WHO Regional Office for Europe and the Ministry of Health and Care Services, Norway, reveal how making people’s access to medicines is a reality thanks to the Oslo Medicines Initiative
For those of us working in global health, the rapid development of highly effective vaccines to fight the spread of SARS-CoV-2, the COVID-19 virus, represented a turning point. Vaccines have allowed us to better manage the pandemic not just from a public health standpoint, but also in terms of mitigating the pandemic’s wider social and economic impacts. Crucially, vaccines have also underlined the importance of innovation as a key plank in our strategies for improving public health more broadly.
Indeed, we need to ask ourselves how many more people would die prematurely or live poorer quality lives in ill-health were it not for the development of safe and effective medicines, vaccines and other medicinal products. Asking precisely this question was at the forefront of our minds when we established the Oslo Medicines Initiative (OMI).
A joint project of the WHO Regional Office for Europe (WHO/Europe) and the Government of Norway, the Oslo Medicines Initiative was established in 2020 and ran until September 2022.
Improving people’s access to effective, yet highly-priced, medicines
Building on the 2019 World Health Assembly Resolution 72.8 on improving the transparency of markets for medicines, vaccines and other health products, the initiative was set up to examine issues around improving access to certain novel medicines in the WHO European Region: medicines which are highly effective, in some cases even curative, but which come with high price-tags that limit their availability to all who would benefit and even threaten national health budgets.
Advanced therapy medicinal products (ATMPs) are one such example. These are products for human use based on genes, tissues or cells, and offer a potential lifeline for millions of people across Europe and Central Asia currently suffering from previously untreatable rare diseases.
“The OMI took as its starting point the need to address these high prices while at the same time ensuring that manufacturers retained the incentives necessary to develop these new products. Ultimately, there is no value to anyone from a product that stays on the shelf.”
The fact that an estimated 40 to 60 ATMPs are expected on the market by 2030 is very promising. That some of these products currently cost over €1.9 million per patient as one-off payments, meaning that many countries cannot afford them is, in contrast very worrying.
Working with all partners
Given our shared commitment to improving health for all, we looked for partners with similar concerns and priorities. We were pleased to involve the Organisation for Economic Cooperation and Development (OECD), the European Commission and the then-French European Union Presidency team in the steering committee.
The Oslo Medicines Initiative took as its starting point the need to address these high prices while at the same time ensuring that manufacturers retained the incentives necessary to develop these new products. Ultimately, there is no value to anyone from a product that stays on the shelf.
It was clear from the outset that solutions will only be found by involving the key stakeholders: those who make and market the products, those who pay for them (countries and health insurance bodies) and those who consume them. The Oslo Medicines Initiative has over the past two years engaged in meaningful consultation with all parties, and worked with leading independent experts and analysts to examine prospective policy directions and strategies around which consensus could be reached.
Over the course of these two years, we have commissioned a series of technical and policy reports, held consultations with key partners and held a series of open webinars and events.
But what we see as the real value-added of the Oslo Medicines Initiative has been the fostering of an open and honest dialogue between parties. Medicines are costly to develop and simply looking at prices to promote access is not the answer. Nor is pointing to inefficiencies in health systems. But with a common recognition of the problem, the next step is working together to address it.
Going from words to action
From 12th-14th September 2022, health ministers from across the WHO European Region met in Tel Aviv, Israel for the 72nd session of the WHO Regional Committee for Europe.
The work of the Oslo Medicines Initiative was presented during a special session, where Ministers agreed to set up a neutral, multistakeholder platform that will allow countries and non-state actors to jointly identify and agree on potential solutions for equitable access to medicines.
The platform, hosted and facilitated by WHO/Europe, will promote and enable direct and open discussions to explore the feasibility of collaboration in several areas.
There is no magic bullet here. Progress and solutions on improving access will take time.
But we share the view of Henry Ford, the American innovator who made the automobile affordable to a much wider market than had previously been possible: “If everyone is moving forward together, then success takes care of itself.” (1)
And we remain optimistic that the rapid development of COVID-19 vaccines can serve as a blueprint: for the type of collaboration which is not only needed, but which is possible, to advance this crucial agenda in the European Region, which, ultimately, is about making sure people can access the medicines they need, when they need them.
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