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Vallin M, Tomson G, Kampmann B, Engebretsen E, Swartling Peterson S, Wanyenze RK, Ottersen OP. Life Science 2.0: reframing the life science sector for 'the benefit on mankind'. Glob Health Action 2024; 17:2330758. [PMID: 38577884 PMCID: PMC11000595 DOI: 10.1080/16549716.2024.2330758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/11/2024] [Indexed: 04/06/2024] Open
Abstract
The COVID-19 pandemic put the life science sector to the test. Vaccines were developed at unprecedented speed, benefiting from decades of fundamental research and now honoured by a Nobel Prize. However, we saw that the fruits of science were inequitably distributed. Most low- and middle-income countries were left behind, deepening the inequalities that the Sustainable Development Goals were set to reduce. We argue that the life science sector must reinvent itself to be better and more equitably prepared for the next health crisis and to ensure fair access to health across current and future generations. Our recommendations include global governance, national strategies and the role of universities and corporations. Improved and more equitable health care should be centre stage for global health action and a core mission of a reframed Life Science sector - what we call Life Science 2.0.Paper ContextMain findings: During the COVID-19 pandemic the Life Science sector stepped up to the challenge, but vaccines and medicines were not equitably distributed.Added knowledge: Obstacles were identified that hindered global access to medical innovations.Global health impact for policy and action: Global and national governance, universities and the private sector should join forces to create a Life Science sector (Life Science 2.0) that affords equitable access to medical advances across geographical and generational boundaries and socio-economic strata.
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Affiliation(s)
- Michaela Vallin
- Chemical Biology Consortium Sweden, SciLifeLab, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Göran Tomson
- Department of Learning, Informatics, Management, and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Beate Kampmann
- Charité Centre of Global Health, Charité Universitätsmedizin, Berlin, Germany
| | | | - Stefan Swartling Peterson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- College of Health Sciences, School of Public Health, Makerere University, Kampala, Uganda
| | - Rhoda K. Wanyenze
- College of Health Sciences, School of Public Health, Makerere University, Kampala, Uganda
| | - Ole Petter Ottersen
- Charité Centre of Global Health, Charité Universitätsmedizin, Berlin, Germany
- Sustainable Health Unit and Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Torreele E. Why are our medicines so expensive? Spoiler: Not for the reasons you are being told…. Eur J Gen Pract 2024; 30:2308006. [PMID: 38299574 PMCID: PMC10836477 DOI: 10.1080/13814788.2024.2308006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/15/2024] [Indexed: 02/02/2024] Open
Abstract
Often described as a natural economic trend, the prices that pharmaceutical companies charge for new medicines have skyrocketed in recent years. Companies claim these prices are justified because of the 'value' new treatments represent or that they reflect the high costs and risks associated with the research and development process. They also claim that the revenues generated through these high prices are required to pay for continued innovation.This paper argues that high prices are not inevitable but the result of a societal and political choice to rely on a for-profit business model for medical innovation, selling medicines at the highest price possible. Instead of focusing on therapeutic advances, it prioritises profit maximisation to benefit shareholders and investors over improving people's health outcomes or equitable access.As a result, people and health systems worldwide struggle to pay for the increasingly expensive health products, with growing inequities in access to even life-saving medicines while the biopharmaceutical industry and its financiers are the most lucrative business sectors.As the extreme COVID-19 vaccine inequities once again highlighted, we urgently need to reform the social contract between governments, the biopharmaceutical industry, and the public and restore its original health purpose. Policymakers must redesign policies and financing of the pharmaceutical research and development ecosystem such that public and private sectors work together towards the shared objective of responding to public health and patients' needs, rather than maximising financial return because medicines should not be a luxury.
