Home Semasa Lack of affordable medicines, jeopardises public health

Lack of affordable medicines, jeopardises public health

by Adrian David

KUALA LUMPUR, 14 MARCH – The affordability of medicines for the public is one of the most pressing obstacles encountered in many countries.

Deputy Health Minister Datuk Lukanisman Awang Sauni said that the matter was a constraint that jeopardised the fundamental right to health for citizens, in their respective countries.

“This reality underscores the urgency in which we must address the issue and sketch the next collaborative actions.

“As the biggest public healthcare provider in Malaysia, the Health Ministry faces unceasing challenges in providing access to affordable medicines for the general population.

“With the rise of medicine prices worldwide and global economic uncertainty, efforts have been made to mitigate the impact of this situation,” Lukanisman said at the ‘Brazil-Malaysia: Equitable Access to Medicines’ seminar at the Mandarin Oriental Kuala Lumpur.

Present was Brazil ambassador to Malaysia Ary Norton de Murat Quintella, while Oswaldo Cruz Foundation-Fiocruz Production and Innovation in Health vice-president Dr Marco Krieger participated via video-conferencing from Brazil.

Lukanisman said that to address the affordability issue, his ministry had since 2019, ventured into pooled procurement of medicines involving other public healthcare providers like the Ministries of Defence and Higher Education.

“This initiative, which encompasses of more than 80 medicines, has provided total savings of RM179 million to the government,” he said.

Lukanisman added that Brazil and Malaysia, despite the geographical distance, shared striking similarities in their healthcare landscapes.

“Both are tropical megadiverse countries; both face common challenges ranging from tropical diseases to emerging pandemics and non-communicable diseases.

“Hence, access and equity in medicine between Brazil and Malaysia is a subject of the utmost importance, and I believe this event provides us with the opportunity to foster cross-sectoral dialogue and the interchange of ideas and understandings on the subject.

“Seminars such as these are essential in fostering professional interactions and serve as a platform for identifying synergies and exchange of best practices in tackling this pressing subject.

“From ensuring the equitable distribution of pharmaceutical manufacturing capacity to combating the discrimination and marginalisation of vulnerable populations, we are poised to delve into the heart of the matter.

“Moreover, we must confront the implications of intellectual property rights on public health, a topic of paramount importance in our discussions,” Lukanisman said.

Moving further, Lukanisman said, Malaysia had implemented the ‘Generic Medicines Policy’ since the establishment of the ‘Malaysian National Medicines Policy’ (MNMP) in 2006.

“Through this policy, procurement and prescribing of medicines are conducted using ‘International Non-proprietary Names’ (INN), thus, prioritising the use of generic medicines, which are often a more affordable option compared to patented medicines.

“Malaysia is leading the ‘Asean Drug Security and Self-Reliance’ (ADSSR) initiative, aiming to improve access to medicines and enhance drug security.

“Potential collaboration areas include pooled procurement, aiming to enhance healthcare affordability.

“In parallel, this event has provided a unique opportunity to gather experts and relevant stakeholders from the government, civil society, and the multilateral system.

“Together, we can spur the development of bilateral and multilateral collaboration towards health for all,” Lukanisman said.

He added that by harnessing the collective expertise and resources of all stakeholders, they could pave the way for a more equitable and accessible healthcare landscape in their countries and beyond.

“By leveraging regional collaboration and sharing resources, we can confront the health threats of our time more effectively.

“Through the ‘South-South Cooperation’, concrete and ambitious projects such as the ‘Hepatitis C Ravidasvir Development’ led by Malaysia and efforts from the Dengue Alliance, hold promise in this regard,” Lukanisman said.

Malaysia, he added, took pride in the successful registration of Ravidasvir in 2021 and its subsequent inclusion in the World Health Organization (WHO) ‘Model List of Essential Medicines’ in 2023.

“This milestone underscores our commitment to developing cost-effective treatments for seven Hepatitis C, thereby expanding access to affordable medicines across sectors,” said Lukanisman.

Under Malaysia’s Madani governance. Lukanisman said the country had outlined its vision through the ‘National Agenda for Healthy Malaysia’ (ANMS) – a comprehensive 10-year plan engaging governmental, private and community sectors – to enhance societal health and well-being.

“In response to the Covid-19 pandemic, Malaysia has proactively strategised for a resilient healthcare system through the Health Ministry’s development of the ‘Health White Paper Policy’.

“This policy aims to ensure accessibility, affordability, sustainability and resilience in healthcare delivery.

“Moreover, the reform emphasises the integration of digital technologies into health systems, including online appointments, virtual clinics, ‘Electronic Medical Records’ (EMR) and leveraging artificial intelligence (AI) for disease surveillance and crisis management,” Lukanisman said.

Considering the shared challenges faced by both Malaysia and Brazil – nations endowed with tropical biodiversity – Lukanisman added that it was imperative to address issues such as non-communicable diseases, emerging pandemics, and tropical illnesses.

