Even today, over 2 billion people in the world do not have access to essential medicines. A factor of inequality measurable with a dramatic parameter: the number of victims who, with little, could be saved. In 2017 alone, over 3 million boys and girls under 15 died mainly from lack of access to basic drugs and vaccines. The alarm launched by Oxfam and ACTION on the occasion of the event promoted by the two organizations in Rome (at the Hotel Nazionale).

A round table at the center of which is the role of Italy and the confrontation between the Government and Italian and international actors, to discuss strategies and proposals to reduce unacceptable inequalities in access to medicines and health on a global level. The forum was attended, among others, by the Minister of Health Giulia Grillo, the Director General of the Department for Development Cooperation of the Foreign Ministry, Giorgio Marrapodi, the Director General of AIFA, Luca Li Bassi and the Head of External Relations of the Fund Comprehensive for the fight against HIV, tuberculosis and malaria, Françoise Vanni.


The unsustainable cost of drugs. It is the root cause of 100 million people falling into poverty each year. Even today, the possibility of accessing treatments, drugs, vaccines and health technologies is reserved only to those who can afford it. The impact of the price of drugs is in fact enormous both for individuals and for states where there is a national health system. If a large part of the world population still does not have access to essential medicines, according to World Bank estimates, 800 million people spend at least 10% of the family budget every year on healthcare expenses, while for about 100 million people these expenses are like this high enough to cause them to fall into extreme poverty every year. An increasingly unsustainable cost, even for national health systems, especially for the most innovative drugs, with the consequence that often many are unable to access treatments.

The impact on poor countries and beyond. The impact in developing countries is particularly serious: in South Africa, for example, for diseases such as breast cancer, 3,000 women die every year, because the cost of treatment is too high for the state coffers: about $ 38,000 for a 12-month Herceptin cycle, 5 times the country's average income. Even in high-income countries such as Italy - where drug spending is 20% of national healthcare spending (29.8 billion euros in 2017, 75% of which is covered by the national healthcare system) - the consequences are increasingly negative for citizens' access to treatment. Just think of the costs of the treatment of Hepatitis C.


The secreted drugs. Compared to the 1 million 600 thousand chronic cases found in 2016 in our country, at the beginning of 2017 only 70 thousand cases had been treated with the most effective drugs introduced in 2013. A situation that forced Italy to negotiate the price of drugs with the manufacturing companies, to achieve a sustainable cost for public funds, which could guarantee treatment for a greater number of patients. A "solved" case, which is being repeated and could be repeated with other essential drugs in Italy and other European countries. Meanwhile, the actual "cost" remains - to date - in many cases only estimated, due to the "confidentiality clauses" introduced in the drug purchase contracts. In Italy today 1,800 drugs are "secreted": almost 60% of those in hospital or distributed by hospital or private pharmacies, including the most innovative drugs for the fight against cancer.

The appeal to the government: Italy does not go back. Especially on universal access to health and transparency of drug costs. Cases such as that faced by Italy for the treatment of Hepatitis C, demonstrate the need to achieve greater transparency in the definition of drug prices. Indeed, tomorrow's appointment comes on the eve of the discussion (between 20 and 29 May), between the countries that make up the WHO assembly, on the resolution proposal presented by Italy, with the aim of improving the access to essential medicines globally. A proposal that starts precisely from the definition of different transparency rules that allow States and citizens to collect and analyze data on the results of clinical trials, patents, drug prices, revenues, costs, subsidies and investments in research and development, including in the public sector and marketing costs.


The universal access principle. "We recognize the courage and commitment of the Italian Ministry of Health and AIFA in being bearers of requests heard by many countries and citizens in the world and we encourage them to continue in the effort to find a consensus among the states that make up the WHO, to the approval of the advanced resolution in early February. - Sara Albiani said political consultant of Oxfam Italia on global health - If it could not be achieved, it is essential, however, that the Italian government continue to fight for the principle of universal access to treatments and drugs for all around the world, including on the occasion of the numerous events that in 2019 will have an important global health agenda: the G7 in France and the G20 in Japan, the United Nations High Level Meeting (HLM) on universal health coverage (UHC) and the conference reconstitution of the Global Fund to fight AIDS, Tuberculosis and Malaria ".


Investing in the Global Fund. The opportunity to invest in the Global Fund to fight AIDS, TB and malaria. Allowing countries access to affordable medicines and other health products is also a key component in the fight against AIDS, tuberculosis and malaria. Almost half of the Global Fund's investments in health programs are used on this. In February, the Global Fund announced the need for a minimum funding of $ 14 billion for the next 3 years, needed to save 16 million lives by 2023, to halve the mortality rate due to HIV, tuberculosis and malaria, and strengthen health systems in developing countries. The refinancing target, which donor countries will have to meet at the Fund's reconstitution conference in October 2019, however, comes at a critical moment. Despite the commitment to defeat these diseases by 2030, after years of progress, the lack of funds and the increase in resistance to insecticides and drugs have slowed progress and caused an epidemic to worsen.