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Affiliation(s)
- Els Torreele
- Institute for Innovation and Public Purpose, University College London, London, UK
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Ares-Blanco S, Guisado-Clavero M, Lygidakis C, Fernández-García M, Petek D, Vinker S, Li D, Stadval A, Solves JJM, Del Rio LR, Larrondo IG, Fitzgerald L, Adler L, Assenova R, Bakola M, Bayen S, Brutskaya-Stempkovskaya E, Busneag IC, Divjak AĆ, Peña MD, Domeyer PR, Gjorgjievski D, Gómez-Johansson M, Hanževački M, Hoffmann K, Iлькoв O, Ivanna S, Jandrić-Kočić M, Karathanos VT, Kirkovski A, Knežević S, Korkmaz BÇ, Kostić M, Krztoń-Królewiecka A, Heleno B, Nessler K, Lingner H, Murauskienė L, Neves AL, López NP, Perjés Á, Petrazzuoli F, Petricek G, Sattler M, Saurek-Aleksandrovska N, Seifert B, Serafini A, Sentker T, Tiili P, Torzsa P, Valtonen K, Vaes B, van Pottebergh G, Gómez-Bravo R, Astier-Peña MP. Exploring the accessibility of primary health care data in Europe's COVID-19 response: developing key indicators for managing future pandemics (Eurodata study). BMC PRIMARY CARE 2024; 25:221. [PMID: 38902681 PMCID: PMC11188206 DOI: 10.1186/s12875-024-02413-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 04/29/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Primary Health Care (PHC) plays a crucial role in managing the COVID-19 pandemic, with only 8% of cases requiring hospitalization. However, PHC COVID-19 data often goes unnoticed on European government dashboards and in media discussions. This project aims to examine official information on PHC patient care during the COVID-19 pandemic in Europe, with specific objectives: (1) Describe PHC's clinical pathways for acute COVID-19 cases, including long-term care facilities, (2) Describe PHC COVID-19 pandemic indicators, (3) Develop COVID-19 PHC activity indicators, (4) Explain PHC's role in vaccination strategies, and (5) Create a PHC contingency plan for future pandemics. METHODS A mixed-method study will employ two online questionnaires to gather retrospective PHC data on COVID-19 management and PHC involvement in vaccination strategies. Validation will occur through focus group discussions with medical and public health (PH) experts. A two-wave Delphi survey will establish a European PHC indicators dashboard for future pandemics. Additionally, a coordinated health system action plan involving PHC, secondary care, and PH will be devised to address future pandemic scenarios. ANALYSIS Quantitative data will be analysed using STATA v16.0 for descriptive and multivariate analyses. Qualitative data will be collected through peer-reviewed questionnaires and content analysis of focus group discussions. A Delphi survey and multiple focus groups will be employed to achieve consensus on PHC indicators and a common European health system response plan for future pandemics. The Eurodata research group involving researchers from 28 European countries support the development. DISCUSSION While PHC manages most COVID-19 acute cases, data remains limited in many European countries. This study collects data from numerous countries, offering a comprehensive perspective on PHC's role during the pandemic in Europe. It pioneers the development of a PHC dashboard and health system plan for pandemics in Europe. These results may prove invaluable in future pandemics. However, data may have biases due to key informants' involvement and may not fully represent all European GP practices. PHC has a significant role in the management of the COVID-19 pandemic, as most of the cases are mild or moderate and only 8% needed hospitalization. However, PHC COVID-19 activity data is invisible on governments' daily dashboards in Europe, often overlooked in media and public debates.
