September 2006 (Basel, Switzerland)
Increasing demand for medication world-wide is not only a topical issue in the countries of the South but also in the developed world, though possibly not to the same extent a matter of life and death. It is also not only a supply-and-demand problem in the traditional sense but there are profound ethical aspects which lend the topic highly explosive political and social dimensions.
The conference organised by the Basel Institute on Governance on 7 September 2006 sought to provide answers to the qualitative and quantitative parameters of the human need for medication as well as define current limitations to supply and distribution that must be overcome. Issues that were covered in the programme included:
Who guarantees the supply of patients with medication and how can access be improved world-wide?
This problem is not only one of providing enough but also of how to pass on advances in technology, better quality medication and the resulting possibility of longevity to a larger proportion of the world's inhabitants. A key issue in this debate is notably that of responsibilities, i.e. who is chiefly responsible for ensuring essential preconditions for providing access to medication, and which other actors can contribute to this in what way.
A closer look at the mechanisms behind the distribution of medical drugs
What can the involved actors, such as governments, the pharmaceutical industry, research institutions, international organisations and medical supply agencies do to guarantee the timely delivery of sufficient and good quality medication? The problem has been approached from a variety of angles, including logistical and training aspects, and encompassed a critical discussion of the multi-stakeholder approach promoted by pharmaceutical companies.
The key issue of affordability
How feasible is it to make the pricing of medical drugs chiefly dependent on the usual laws of market economy? Is it reasonable to adopt a shareholder perspective over a multi-stakeholder approach in this field? How does this affect the availability and affordability of key drugs for poorer countries, for whom this issue poses far more fundamental problems than for fully industrialised societies? Even though there are regulations governing such trade areas, the NGO "Médecins sans Frontières", for instance, regards the provisions of the World Trade Organization's "Trade-Related Aspects of Intellectual Property Rights" (TRIPs) as insufficient when it comes to guaranteeing adequate pricing of medical drugs in the developing world, while the pharmaceutical companies state that only 5% of essential medication is presently still patented, and that therefore patent laws are not the main hindrance to access to medication. The issue of affordability was further discussed from the perspective of a developed country – Switzerland – where like in other western countries the cost of health care systems has spiralled out of control.