“The escalating cost of medications poses a threat to the fundamental health rights of citizens in both countries, requiring collaborative measures to mitigate these challenges.

“Therefore, the joint determination and commitment that each of you has displayed today to discuss this matter is extremely motivating.

“It is imperative that we capitalise on this occasion to devise a plan for the future in which universal access to medicines is equitable.

“Together, we can foster the development of healthier and more resilient communities while striving to achieve improved health outcomes for all individuals,” Lukanisman summarised.

Meanwhile, de Murat Quintella highlighted how the inequalities in access to medicines and medical products affected women in a disproportionate way.

He said that In Brazil, the gender pay gap between men and women was estimated at 22 per cent.

“Different studies have shown that approximately half of Brazilian households have women as their main provider, with more than half of those being black women, which in Brazil still means, unfortunately, women most likely to be underprivileged.

“If we take into consideration that Brazilian families’ expenses with private healthcare represent 5.8 per cent of the gross domestic product in 2019, a number that is twice as high as the Organisation for Economic Co-operation and Development average of 2.3 per cent, we can see how the affordability of health care and the socioeconomic situation of women are deeply connected and intertwined, compounding on the challenges for women’s and families’ well-being,” de Murat Quintella said.

He added that like Malaysia, Brazil was investing in tackling the health challenges that most affect women.

He said that Brazil had its first female Minister of Health, Nísia Trindade, the former president of Fiocruz.

Last February, Nísia launched the ‘National Strategy of Prevention and Elimination of Cervical Cancer’, based on expanding vaccination against human papillomavirus (HPV), with a goal to reaching 80 per cent of the target population.

“As Malaysia, Brazil is determined to eliminate cervical cancer as a public health problem.

“In this regard, we took part in the ‘Global HPV Consortium’ launched here in Kuala Lumpur last September and look forward to working together on this area.

“However, ensuring access to safe, effective, quality and affordable diagnostics, vaccines, medicines and medical products is still constrained by several barriers, related to the international frameworks in place for production of medicines, as well as for research, development and innovation in health.

“Malaysia and Brazil find themselves in a similar situation.

“Our countries are both classified by the World Bank as upper middle-Income countries, with Malaysia very close to reaching high-income country status.

“Both governments have a commitment to ensure the right to health, providing solid government financial support and guarantee medical products to their population,” said de Murat Quintella.

He pointed out that production and research in the pharmaceutical sector was still highly concentrated in the global north, which accounted for more than 70 per cent of all research conducted.

“The paradox that affects upper-middle income countries was stark during Covid-19.

“Brazil and Malaysia, which do not host large pharmaceutical industries, reserved significant resources to the procurement of medical products and vaccines – and despite being willing to pay similar prices as developed countries – were left in the back of the line, having to leave behind large segments of their populations in vulnerable situations.

“That is why Brazil has set the goal of producing 70 per cent of its demand for medicines, vaccines and medical supplies internally, while at the same time committing to technology transfer and open innovation in health.

“Brazil is also enhancing its preparedness to health emergencies, aware of the challenges in the coming years associated with climate change, emerging infectious diseases and non-communicable conditions,” de Murat Quintella said.

He cited an example of the challenge as the current dengue emergency in Brazil.

To address it, he said the Brazilian government had allocated 1.5 billion reais to support local governments in dealing with emergencies in 2024.

It also had acquired 6.5 million doses of vaccine for 2024 and nine million for 2025; and created an ‘Arbovirus Emergency Operations Center’ to monitor cases of dengue, zika and chikungunya and coordinate response actions and clinical management of patients.

“Of course, Brazil also extends its full support to the Dengue Alliance, a project that unites Brazil, Malaysia, Thailand and India, as well as ‘Drugs for Neglected Diseases’ in research and development for treatments against dengue.

“These discussions are central to the priorities of Brazil for our G20 presidency.

“The ‘Health Working Group’ of the G20, under the Brazilian presidency, will focus on how local and regional production of medicines contributes to pandemic preparedness, as well as on the impacts of climate change on health.

“Furthermore, Brazil has invited Malaysia to be a member of the Bioeconomy Initiative of the G20 this year, a forum that will discuss, among other topics, how bioeconomy plays a crucial role in ensuring equitable access to essential medical products,” de Murat Quintella said.

More importantly, the debates today represent a cornerstone for cooperation between Brazil and Malaysia.

De Murat Quintella stressed that the links between Brazil and Malaysia were historical, geographical, natural and political.

“In the current scenario of an international order that is being put into an extraordinary level of tension due to geopolitics and climate change, important countries in the global south must put in the efforts to work together, multilaterally, bilaterally or within like-minded groups, to recenter the debate on international development and autonomy for all people.

“Guaranteeing health and the well-being for all is a foundation of our collective goals as an international community.

“Malaysia and Brazil are, thus, in privileged positions to promote the right to health,” de Murat Quintella said. – airtimes.my

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