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Affiliation(s)
- Sara Ares-Blanco
- Federica Montseny Health Centre, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- SemFYC representative in EGPRN (European General Practitioner Research Network), Madrid, Spain
| | - Marina Guisado-Clavero
- Investigation Support Multidisciplinary Unit for Primary Health Care and Community North Area of Madrid, Madrid, Spain
| | - Charilaos Lygidakis
- World Organization of Family Doctors (WONCA) Chief Executive Officer, Brussels, Belgium
| | - María Fernández-García
- Las Cortes Health Centre, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
- semFYC Vice-Chair, Madrid, Spain
| | - Davorina Petek
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- EGPRN, Brussels, Belgium
| | - Shlomo Vinker
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University and WONCA Europe President, Tel Aviv, Israel
| | - Donald Li
- World Organization of Family Doctors (WONCA) Past president, Brussels, Belgium
| | - Anna Stadval
- World Organization of Family Doctors (WONCA) President, Brussels, Belgium
| | | | - Lourdes Ramos Del Rio
- Federica Montseny Health Centre, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | - Ileana Gefaell Larrondo
- Fundación de Investigación e Innovación Biosanitaria de Atención Primaria (FIIBAP), Madrid, Spain
- Red de Investigación de Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Barcelona, Spain
| | - Louise Fitzgerald
- Member of Irish College of General Practice (MICGP), Member of Royal College of Physician (MRCSI), Dublin, Ireland
| | - Limor Adler
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Radost Assenova
- Department Urology and General Practice, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Maria Bakola
- Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Science, University of Ioannina, Ioannina, Greece
| | - Sabine Bayen
- Department of General Practice, University of Lille, Lille, France
| | | | - Iliana-Carmen Busneag
- Spiru Haret" University, Occupational Health Expert, Practicing family doctor, Bucharest, Romania
| | - Asja Ćosić Divjak
- Health Centre Zagreb West and Department of Family Medicine, University of Zagreb, Zagreb, Croatia
| | - Maryher Delphin Peña
- Department of Geriatric Medicine, Hôpitaux Robert Schuman, Luxembourg, Luxembourg
| | | | | | | | - Miroslav Hanževački
- Health Centre Zagreb West and Department of Family Medicine, University of Zagreb, Zagreb, Croatia
| | - Kathryn Hoffmann
- General Practice and Primary Care, Med. University of Vienna, Vienna, Austria
| | - Oкcaнa Iлькoв
- Department of Family Medicine and Outpatient Care, Medical Faculty 2, Uzhhorod National University, Uzhhorod, Ukraine
| | - Shushman Ivanna
- Department of Family Medicine and Outpatient Care, Medical Faculty 2, Uzhhorod National University, Uzhhorod, Ukraine
| | | | - Vasilis Trifon Karathanos
- Medical Department, Medical Education Unit, Laboratory of Hygiene and Epidemiology, Faculty of Health Sciences, University of Ioannina- Greece. GHS, Larnaca, Cyprus
| | - Aleksandar Kirkovski
- Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia
| | | | | | - Milena Kostić
- Dr Đorđe Kovačević Health Center, Lazarevac, Belgrade, Serbia
| | | | - Bruno Heleno
- Comprehensive Health Research Center, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
- USF das Conchas, Regional Health Administration Lisbon and Tagus Valley, Lisbon, Portugal
| | - Katarzyna Nessler
- Department of Family Medicine, UJCM at Uniwersytet Jagielloński - Collegium Medicum, Krakow, Poland
| | - Heidrun Lingner
- Hannover Medical School, Center for Public Health and Healthcare, Hannover, OE, Germany
| | - Liubovė Murauskienė
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnus, Lithuania
| | - Ana Luisa Neves
- Imperial College London, London, UK
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Naldy Parodi López
- Närhälsan Kungshöjd Health Centre, Gothenburg, Sweden
- Department of Clinical Pharmacology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ábel Perjés
- Department of Family Medicine at the University of Semmelweis, Budapest, Hungary
| | - Ferdinando Petrazzuoli
- Department of Clinical Sciences in Malmö, Centre for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Goranka Petricek
- Health Centre Zagreb West and Department of Family Medicine, University of Zagreb, Zagreb, Croatia
| | | | | | - Bohumil Seifert
- Charles University, First Faculty of Medicine, Institute of General Practice, Prague, Czech Republic
| | - Alicia Serafini
- Azienda Unità Sanitaria Locale di Modena, Laboratorio EduCare, University of Modena and Reggio Emilia, Modena, Italy
| | - Theresa Sentker
- Center for Public Health and Healthcare, Hannover Medical School, Hannover, Germany
| | - Paula Tiili
- Communicable Diseases and Infection Control Unit, City of Vantaa, Vantaa and University of Helsinki, Helsinki, Finland
| | - Péter Torzsa
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Kirsi Valtonen
- Communicable Diseases and Infection Control Unit, City of Vantaa, Vantaa and University of Helsinki, Helsinki, Finland
| | - Bert Vaes
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Gijs van Pottebergh
- Academisch Centrum voor Huisartsgeneeskunde KU Leuven Kapucijnenvoer, Leuven, Belgium
| | - Raquel Gómez-Bravo
- CHNP, Rehaklinik, Ettelbruck, Luxembourg.
