Pharma is Onboard with the UN’s Sustainability Agenda – but We Underestimate the Challenges at Our Peril
If everything that the UN aims to achieve in its 15-year sustainable development agenda – set to be published in September – comes to fruition, then the world will doubtless be a much more prosperous, peaceful, cleaner, educated and, of course, a much healthier, place in which to live.
To promote physical and mental health and well-being, and to extend life expectancy for all, the agenda demands that we achieve universal health coverage and access to quality health care: “No one must be left behind”.
The goals and targets listed in the agenda, entitled: “Transforming Our World: the 2030 Agenda for Sustainable Development”, will come into effect on 1 January 2016. The drafters are to be commended for being both comprehensive in addressing major health threats, while being specific about targets. While these targets are eminently laudable and theoretically achievable, though, the challenges facing the UN’s healthcare agenda shouldn’t be underestimated.
Underlying some of the health targets are policy choices about the environment, transport and the control of threats that come from alcohol abuse and tobacco consumption. If we can improve the incidence of mortality and morbidity related to these causes, it may be possible to alleviate the demand for healthcare and bring health systems back towards sustainability.
These are familiar messages for the EU and they are underpinned by a sense of logic. This is mainly because they revolve around issues of regulation, meaning that if the political will is there, they can be achieved.
There are also specific areas of the UN sustainable development agenda in which the pharma industry has already made great strides. The UN calls for accelerating the pace of progress made in fighting malaria, HIV/AIDS, tuberculosis, hepatitis, Ebola and other communicable diseases and epidemics, including by addressing growing anti-microbial resistance and the problem of unattended diseases affecting developing countries.
Recent developments in curatives for hepatitis and new candidate vaccines for malaria, dengue fever and Ebola show that the industry is ahead of the curve. Also, through the Innovative Medicines Initiative, the prospects for fighting anti-microbial resistance more effectively are also looking good.
Nevertheless, there remain other areas of the sustainable development agenda about which the pharmaceutical industry is less optimistic. The UN agenda seeks understandably to secure universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
It is not that the industry is not a strong advocate for and supporter of the goal of universal health. Our concern is that the economic crisis has produced a stark reminder of how lucky we are to have comprehensive health coverage in Europe and that it simply cannot be taken for granted. I’d even go further and say that for many people, universal health coverage is a dream.
Regrettably, it will remain the case until and unless healthcare systems are adequately financed. This is an issue that is mentioned in the agenda, yet there are no concrete targets set either for aggregate spending or for the expansion of insurance coverage. For the industry, this is a clear oversight within the agenda.
There is another important issue, highlighted by the World Health Organization, though: if you’re looking to expand coverage from a low base, which populations and which services do you prioritise?
An early warning target would be one potential priority, particularly given the lessons learnt from Ebola in terms of health system resilience. Another would be an increased focus on maternal and child health. Together these could form core capabilities of the health system and represent a good starting point from which to define a basic package of care that could consolidate the capabilities of all stakeholders.
On the innovation front, though, we have met with a degree of disappointment. This is embodied by a failure to translate what is happening in innovation systems into the sustainable development goals.
Our experiences in Europe and throughout the developing world flag up new ways of partnering in R&D, capacity-building, and improving access. China, Turkey, India and Brazil feature high on the list for resident patent filings, underscoring a world undergoing evolution. The bottom line is that innovation is becoming a global process from which we can all benefit and to which we must contribute.
On another, and from our perspective, positive note, though, the latest sustainable development goals envisage international trade as an engine for development, economic growth and poverty reduction.
With this in mind, we have to be clear: health goes beyond human cures, preservation and the extension of life; it is also a crucial driver for wealth. The ultimate value of the pharma industry is that it can offer all of these benefits by boosting overall patient health, while creating high value jobs and revenue.
Most businesses support making trade easier by removing barriers but in our sector this goes far beyond reductions in bureaucracy, taxes or tariffs. Regulatory convergence, which speeds medicines to patients faster by building on efforts in other countries, is an essential element. It ensures quality and safe medicines, rather than starting from scratch and reinventing the wheel.
It also means creating common platforms for cooperation, through which potential benefits may range from limiting the number of duplicated trials conducted in children to enhancing efficiencies or reducing costs. This is acknowledged clearly in the UN agenda, which states that all countries and all stakeholders, acting in collaborative partnership, will implement its plan.
It is therefore essential that we prevent the naysayers from dominating the free-trade debate. Instead, we must allow the facts speak for themselves – if we take the time to look, the decidedly positive evidence that it will boost the healthcare agenda is overwhelming.