Center for Bioethics

Ethics of Access to Essential Medicines

The World Health Organization estimates that 10 million people die annually due to an inability to access medicines and vaccines available in other communities. Most of these deaths occur in developing countries. A growing consensus exists that private industry and universities have a role in improving access to drugs within low- and middle-income countries.

Sound Ethics Episodes

Two Sound Ethics sessions in 2008 address the topic of access problems to essential medicines among people in developing countries.

Medicines in the Developing World

In Sound Ethics: Medicines in the Developing World (April 6, 2008) Eric Meslin, PhD, talks with Alan Breier, MD, Vice President for Medical and Chief Medical Officer, Eli Lilly and Co., the role of industry in improving access to essential medicines. Breier also shares Lilly’s efforts to extend access to medication, efforts exemplified by the Lilly MDR-TB Partnership, a program that works with the World Health Organization to provide medications and training for the prevention and treatment of multi-drug resistant tuberculosis.

Essential Medicines for Low-Income Countries

In Sound Ethics: Essential Medicines for Low-Income Countries (May 4, 2008) Eric Meslin, PhD, talks with Caroline Rouse, then a second-year student at Indiana University School of Medicine, the role universities can play in building better access to medicines. Rouse, who was a member of the IU chapter of Universities Allied for Essential Medicines, shares the aims and activities of this advocacy group.

Academic Studies

Overarching reports on the topic of Essential Medicines include the MSF Campaign for Access to Essential Medicines, the World Health Organization’s Essential Medicines publication and the World Health ‘s Organization WHO Model Lists of Essential Medicines.

Hogerzeil HV. Essential medicines and human rights: what can they learn from each other? Bull World Health Organ. 2006 May;84(5):371-5. Epub 2006 May 17.  PMID: 16710546

World Health Organization. Equitable access to essential medicines: a framework for collective action. WHO Policy Perspectives on Medicines. March 2004.

Pécoul B. New drugs for neglected diseases: from pipeline to patients. PLoS Med. 2004 Oct;1(1):e6. Epub 2004 Oct 19.  PMID: 15526054

Quick JD. Essential medicines 25 years on: closing the access gap. Health Policy Plan. 2003 Mar;18(1):1-3.  PMID: 12582103

Quick JD, Hogerzeil HV. Ten best readings in … essential medicines. Health Policy Plan. 2003 Mar;18(1):119-21.  PMID: 12582115

Pécoul B, Chirac P, Trouiller P, Pinel J. Access to essential drugs in poor countries: a lost battle? JAMA. 1999 Jan 27;281(4):361-7.  PMID: 9929090

Patents, Pharmaceuticals and the Role of Universities

Chaifetz S, Chokshi DA, Rajkumar R, Scales D, Benkler Y. Closing the access gap for health innovations: an open licensing proposal for universities. Global Health. 2007 Feb 1;3:1.  PMID: 17270051

Chokshi DA. Improving access to medicines in poor countries: the role of universities. PLoS Med. 2006 Apr;3(6):e136.  PMID: 16608382

Kapczynski A, Crone ET, Merson M. Global health and university patents. Science. 2003 Sep 19;301(5640):1629.  PMID: 14500943

Philadelphia Consensus Statement – On University Policies for Health-Related Innovations. Universities Allied for Essential Medicines.

‘t Hoen EF. The responsibility of research universities to promote access to essential medicines. Yale J Health Policy Law Ethics. 2003 Summer;3(2):293-300.  PMID: 14577145

Patents, Pharmaceuticals and the Role of Industry

Pogge T. Montréal statement on the human right to essential medicines. Camb Q Healthc Ethics. 2007 Winter;16(1):97-108.  PMID: 17345971

Calon F. Nonpatentable drugs and the cost of our ignorance. CMAJ. 2006 Feb 14;174(4):483-4.  PMID: 16477060

Novas C. What is the bioscience industry doing to address the ethical issues it faces? PLoS Med. 2006 May;3(5):e142. Epub 2006 Apr 4.  PMID: 16573362

Attaran A. How do patents and economic policies affect access to essential medicines in developing countries? Health Aff (Millwood). 2004 May-Jun;23(3):155-66.  PMID: 15160813

Danzon PM, Towse A. Differential pricing for pharmaceuticals: reconciling access, R&D and patents. Int J Health Care Finance Econ. 2003 Sep;3(3):183-205. Review.  PMID: 14625999

Yamin AE. Not just a tragedy: access to medications as a right under international law. Boston Univ Int Law J. 2003 Fall;21(2):325-71.  PMID: 16514750

Literature Searches

PubMed Search: Drugs, Essential/supply and distribution

Google Scholar Search: Essential Medicines and Ethics