- Department of Behavioural and Cognitive Sciences, Research Group Self-Regulation and Health, Institute for Health and Behaviour, Faculty of Humanities, Education, and Social Sciences, Luxembourg University, WONCA SIGFV Executive, SSLMG Executive, Luxembourg, Luxembourg.
| | - Maria Pilar Astier-Peña
- Universitas Health Centre, Public Health Service of Aragon, Zaragoza, Spain
- Chair of Patient Safety Working Group of Semfyc (Spanish Society for Family and Community Medicine) and and SECA (Spanish Society for Healthcare Quality) Board Member, Madrid, Spain
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Keita M, Boland ST, Okeibunor J, Chamla D, Gueye AS, Moeti M. 10 years after the 2014-16 Ebola epidemic in west Africa: advances and challenges in African epidemic preparedness. Lancet 2024; 403:2573-2575. [PMID: 38527478 DOI: 10.1016/s0140-6736(24)00583-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 03/19/2024] [Indexed: 03/27/2024]
Affiliation(s)
- Mory Keita
- WHO Regional Office for Africa, Cité de Djoué, PO Box 06, Brazzaville, Congo
| | - Samuel T Boland
- WHO Regional Office for Africa, Cité de Djoué, PO Box 06, Brazzaville, Congo.
| | - Joseph Okeibunor
- WHO Regional Office for Africa, Cité de Djoué, PO Box 06, Brazzaville, Congo
| | - Dick Chamla
- WHO Regional Office for Africa, Cité de Djoué, PO Box 06, Brazzaville, Congo
| | - Abdou Salam Gueye
- WHO Regional Office for Africa, Cité de Djoué, PO Box 06, Brazzaville, Congo
| | - Matshidiso Moeti
- WHO Regional Office for Africa, Cité de Djoué, PO Box 06, Brazzaville, Congo
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Torreele E, Sherwin H. Health equity requires transformational change: Financial incentives based on worn-out market thinking will not deliver. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003147. [PMID: 38662780 PMCID: PMC11045057 DOI: 10.1371/journal.pgph.0003147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Affiliation(s)
- Els Torreele
- Independent Researcher and Advisor, Geneva, Switzerland
| | - Heather Sherwin
- Director Impact Investing, ELMA Philanthropies Services, Cape Town, South Africa
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Ravinetto R, Henriquez R, Srinivas PN, Bradley H, Coetzee R, Ochoa TJ, Semuto Ngabonziza JC, Mazarati JB, Van Damme W, van de Pas R, Vandaele N, Torreele E. Shaping the future of global access to safe, effective, appropriate and quality health products. BMJ Glob Health 2024; 9:e014425. [PMID: 38195155 PMCID: PMC10807033 DOI: 10.1136/bmjgh-2023-014425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 12/10/2023] [Indexed: 01/11/2024] Open
Affiliation(s)
- Raffaella Ravinetto
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
- School of Public Health, University of the Western Cape, Cape Town, Western Cape, South Africa
| | - Rodrigo Henriquez
- Maestría de Epidemiología y Salud Colectiva, Universidad Andina Simón Bolívar, Quito, Ecuador
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Hazel Bradley
- School of Public Health, University of the Western Cape, Cape Town, Western Cape, South Africa
| | - Renier Coetzee
- School of Public Health, University of the Western Cape, Cape Town, Western Cape, South Africa
| | - Theresa J Ochoa
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jean Claude Semuto Ngabonziza
