Low Cost Measures To Tackle Health SDGs Proposed Ahead of UN Meeting

The coalition proposes several low-cost practical measures which could rapidly improve and accelerate access to care and reduce NCD mortality.

KUALA LUMPUR, Sept 20 — A coalition of 15 think-tanks from 14 countries, including two from Malaysia, has proposed slashing taxes and tariffs, and expediting the drug approval process to improve access to medicines.

As the 74th session of the United Nations General Assembly gets underway in New York, the think tanks, including the Galen Centre for Health & Social Policy and the Institute for Democracy and Economic Affairs in Malaysia, released a list of recommendations aimed at helping countries work towards achieving the health-related Sustainable Development Goals (SDGs).

Recommendations towards achieving SDG 3.4 & S.8 related to non-communicable diseases and universal health coverage.
Source: Accelerating access to medicines:Policy recommendations for achieving the health-related Sustainable Development Goals (September 2019)

Of particular focus has been the need to tackle escalating high out-of-pocket costs related to healthcare and slow progress of countries meeting targets related to preventable non-communicable diseases (NCDs) such as cancer, cardiovascular disease and diabetes.

Many of these issues have been linked to struggles and complications surrounding public and private health care financing and capacity gaps in public and private sector delivery systems.

However, the coalition’s document proposes several low-cost practical measures which governments could immediately take to rapidly improve and accelerate access to treatment and care and reduce NCD mortality.

To reduce the cost of medication, the group suggests reviewing and abolishing tariffs and various taxes on medicines which in some countries have caused a mark-up of up to 300 per cent to the manufacturer’s selling price.

Tariffs can be obstacles to access to medicines

Twenty-two World Trade Organisation members have already agreed to the elimination of import duties on around 7,000 pharmaceutical products under the “Zero for Zero Initiative”. Seven out of 19 countries with the world’s highest tariffs on medicines are in Asia.

Such tariffs and taxes are seen as obstacles to improving access to medicines and fulfilling the right to health.

The recommendations also call for the review and elimination of Non-Tariff Measures (NTMs) which lack consistency, utility and transparency and could act as barriers to free trade. These include cumbersome export/import procedures, inefficient customs procedures, burdensome labelling, packaging requirements, the need for multiple permits and licenses, and bureaucratic red tape. These were found to be higher in lower middle income countries.

Access to innovative and improved medicines and medical technologies has been deemed crucial by the coalition to tackle the rising burden of NCDs.

However, the availability of new medicines is often affected by delays and backlogs involved in the patent process at the national level. This results in patients unable to access such treatments until many years after its global launch, hampering access to those medicines. In Thailand, the brief points out, it can take more than 14 years to get a life sciences patent.

It can take several years for a patent to be approved nationally.

Bottlenecks and delays in gaining drug regulatory approval from national authorities can potentially add years before the medicine is available to patients.

Malaysia, along with India, Taiwan, Singapore and South Korea, was named in the document being among countries where delays averaged between 400-500 days.

A medicine’s availability in the public health system is determined on how soon it can be included on the National Formulary List and the rate of reimbursement. Accelerating decision-making on these issues, the coalition states, will improve patient access to medicines and improve reimbursements.

Finally, the recommendations emphasise the need to promote open trade in medicines and to move away from protectionist policies which balkanise value-chains and impose measures such as multiple and duplicative local manufacturing plants, and reduction in the number of suppliers.

It states clearly that choice and access to medicines would improve more rapidly under market competition.

The 74th session of the United Nations General Assembly is currently underway in the United States, with a one-day high-level meeting on Universal Health Coverage expected to be convened next Monday.

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