Access to Healthcare and Medicines

Building on his report for the European Parliament of 2005 on Major and Neglected Diseases, John Bowis - together with his ACP colleague, Mr. Martin Magga from the Soloman Islands, has presented a report to the ACP-EU Joint Parliamentary Assembly on Access to Healthcare and Medicines with a particular focus on neglected diseases.

One sixth of the world's population - 1 billion people - is affected by diseases the world neglects. Many of these neglected diseases - such as Sleeping Sickness, Buruli Ulcer, Chagas' Disease, Dengue, Kala Azar, River Blindness and Snail Fever - may not have high levels of mortality but can be called poverty diseases because of they cause chronic illness, disability and deformity - making it difficult or impossible to work and contribute to the family and economy.

Diarrhoea, for instance, causes 2.2 million fatalities a year (more than the death toll of Tuberculosis). Waterborne diseases, malnutrition, parasitic worms and vectors all impact on people in developing countries. The Onchocerca volvulus worm, for example, causes blindness and skin disease, infecting 37 million people; 95% of whom are in West and Central Africa. And there are new threats and challenges such as multi-drug resistant strains of diseases such as TB.

The report sets out the range of responses to improve access to healthcare and medicines by:

- ensuring national budgets and international aid focus on health;

- promoting all the prevention tools at our disposal and developing new ones;

- building the capacity and infrastructure of health systems;

- advancing the research and development into new diagnostics, drugs and vaccines.

The report audits the positive developments, for example, the World Health Assembly is now working on a needs-driven, essential health Research and Development (R&D) programme, and there is specific mention and money for neglected diseases in the EU's Seventh Framework Programme for Research. Above all, there is renewed political will to do something about the neglected diseases of the developing world.

But the report notes that there are still big gaps in R&D. A greater emphasis needs to be placed on the "D" in the "R&D" so that we can take the wealth of basic research and translate it into innovate treatments and therapies - suited to the local needs and conditions of resource-poor countries. Integrated projects taking candidate chemicals through the development process to registration and manufacture of new products have sadly been lacking in the past. There has been an over-reliance on existing technologies and interventions. Patients suffering from neglected diseases are still too often given archaic drugs, some of which are highly toxic, ineffective or difficult to administer.

The challenge now is to sustain and step up the Research and Development efforts, using public-private partnerships and other instruments to support drug candidates through the development pipeline and to expand the work to a broad range of diseases beyond HIV/AIDS, Malaria and TB.

The report also stresses the importance of health capacity building. It is no use having new drugs, vaccines and equipment if there is no system for their delivery, administration and use on the ground. Health system infrastructure, including both human and institutional capacity, is absolutely critical to improving healthcare. In addition to the lack of diagnostic tools and drugs, the fight against disease and ill health is impeded by weak health systems, a crisis in health workforce numbers, and ineffective aid.

Health systems in many countries are starved of resources. The countries themselves need to invest more from national budgets. The Abuja Declaration of 2001 set a target of 15% of national public expenditure to be dedicated to health, yet many developing countries are still woefully behind in achieving this target. The international community will need to complement country-level investments with secure, long-term financial support and technical support, including training of health workers at the local level.

The report will be adopted at the ACP-EU meeting in Rwanda (2007).