- Research, Innovation and Data Science Division, Rwanda Biomedical Center, Kigali, Rwanda
- Department of Clinical Biology, University of Rwanda, Kigali, Rwanda
| | | | - Wim Van Damme
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | | | - Nico Vandaele
- Access-To-Medicines Research Centre, KU Leuven, Leuven, Belgium
| | - Els Torreele
- , Institute for Innovation and Public Purpose, University College London, London, UK
- Independent Researcher and Advisor, Geneva, Switzerland
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Torreele E. Tackling vaccine inequity in 2023: have we made progress? Expert Rev Vaccines 2024; 23:1-4. [PMID: 38078804 DOI: 10.1080/14760584.2023.2292771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/05/2023] [Indexed: 12/18/2023]
Affiliation(s)
- Els Torreele
- Independent Researcher and Advisor, Geneva, Switzerland
- Institute for Innovation and Public Purpose, University College London, London, UK
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Guttieres D, Diepvens C, Decouttere C, Vandaele N. Modeling Supply and Demand Dynamics of Vaccines against Epidemic-Prone Pathogens: Case Study of Ebola Virus Disease. Vaccines (Basel) 2023; 12:24. [PMID: 38250837 PMCID: PMC10819028 DOI: 10.3390/vaccines12010024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/13/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
Health emergencies caused by epidemic-prone pathogens (EPPs) have increased exponentially in recent decades. Although vaccines have proven beneficial, they are unavailable for many pathogens. Furthermore, achieving timely and equitable access to vaccines against EPPs is not trivial. It requires decision-makers to capture numerous interrelated factors across temporal and spatial scales, with significant uncertainties, variability, delays, and feedback loops that give rise to dynamic and unexpected behavior. Therefore, despite progress in filling R&D gaps, the path to licensure and the long-term viability of vaccines against EPPs continues to be unclear. This paper presents a quantitative system dynamics modeling framework to evaluate the long-term sustainability of vaccine supply under different vaccination strategies. Data from both literature and 50 expert interviews are used to model the supply and demand of a prototypical Ebolavirus Zaire (EBOV) vaccine. Specifically, the case study evaluates dynamics associated with proactive vaccination ahead of an outbreak of similar magnitude as the 2018-2020 epidemic in North Kivu, Democratic Republic of the Congo. The scenarios presented demonstrate how uncertainties (e.g., duration of vaccine-induced protection) and design criteria (e.g., priority geographies and groups, target coverage, frequency of boosters) lead to important tradeoffs across policy aims, public health outcomes, and feasibility (e.g., technical, operational, financial). With sufficient context and data, the framework provides a foundation to apply the model to a broad range of additional geographies and priority pathogens. Furthermore, the ability to identify leverage points for long-term preparedness offers directions for further research.
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Affiliation(s)
- Donovan Guttieres
- Access-to-Medicines Research Centre, Faculty of Economics & Business, KU Leuven, 3000 Leuven, Belgium; (C.D.); (C.D.); (N.V.)
