustainable networks and capacity for global research.	No numerical targets have been set.
Recommendations by the Provisional Committee on Proposals Related to a WIPO Development Agenda (PCDA), June 2007	Target (inter alia): In its activities, including norm setting, WIPO should take into account the flexibilities in international IP agreements, especially those which are of interest to developing countries and LDCs (Cluster B, para. 17); To request WIPO to intensify its cooperation on IP related issues with UN agencies, according to Member States’ orientation, in particular UNCTAD, UNEP, WHO, UNIDO, UNESCO and other relevant international organizations, especially WTO in order to strengthen the coordination for maximum efficiency in undertaking development programmes.	No numerical targets have been set.
G 8 Heiligendamm Declaration on Growth and Responsibility in Africa, June 2007	Target: G 8 to work with - intergovernmental organizations to respond constructively to requests by African developing countries without manufacturing capacities with regard to the use of the flexibilities referenced in the WTO Doha Declaration on TRIPS and Public Health, while respecting WTO obligations; - the pharmaceutical industry to consider supporting local production of HIV/AIDS pharmaceuticals by voluntary licenses and laboratory capacities that meet international standards and strengthen regulatory, certification and training institutes.	No numerical targets have been set.
European Parliament Resolution on the TRIPS Agreement and access to medicines, 12 July 2007	Target: EU and its Member States to take additional measures to facilitate and increase the production of pharmaceutical products by the developing countries themselves; to provide concrete financial support for local production of pharmaceuticals in all developing countries, especially LDC.	No numerical targets have been set.
African Union Pharmaceutical Manufacturing Plan for Africa, October 2007	Target: to pursue, with the support of partners, the local production of generic medicines on the continent and to make full use of the flexibilities within the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and the WTO Doha Declaration on TRIPS and Public Health. Indicator: consideration by African governments of legislative reforms of domestic IP statutes and regulations.	No numerical targets have been set.
WHO Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property, Adopted by resolution 61.21 at the May 2008 World Health Assembly	Target: for WHO intergovernmental working group to elaborate a draft global strategy and plan of action for essential health research concerning diseases that disproportionately affect developing countries. Indicators: Number of countries engaged in initiatives to strengthen capacities to manage and apply intellectual property rights to contribute to innovation and promote public health, including capacities relevant to the development and application of international agreements Number of countries integrating flexibilities for protection of public health of the TRIPS Agreement into national legislation Number and type of initiatives between secretariats and governing bodies of relevant regional and international organizations aimed at coordinating work relating to intellectual property and public health	Finalize the timeframes, and estimated funding needs for the implementation of the global strategy and plan of action.
Affordable Medicines Facility—Malaria (AMFm), to be launched in 2010	The AMFm aims to promote the use of effective antimalarials and drive out ineffective medicines from the market by reducing consumer prices to an affordable level through price negotiations and a buyer co-payment.	No numerical targets have been set.
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