The Inconvenient Truths About Our Current R&D Model and Access to Medicines

[This article has been written by Eva Martich, 'Science for Patients' project coordinator at ISGlobal, and Claudia Vaca, professor at Universidad Nacional de Colombia. Centro de Pensamiento Medicamentos, Información y Poder]

Ensuring that everyone has access to the medicines and medical technologies they need has become a challenging problem for health care systems all over the world. The discussion around this issue has been led by civil society organisations, policy experts and decision makers but little is known about how scientists view the question. Since the scientific community plays a key role in the research and development (R&D) process, two academic institution in two different countries (Spain and Colombia) independently decided to investigate the perceptions of researchers and scientists working in the field of health and to understand the setting in which they carry out their research.

Since the scientific community plays a key role in the R&D process, academic institutions in two different countries (Spain and Colombia) decided to investigate the perceptions of researchers and scientists working in the field of health and to understand the setting

In Colombia, the project was called “Research and innovation in public health” and was led by the Centro de Pensamiento Medicamentos Información y Poder, a think tank at the National University of Colombia.

The Spanish project, entitled “Science for patients: Promoting the involvement of Spain's scientific community in the discussion around access to medicines and the R&D model”, was led by the Barcelona Institute for Global Health (ISGlobal).

Through the voices of scientists and researchers working  in different areas, the two projects sought to explore the role of biomedical research in their respective countries and to examine the role of the State as a generator of innovation, particularly in biomedical research relevant to public health. They also  scrutinised the function of intellectual property (especially patents) and the eventual access of the general public to the technologies developed as a result of research.

During the final phase of data collection, the two teams met at a workshop to discuss the diagnosis and current situation as well as their respective proposals. Interestingly, despite the differences between the two countries, the problems surrounding this issue are common to both and the challenges equally complex.

Despite the differences between the two countries, the problems surrounding this issue are common to both and the challenges equally complex

In the course of the workshop, we summarised the problems we call the inconvenient truths of the R&D model (one in which patents are viewed as the primary driver of innovation):

• Research is not always directed towards resolving the priority health problems affecting the majority of the population;
• The reporting of research and how the prices of medicines and medical technologies are fixed is not sufficiently transparent;
• There are not enough incentives for research addressing issues that are important for health but not financially attractive  
• The current research model disincentivises collaboration within the scientific community and may delay scientific progress.

Another R&D model is possible: a model designed to address the health needs of the population.

Another R&D model is possible: a model designed to address the health needs of the population

• Strengthen the involvement of the public sector at all stages of research and particularly the role of government in terms of funding and defining the priorities of R&D. Different or complementary approaches to intellectual property issues are needed because patents are not the main incentive for researchers and tend to interfere with access to technologies and information.
• Develop open scientific collaboration strategies that speed up and enhance scientific work in order to counteract the lack of transparency in the current model.
• Understand and influence the transfer of technologies generated in research centres to remedy the current lack of connection between the management of the results of basic research and the development of the final products with an impact on health.

We were inspired by the similarities between the findings of the two projects. In spite of the different scenarios, resources and contexts, health scientists in both countries recognize that a significant volume of biomedical research is publicly funded and that the design and development of products to treat or diagnose diseases of poverty will only be useful if the final price of these products is very low. We must take advantage of these commonalities to work towards a global scientific community that is more aware of the issue of access to medicines and medical technologies.