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Park SP, Lee HJ, Yu Y, Lee EYJ, Park YS. Designing the global vaccine supply chain: balancing intellectual property rights with post COVID-19 vaccine equity. BMJ Glob Health 2023; 8:e013669. [PMID: 38035734 PMCID: PMC10689365 DOI: 10.1136/bmjgh-2023-013669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/21/2023] [Indexed: 12/02/2023] Open
Abstract
This article aims to propose practical solutions that coordinate the conflicting interests between the global community and the pharmaceutical industry on the intellectual property (IP) waiver for COVID-19 vaccines and facilitate a more equitable vaccine supply chain in the post-COVID-19 world. We critically conducted a narrative literature review to identify procedural and practical issues in the current vaccine supply chain. The search was conducted across various academic disciplines, including biomedical science, life science, law and social science, using resources such as PubMed, Web of Science, Scopus and Westlaw. After screening 731 articles, 55 studies were selected for review. The narrative review revealed several critical barriers that hinder vaccine supply in less-developed countries (LDCs) as follows: (1) WTO Trade-Related Aspects of Intellectual Property Rights (TRIPs) waiver requests may not be granted due to its stringent consensus rule; (2) the current compulsory license system may not work due to the complexity of IP rights covering COVID-19 vaccine technologies; (3) only a few LDCs have domestic companies capable of manufacturing vaccines, and (4) political and economic tensions among countries exacerbate existing barriers to vaccine distribution in LDCs. Based on these findings, we proposed a comprehensive compulsory license system, which combines TRIPS's compulsory license system with the third-party beneficiary mechanism under Common Law. This integrated approach offers a balanced solution that ensures fair compensation for vaccine developers while facilitating broader vaccine access.
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Affiliation(s)
- Sung-Pil Park
- Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Hye Jin Lee
- Intellectual Property High Court, Daejeon, South Korea
| | - Yang Yu
- Shanghai University of International Business and Economics, Shanghai, China
| | | | - Young Soo Park
- Korea Advanced Institute of Science and Technology, Daejeon, South Korea
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Kavanagh MM, Abinader LG, Banda A. Equity and technology in the pandemic treaty. BMJ 2023; 383:2533. [PMID: 37923325 DOI: 10.1136/bmj.p2533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Affiliation(s)
- Matthew M Kavanagh
- Center for Global Health Policy and Politics, Georgetown University School of Health and O'Neill Institute for National and Global Health Law, Washington, DC, USA
| | - Luis Gil Abinader
- Center for Global Health Policy and Politics, Georgetown University School of Health and O'Neill Institute for National and Global Health Law, Washington, DC, USA
| | - Amanda Banda
- Center for Global Health Policy and Politics, Georgetown University School of Health and O'Neill Institute for National and Global Health Law, Lilongwe, Malawi
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Torreele E, Wolfe D, Kazatchkine M, Sall A, Ruxrungtham K, Fitchett JRA, Liu J, Kobinger G, Vaca-González C, Gómez C, Terblanche P, Swaminathan S, Olliaro P, Clark H. From private incentives to public health need: rethinking research and development for pandemic preparedness. Lancet Glob Health 2023; 11:e1658-e1666. [PMID: 37652070 DOI: 10.1016/s2214-109x(23)00328-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/28/2023] [Accepted: 07/10/2023] [Indexed: 09/02/2023]
Abstract
Pandemic preparedness and response have relied primarily on market dynamics to drive development and availability of new health products. Building on calls for transformation, we propose a new value proposition that instead prioritises equity from the research and development (R&D) stage and that strengthens capacity to control outbreaks when and where they occur. Key elements include regional R&D hubs free to adapt well established technology platforms, and independent clinical trials networks working with researchers, regulators, and health authorities to better study questions of comparative benefit and real-world efficacy. Realising these changes requires a shift in emphasis: from pandemic response to outbreak control, from one-size-fits-all economies of scale to R&D and manufacture for local need, from de novo product development to last-mile innovation through adaptation of existing technologies, and from proprietary, competitive R&D to open science and financing for the common good that supports collective management and sharing of technology and know-how.
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Affiliation(s)
- Els Torreele
- Institute for Innovation and Public Purpose, University College London, London, UK.
