GlaxoSmithKline is determined to play its full part in improving access to medicines for the world’s poorest people. Millions of people in developing countries do not have ready access to basic healthcare services, including safe and effective medicines.

The company is involved in many initiatives to improve health in the developing world, including tackling major killers such as HIV/AIDS, malaria and TB. Both Glaxo Wellcome and SmithKline Beecham had a history of addressing developing world diseases, in terms both of the R&D they undertook and the efforts made to improve access to existing medicines.

R&D for diseases of the developing world
GlaxoSmithKline makes very significant investments in researching new products to prevent and treat developing world diseases. The company has extensive research programmes into both the prevention and treatment of the three diseases that are the focus of international efforts – HIV/AIDS, malaria and TB. GlaxoSmithKline is the only company working to develop vaccines for all three diseases. It also has a dedicated specialist team within the company working on treatments for tropical diseases, with programmes to develop anti-malarials, de-worming agents and anti-diarrhoeals.

Development of these drugs and vaccines involves external research collaborations. For example, the company has an agreement with the Malaria Vaccine Initiative, a non-profit organisation, to test the only malaria vaccine candidate yet to show effectiveness in preventing malaria. This will speed the development of the vaccine, with the potential to save the lives of millions of children.

Other collaborative projects include two commissioned under the Medicines for Malaria Venture and the Action TB programme which harnesses academic expertise in order to develop new TB treatments.

However, efforts to develop incentives and joint funding are essential to stimulate such research. In addition to its own research efforts, GlaxoSmithKline will continue to work with donor agencies to identify additional research and development funding so that developing country diseases can be effectively tackled.

Commitment to lower prices
Both Glaxo Wellcome and SmithKline Beecham have offered lower prices for a range of medicines for use in developing countries. Most significantly this has covered vaccines and anti-retroviral therapies for HIV/AIDS. The company is a leading provider of vaccines to the developing world, and has been offering very substantial discounts to governments, charities and agencies for public health programmes for nearly 20 years.

GlaxoSmithKline is one of five companies offering low price anti-retrovirals as part of the Accelerating Access Initiative (AAI). This aims to accelerate sustained access to appropriate interventions for the prevention, care and treatment of people living with HIV/AIDS. AAI is a partnership between the pharmaceutical industry and five UN agencies, which works with governments to ensure appropriate treatment of patients, both in terms of their overall health care and their use of drugs.

The prices available through the AAI – which represent discounts of some 90 per cent on world prices – are also being offered by GlaxoSmithKline to not-for-profit organisations that are able to deliver anti-retrovirals to patients in developing countries, including selling directly to aid organisations and UN agencies for use in their own programmes.

Additionally, the company is working with employers in Africa who offer HIV/AIDS care and treatment directly to their staff through their own workplace clinics.

Working in partnership
GlaxoSmithKline is committed to maximising affordable access to medicines in the developing world and is exploring a framework in which the company can offer lower prices for all medicines for those who most need them in developing countries.

In addition to the acknowledgement that improving access to medicines is a shared responsibility, this framework needs to embrace three core principles – partnership, protection of products from diversion and parallel trade, and agreement that developing country prices should not be used as a benchmark for prices in developed countries. Although this framework does not currently exist, the company is working hard with all stakeholders to make products available at discounted prices while the framework develops.

To make real progress in tackling the HIV/AIDS pandemic, particularly in Sub-Saharan Africa, increased donor funding from the developed world is needed to enhance healthcare capacity and to facilitate the purchase of the anti-retroviral medicines. Even at such significantly reduced prices, the cost of the anti-retroviral therapy and the associated health care infrastructure that is necessary to deliver this to patients is way beyond the means of many developing country governments.

While the pharmaceutical industry has a role to play in improving access, significant barriers exist, most notably poverty, inadequate public spending and weak healthcare infrastructures. These problems must be addressed as a shared responsibility by all sectors of society, including governments in both the developed and developing world, international agencies, non-governmental agencies and pharmaceutical companies.