50 Years Of Global Health Progress – Interview With IFPMA Head Thomas Cueni

Dr Tedros Adhanom Ghebreyesus, WHO Director-General, in his inaugural speech at the World Health Assembly this week, explained that partnerships are a key strategy for the WHO to ensuring healthy lives and promoting well-being for all at all ages.  He added that the WHO is engaging with the private sector as a crucial partner in achieving health for all. Thomas Cueni, IFPMA’s Director General, in an interview with Health Policy Watch on the occasion of the IFPMA’s 50-year anniversary, explains how the research-based biopharmaceutical industry together with IFPMA have contributed to the huge strides in health progress over 50 years. He explains the major leaps forward, setbacks and mistakes, as well as how industry is part of the solution, as “do-ers” and partners in global health progress.  Cueni also talks about pricing and cost of R&D.  

HEALTH POLICY WATCH (HPW): Could you tell us something about the Report on 50 years of the Global Health Progress and how the pharmaceutical industry and how IFPMA has changed since it was set up back in 1968?

THOMAS CUENI: A 50^th anniversary is a time to take stock of what has been achieved and what has fallen short and why. I am surprised when I talk to people about how today’s world compares to 50 years ago and, all too frequently they say it’s ‘much worse’ when quite the opposite is true. When we compiled the 50 Years of Global Health Progress report, what shone out was that transformative progress has been made over that period: people live longer, are healthier and have a better quality of life irrespective of where they live.

The report has consciously homed in on just seven areas of innovation to show the extent of change. The report looks for example at the progress achieved in transforming HIV/AIDS from a deadly disease to a chronic illness is not simply an example of innovation at work but also of a sea-change in access to new treatments. Another area highlighted are the millions of treatments for neglected tropical diseases [NTDs] that are reaching people in some of the poorest parts of the world. We also trace the progress made in treating not one, but scores of types of cancers. Then, progress in treating cardiovascular disease tends to be forgotten, but a quick look back into history, and no less than three US presidents (Truman, Eisenhower and Johnson) died of what is now preventable heart disease. Today’s treatment for diabetes type 1 is like day and night compared with 50 years ago, with new formulations and far easier management of the illness radically improving the lives of sufferers. Hepatitis C used to be a fatal disease, extremely costly to treat and, now, it is curable within 8 to 12 weeks. This is just a snapshot of the astounding progress achieved, a process in which R&D based biopharmaceutical innovation has played a key role.

HPW: Looking back into the past is useful, but how does it apply now?

CUENI: The report marks 50 years since IFPMA was established but celebrating this milestone is not our sole purpose. The intent behind the report is to take stock of the tremendous progress made but to drive home the message that much more needs to be done to bring the fruits of our innovation to all.

We have chosen to launch the report at an event coinciding with the World Health Assembly that gives us reason to reflect on our mistakes and discuss the challenges remaining. There is plenty to discuss. Top of the agenda is the fact that 60 % of the world’s population have to pay for their medicines out of their own pockets. For many, even 20 cents a day may be too much for somebody who has $2 a day as disposable income or even less to live on. We have invited Tim Evans from the World Bank to explain how the UHC nut needs to be cracked. Dame Sally Davis, chief medical officer of the UK, is in my opinion the global champion on antimicrobial resistance. This is an issue that has been creeping up on us over past decades to become a full crisis, with today an estimated 700,000 people dying each year of antibiotic resistant diseases. A huge worry is that this number, already a source of great anxiety, could increase to 10 million a year by 2050. These are just two enormous challenges the global health community faces now and in the years ahead. But ones we are determined to tackle.

HPW: IFPMA is calling for more partnerships, and Dr Tedros also made reference to this in the opening speech of the WHA, how do we know if they really have an impact on improving global health?

CUENI: Vaccination is a great area to demonstrate the impact of innovation combined with partnerships. GAVI Alliance is a crucial initiative which, in partnership with the R&D based biopharmaceutical industry, has brought great progress. Now, thanks to GAVI, you have vaccination rates in low income countries (LDCs) which are almost equal to those in industrialized countries. Back in 1971, the MMR vaccine in one shot was approved in 1971. Today vaccines have been developed to prevent 26 diseases. Vaccines are proven to be one of the most effective and cost efficient medical technologies ever developed. Immunization saves between 2 and 3 million children’s lives per year. However, looking at the challenges remaining, vaccination rates are much lower in crisis countries, conflict countries, and they even lag behind in middle income countries.

HIV/AIDS is another area where partnership have led to tremendous progress. The Global Fund [for AIDS, Tuberculosis and Malaria] backed by the private sector allowed countries to provide coverage to patients who would not even have been able to gain access to very cheap generic medicines. There is also the Medicines Patent Pool. This partnership has negotiated voluntary licenses concerning HIV/AIDS with companies so that the most recent treatments are available. I can recall the late 1990s when the average treatment regime with ARV (antiretroviral) drugs involved more than 20 medicines per day, which was daunting. Today, modern treatments for HIV/AIDS are what is called combination drugs, vastly increasing the chances that the patient will follow the regime, with fewer side effects and more easily administered, so the chances of people surviving with HIV/AIDS are infinitely better. Today, there is a willingness, which did not exist 20 years ago, on the part of companies to enter into voluntary licensing agreements and offer their patented drugs to generic companies so that they are made more widely available. There are other partnerships involving the R&D based pharmaceutical industry, including: MMV, TB Alliance, FIND, DNDi, the London Declaration on NTDs. Industry’s willingness to enter into partnerships that make a difference is clear and sustained.

NOTE: READ THE FULL INTERVIEW ON HEALTH POLICY WATCH, www.healthpolicy-watch.org.