A group of 22 pharmaceutical companies have announced a new initiative aimed at tackling noncommunicable diseases and better assessing their individual, and collective, work to enable better access to care in developing countries.
The new initiative, called Access Accelerated, will work toward understanding, piloting, implementing and measuring programs that tackle some of the biggest barriers to access to care for people with NCDs in an effort to contribute to the Sustainable Development Goal target of reducing premature deaths from NCDs by one-third.
About 80 percent of premature deaths due to NCDs, which include cancer, heart disease, diabetes, stroke and chronic lung disease, take place in low- and middle-income countries, according to the World Health Organization.
“NCDs have reached a point of crisis with most of the burden carried by lower and lower middle income countries,” wrote Olivier Brandicourt, the CEO of the pharmaceutical company Sanofi in an email to Devex. “The challenge we have to address today is access for patients that can’t get diagnosed or treated because of weak primary health care delivery systems.”
At the heart of the new initiative is a commitment to study the existing work being done by the companies involved and developing a universal framework that can better assess progress and impact. That data is likely to provide new insights that individual companies, the initiative, and the broader development community can use to determine the best ways to address some of the challenges in access to and availability of treatments for NCDs.
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The evaluation work will be done by Boston University, which is well into a robust study of a NCD access program in Kenya for one of the initiative’s partners, Novartis. A review of International Federation of Pharmaceutical Manufacturers and Association’s directory of partnerships found that about a third of them, about 120 in total, related to access to medicines but that only seven had been evaluated, said Richard Laing*, a professor in the department of global health at the Boston University School of Public Health.
Laing said he was critical of the lack of efforts to measure whether the many programs are actually producing results and has often raised the issue with the companies directly.
“If you’re doing a clinical trial, would you consider giving meds and not measuring the effect?” Laing said he sometimes asks.
Laing’s work is now to develop a common evaluation framework that could apply across a wide range of programs — from training personnel, to public education, to stock control, improving the use of medicines and supporting construction. They’ll be looking to develop an assessment that looks at inputs, outputs, long-term results, short-term results and outcomes, he said.
The intention is that all of the information that is gathered will be public and open, as Boston University has insisted on with past research projects, including the one with Novartis, but Laing said he’s unsure if they will be able to share everything yet.
Another critical question will be what the companies involved will be willing to invest in the research and whether they will supply only data they are already gathering or whether they are willing to fund more robust research into the programs that could include, among other things, a look at socioeconomic status of beneficiaries. The issue of equity, and whether the poorest benefit from a particular program is an issue that is often left out of the analysis and is of interest to Laing.
“I think the point of this is robust methodology generates reliable data and companies, if they want to claim credit for what they’re doing, have to invest in data collection,” he said.
In addition to the research, the initiative will work with partners, including the World Bank Group and the Union for International Cancer Control, to see how to best address some of the financing, regulatory and delivery issues in individual countries and address specific diseases.
It will develop a series of pilots and programs that look to build on what’s working, avoid duplication and look to fill the gaps. While there are examples of collaboration among pharmaceutical companies, it is often challenging for companies in the highly-regulated and highly-competitive industry to work together.
But that is not a concern, Sanofi’s Brandicourt said in the email.
“We are collaborating here to solve the access issue,” he wrote. “This will be achieved through the many positive collaborative measures that have been outlined as well as individual company actions, but Access Accelerated does not involve the alignment of any commercial or R&D strategies.”
*Update Jan. 23, 2017: This article has been updated to correct the spelling of Richard Laing’s name.