| | - Daniel Wolfe
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michel Kazatchkine
- Global Health Centre, The Graduate Institute for International Affairs and Development, Geneva, Switzerland
| | | | - Kiat Ruxrungtham
- School of Global Health and Chula Vaccine Research Centre, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Joanne Liu
- School of Population and Global Health, McGill University, Montréal, QC, Canada
| | - Gary Kobinger
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, USA
| | - Claudia Vaca-González
- Think Tank Medicines, Information and Power, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Carolina Gómez
- School of Pharmacy, National University of Colombia, Bogotá, Colombia
| | - Petro Terblanche
- Afrigen Biologics, Cape Town, South Africa; Faculty of Sciences, North-West University, Potchefstroom, South Africa
| | | | - Piero Olliaro
- ISARIC Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Helen Clark
- The Helen Clark Foundation, Auckland, New Zealand
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Affiliation(s)
- Kelley Lee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
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13
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Yang J, Feng X, Zhou S, Zhang L, Hu Y, Chen Y, Zhang Z, Xu M. Evolving market-shaping strategies to boost access to essential medical products in developing countries with HIV self-testing as a case study. Glob Health Res Policy 2023; 8:26. [PMID: 37443153 PMCID: PMC10347778 DOI: 10.1186/s41256-023-00310-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023] Open
Abstract
The COVID-9 pandemic has exacerbated health inequities among countries in the Global South with limited access to essential medical products, leading to a higher infection and mortality rate, especially among vulnerable populations. Despite tremendous progress in global health financing, the estimated annual financing gap in developing countries is projected to reach US$371 billion per year by 2030. Therefore, developing market-shaping strategies is of great importance in ensuring adequate supply, affordable prices, and equitable access to essential medical products in low-and middle-income countries. We propose a strategic and appropriate market-shaping intervention framework for governments, international organizations, and NGOs to maximize access to essential medical products in developing countries. In the health field, we believe that market shaping strategy could be defined as a set of purposeful activities that market forces may intervene with to advance the development, production, supply, and distribution of global goods for health, making essential medical products more affordable, accessible, innovative, sustainable and quality assured. We argue that when designing a market-shaping strategy, policy or decision-makers must take full advantage of the key drivers to keep the market dynamic, interactive, and constantly evolving to meet the unmet medical needs. In addition, different forms of market-shaping interventions are determined by objectives and specific issues to be addressed. More comprehensive market shaping strategies, including the strategic use of market expansion, market disruption, market maintenance, and market contraction alone or together, deserve to be explored and key stakeholders are also expected to join forces to make the intervention more efficient and productive.
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Affiliation(s)
- Jian Yang
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Xiangning Feng
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Shuduo Zhou
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Li Zhang
- Asia Pacific Medical Technology Association (APACMed), Singapore, Singapore
| | - Yunxuan Hu
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Ying Chen
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Zhenyu Zhang
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Ming Xu
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.
- Institute for Global Health and Development, Peking University, Beijing, China.
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Evaborhene NA, Oga JO, Nneli OV, Mburu S. The WHO pandemic treaty: where are we on our scepticism? BMJ Glob Health 2023; 8:e012636. [PMID: 37316254 DOI: 10.1136/bmjgh-2023-012636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 05/14/2023] [Indexed: 06/16/2023] Open
Affiliation(s)
| | - Jessica Oreoluwa Oga
- School of Law and Security Studies, Babcock University, Ilishan-Remo, Ogun, Nigeria
| | - Onyeka Vivian Nneli
- Associate Service Delivery Officer, Palladium International Development, Abuja, Nigeria
| | - Sheila Mburu
- Health Advisor, Tony Blair Institute for Global Change, London, UK
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15
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Barnes-Weise J, Hoemeke L, Telford B. Public investment in the development of vaccines: providing equitable access around the world. BMJ 2023; 381:743. [PMID: 37024131 DOI: 10.1136/bmj.p743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Affiliation(s)
- Julia Barnes-Weise
- Global Healthcare Innovation Alliance Accelerator (GHIAA), PO Box 14713, Research Triangle Park, NC 27709, USA
| | - Laura Hoemeke
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Bridie Telford
- Global Healthcare Innovation Alliance Accelerator (GHIAA), PO Box 14713, Research Triangle Park, NC 27709, USA
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16
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Promote global solidarity to advance health-system resilience: proposals for the G7 meetings in Japan. Lancet 2023; 401:1319-1321. [PMID: 37028441 DOI: 10.1016/s0140-6736(23)00690-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 04/09/2023]
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