‘Walking the walk’ on AMR report

Jayasree K Iyer

The young set running drug firms is raring to team up with Access to Medicine Foundation



When Jayasree K Iyer met Cipla doyen YK Hamied for breakfast recently in Mumbai, the ground was in a sense being prepared for the Access to Medicine Foundation’s first report on generic drugs.

Only this one would be focussed on anti-microbial resistance (AMR), a global concern gripping governments as people develop resistance to antibiotics leading to their illnesses not subsiding even with the most powerful antibiotics.

Jayasree heads Netherlands-based Access to Medicine Foundation, a non-profit whose past reports on innovator drug companies and their approach to medicine access and pricing have delivered interesting insights. Sometimes even contrary to the common perception of large drug companies being the villain of the piece.

This time though Jayasree is looking at the other side of the medicine divide, at generic companies that make medicines which are chemically equivalent to an innovator medicine. And she is pleasantly surprised by the ‘speed’ and commitment shown by the younger brigade running companies including Cipla, Lupin, Wockhardt and Dr Reddy's, towards participating in this report. The report should be ready by December, she says sitting in a noisy coffeeshop at the heart of the Bandra Kurla business hub.

The idea is to ‘motivate’ generic makers to get involved with access issues, and in this case with a focus on AMR and the best practices around it, she explains. Companies making antibiotics and anti-infective drugs need to do more in terms of surveillance and packaging, look at appropriate use in sales, she says of how companies can extend themselves.

An interesting feature involving the Foundation’s reports is its interplay with investors. Tangible details are pitched to investors who then rely on the information to push ethical behaviour. Investors see an opportunity as access means volumes, but they also see reputaional risk or a ‘bad deal’ when there is a breach, fine or the cost of government sanctions. “Investors don’t want unethical behaviour,” she says emphatically.

Transparency & access

Just months ago the Foundation came out with a vaccine report featuring eight major developers, including big-revenue companies like GlaxoSmithKline, Merck & Co, Pfizer, Sanofi, and one of the largest sales volume companies, Pune-based Serum Institute of India. The report quotes World Health Organisation’s estimates that 19.4 million infants miss out on basic vaccines. For the Foundation, the vaccine report was like navigating a minefield, where practices are evaluated and not products, she says, as a critical report can become an ammunition for the anti-vaccine lobby.

Be it Pfizer, Sanofi, GSK or Serum, they need to do more in terms of public disclosure, price transparency, faster development of key molecules, supply chain commitments, she points out.

Making the ethical point again, she says, the landscape you are selling into has changed and to be a market leader you need to offer the product in a more responsible way. It’s no longer just transactional, she says, as companies are being forced to reinvest in land, recast royalties, etc.

But what about conflict of interest in a vaccine report, since one of the Foundation's funders, the Bill & Melinda Gates Foundation, is also a big supporter of global vaccine programmes?

“We have an independent board. Even though there are many influences, we have very strict rules and bring it back to a multi stakeholder discussion... you need to have a consensus,” she says. The Foundation is also funded by UK AID and the Dutch Ministry of Foreign Affairs.

Cancer report

Last month, the Foundation released a report on cancer care in the developing world and the role of drug companies. It found that market leaders in oncology were in fact addressing cancer care for the poor, with 129 separate initiatives up and running.

But coming back to the task ahead with 20 plus generic drugmakers, including Indian companies, Jayasree says, they are progressive and keen to do things differently. The effort is to show that investing in healthcare is critical. “Talking the talk is no longer accepted, it’s time to walk the walk,” she says, of the report that will look to measure outcomes around AMR.

Published on June 09, 2017
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