On 26 January, Professor Kathryn Taubert delivered a statement during discussions on the Global Shortage of Essential Medicines and Vaccines at the 140th Session of the World Health Organization Executive Board (or ‘EB 140’) in Geneva.
The World Heart Federation statement she delivered focused on:
- Patient needs for CVD medicines, especially in LMICs
- Stockouts of BPG, the generic antibiotic used to prevent and control RHD
- Innovative solutions to shortages of CVD medicines, such as the Polypill
- The recent definition of ‘shortage’ agreed by the WHO
- The need for robust health data systems and cross-sector collaboration.
Professor Taubert joined us for a short Q&A, to explain why the World Heart Federation is advocating so strongly on this topic.
Q: Are global shortages of essential medicines and vaccines a big problem for the CVD community?
A: Absolutely, especially in LMICs (low- and middle-income countries). Between 70-80% of people living with CVD in these settings do not receive the medicines they need to manage their conditions, often resulting in terrible health outcomes. These figures are especially shocking as many CVD medicines, such as aspirin and statins, can be produced as cheap generic drugs and are readily available in high-income settings. Despite this, the right medicines are not getting to many of the people who need them. For this reason, the World Heart Federation needs to keep its finger on the pulse and continue to promote access to medicines for the CVD community.
Q: Why is the example of Benzathine Penicillin G (the drug used to prevent and control rheumatic heart disease) so important?
A: BPG is a great example to use when advocating for access to essential CVD medicines. In theory, nobody at risk of developing RHD should be without access to BPG: it is a safe and low-cost drug which has been on the WHO Essential Medicines List for forty years! However, in practice, the situation is very different. Stockouts continue to occur in countries all over the world due to various issues, including changing markets, economies and suppliers. We need to work with WHO and other stakeholders to find solutions to these problems, or else risk neglecting the millions of people living with RHD around the world.
Q: What are the benefits of a “polypill”? Could they really solve the global shortage of essential medicines for CVD?
A: Unfortunately, no single intervention can ‘solve’ shortages in essential CVD medicines, but the polypill (also known as a fixed dose combination drug) might certainly help. The concept of the polypill, which is based on combining generic drugs typically used in the management of CVD into a single pill, has already been proven to improve adherence to CVD medicines. There may be other benefits, including simplifying supply chains, improving affordability and access to treatment, as well as reducing packaging and shipping costs. These factors would potentially improve access to essential CVD medicines, which is why the World Heart Federation is calling for more research and action in this area.
Q: What is the significance of the new WHO definition of ‘shortage’?
A: Last year, the WHO was tasked to come up with a set of definitions for key words involved in access to medicines, such as ‘shortage’. The definition presented today is promising, as it puts people first and makes several references to the needs of patients. Having reached global consensus on language, WHO and other stakeholders can now move forward and drive the process ahead to find solutions.
Q: What other recommendations does the World Heart Federation have to fix the global shortage of medicines for CVD?
A: There are several practical steps that governments and the global community can take. For example, we will not be able to solve shortages in essential medicines until we have better information and data about the burden of disease, i.e. how many people actually need treatment. Investing in stronger health information systems is key. Then once we have the data, we must advocate strongly for essential CVD medicines to be prioritized in national procurement strategies. For all of this to succeed, it is crucial that we work together with allies in other areas, including relevant private sector stakeholders. While there’s no ‘quick fix’ solution, sustained cooperation will help to push our agenda forward and improve access to medicines for people living with CVD.
