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Global Disease Burden and the Access Gap

Global Disease Burden and the Access Gap. UAEM Introductory Seminar September 27, 2008 By Goldis Chami. Outline. Global Disease Burden Drug Pipeline Access Gap Research & Development Gap. Global Disease Burden: World Health Statistics. Life expectancy at birth:.

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Global Disease Burden and the Access Gap

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  1. Global Disease Burdenand the Access Gap UAEM Introductory Seminar September 27, 2008 By Goldis Chami

  2. Outline • Global Disease Burden • Drug Pipeline • Access Gap • Research & Development Gap

  3. Global Disease Burden: World Health Statistics Life expectancy at birth:

  4. Global Disease Burden: World Health Statistics Life expectancy at birth:

  5. Global Disease Burden:Average Life Expectancy

  6. Global Disease Burden: Why? • Poverty - Basic nutrition and clean water - Shelter - Education - Basic Medical Care (Public Health)  Essential Medicines

  7. Global Disease Burden: World Health Statistics Mortality per 100,000 population

  8. Global Disease Burden: The Coverage Gap

  9. HIV/AIDS • 3.6 million living with the disease worldwide • Most of these individuals in sub-Saharan Africa • Has killed 25 M

  10. Hepatitis B (HBV) • Viral, transmitted much the same as HIV • Cirrhosis of liver & liver cancer • Vaccine available, extremely effective • Not always available in LMI countries • In endemic areas, prognosis for HIV is worsened

  11. Heart Disease • Deaths have declined by >50% in industrialized countries • 93% of morbidity and mortality from CVD in LMI countries

  12. Essential Medicines • Fundamental to basic care • WHO lists 312 essential medicines • 33% of the world has no access *Cough*

  13. Issues: The Access Gap • The systematic inability of individuals in developing countries to obtain existing and essential medicines • In poorest parts of Africa, nearly 50% have no access • < 4% in LMI countries get needed anti-retrovirals

  14. What Causes the Access Gap? • PRICE: the consumption of medicines is sensitive to price, especially in the poorest countries • Price, in turn, is affected by PATENT STATUS • The most significant factor in lowering prices is the introduction of generics into a country – MSFO • Generic competition the single most important tool to remedy the access gap - Oxfam

  15. From Discovery to Drugs

  16. When the Drug Development Pipeline Fails to Flow…

  17. Research & Development Gap • The massive underinvestment in medicines for neglected diseases, which primarily impact those in LMI countries • The 10/90 Gap • TB & tropical disease = 11.4% of the tropical disease burden • …but only 13 out of 1393 drugs targeted these

  18. Research & Development Gap Cont’d • Current system fails to optimize existing meds & technologies for use in developing countries • Examples will come later • Diagnostic tools not appropriate

  19. R&D Gap: African Sleeping Sickness • Most commonly used drug to treat = arsenic based, kills 5% of those treated. • New drugs needed, but none have been developed • Why? R&D system depends on patents & market-based incentives. • 5-7% of profits from LMI countries

  20. R&D Gap The patent system leads R&D toward the most profitable disease and conditions, rather than toward diseases that cause the most morbidity and mortality.

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