Cheaper drugs will not solve today’s health concerns

OECD Forum, 14th May, 2001: Health: Challenges for the 21st Century; moderator Donald J. Johnston, secretary-general, OECD
OECD Observer

The health of poor nations is every nation’s problem, even the richest. But money alone is no panacea. This was the main message of a panel discussion on healthcare at OECD’s Forum 2001 on Sustainable Development and the New Economy.

“Diseases such as HIV/AIDS are a common global enemy that threaten economic growth and national security,” said Raymond Gilmartin, chairman, president and CEO of Merck & Co., Inc. If it continues, warned Donald Johnston, OECD secretary-general, the wide gap in health status between developed and developing nations will greatly impede sustainable development.

“The nature of the challenge is bigger than any country or company,” said Mr Gilmartin, who suggested a multi-pronged attack – through government, private, and corporate partnerships – to affect real change.

He cited Merck’s involvement with the Gates Foundation (established by the founder of Microsoft) and the government of Botswana to address HIV/AIDS, which, thanks to a combined $100 million donation from the two corporations, has been able to develop its own broad education and disease prevention programme. This now serves as a model for other such programmes.

Mr Gilmartin called for a global fund for diseases like AIDS, malaria and tuberculosis. But even with such a “modern-day Marshall Plan,” the grave health concerns in developing nations cannot be solved amidst political infighting and civil wars.

“The guns must be silenced,” said Cunningham Ngcukana, general secretary, National Council of Trade Unions in South Africa. Conflicts in nations like Somalia, Angola, and Liberia are further exacerbating an already terrible situation by creating a huge refugee problem that in turn fuels huge health problems. Mr Ngcukana questioned whether the West’s response might be different if it were its own people who were affected.

Bernard Kouchner, French minister of health and former president of Médecins Sans Frontières (Doctors Without Borders), reiterated that disease has no borders. He went on to applaud the World Health Organisation for convincing governments of the North to share therapies with poorer countries. “The rich nations must invest in pharmaceutical research so pharmaceutical companies can give the molecules to the poor nations,” he said.

Disease and poverty create a vicious cycle that is increasingly difficult to break. While HIV/AIDS is generally under control in the rich nations, it has reached epidemic proportions in Africa. Of the 34 million people diagnosed with HIV, 24 million live in sub-Sahara Africa, now home to over two-thirds of the world’s HIV population. While whole populations and economies are headed for destruction, many in the West continue to harp on about the costs of these health problems.

“No one raises concerns about communication costs, but they do when the issue is health,” said Jean-Hervé Bradol, president, Médecins sans Frontières. Mr Bradol went on to praise the recent efforts by pharmaceutical companies to help out and called on medical associations to do more.

All agreed that raising money to bring treatments to poor nations is but a first step. After all, as Mr Kouchner pointed out, even if we had an unlimited supply of drugs, we would still need to create infrastructures to provide education to populations, and provide doctors and healthcare professionals to manage the therapies. Sustainable healthcare practices are now needed. That means going beyond just supplying doctors and drugs. “We actually need something like ‘hospitals without borders,’” Mr Kouchner explained.

©OECD Observer May 2001 

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