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Global access to medicines
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Global access to medicines
Adequate medical care is not a matter of course in many regions of the world. That’s why Bayer is committed worldwide to enabling greater access to medicines and health services. With its new strategy of “Social Health Care Programs,” Bayer aims to play an active role where the need is greatest and the company’s own expertise is particularly high.
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| Dr. Ulrich Köstlin, member of the Bayer HealthCare Executive Committee “We view our efforts to achieve sustainable health care as a central element of our corporate responsibility.” |
The challenges are considerable: Often there is a shortage of not just medicines, but also hospitals and treatment stations, adequately trained personnel and information on preventive health care. “People in developing countries are particularly affected by this situation,” says Dr. Ulrich Köstlin, member of the Board of Management of Bayer Schering Pharma AG and of the Bayer HealthCare Executive Committee. “Many live in regions where pathogens are particularly common due to the climate. Widespread poverty additionally creates a social and living environment that fosters the spread of diseases.”
Bayer is aware of its social responsibility and therefore supports international efforts to improve medical care worldwide. These activities take place in a broad network of international organizations, governmental agencies, companies and non-governmental organizations (NGOs) – after all, effective solutions in health care can only be developed on a joint basis.
Strategy developed for global health care
Bayer develops and produces drugs that help to save human lives and improve the quality of life of patients and their families. To enable as many people as possible to benefit from these products, Bayer HealthCare’s Bayer Schering Pharma Division in 2008 devised a strategy aimed at promoting access to health care: the “Social Health Care Programs” (SHCP).
This strategy combines the existing activities in the area of social health care and has three clear focus areas: reproductive health care (family planning), tackling neglected tropical diseases and programs for improved access to innovative medicines. “We want to concentrate on projects where we possess special expertise,” explains Köstlin. “That’s where our efforts can be most successful.”
Ideally, social and corporate value-added go hand in hand here. Yet it takes time to develop sustainable solutions. That’s why Bayer focuses on long-term programs and supports particularly projects that enable structural changes over a longer period of time. “It goes without saying that we will continue to provide rapid, targeted relief in emergency situations through the donation of medicines or medical equipment. Yet our focus is clearly on lastingly improving health care,” says Köstlin, explaining the company’s support strategy.
Another goal of the strategy is to create more transparency. The aim is for clear criteria to facilitate decisions in favor of or against specific support projects in the future. Projects are evaluated for the Group and the selection of new projects prepared by a central unit at Bayer Schering Pharma in Berlin. Bayer is convinced that these activities will also positively impact the company’s business success. Access to drug products is being improved in the long term by means of a differentiated pricing strategy that takes both the health burden and the level of development in the relevant recipient country into account. Such differentiated pricing also helps to gain access to new markets and expand existing markets. In this way, the SHCPs are contributing to the economic performance of the company. The Bayer Group also supported the evaluation of the Access to Medicine Index. This index was established in 2008 by the Access to Medicine Foundation and a number of committed investment societies to render more transparent and facilitate the comparability of companies’ contributions to improved health care access 
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Enabling self-determined family planning
Bayer’s family planning activities are aimed at enabling self-determined family planning at affordable prices and reducing mother and infant mortality. “As the market leader in hormonal contraceptives, we have a wealth of experience and a long tradition in promoting women’s health and family planning”, Köstlin explains. Our partners include the Reproductive Health Supplies Coalition (RHSC) – a joint international initiative of governmental agencies, private sector companies and NGOs – the United Nations Fund for Population Activities and a number of developmental aid organizations. In the context of these programs, various contraceptives are distributed at cost price or at heavily reduced prices. Through a collaboration initiated in August 2008 with the organization John Snow Inc. and the United States Agency for International Development (USAID), a total of eight million women in developing countries will receive access to hormonal contraception and health education in the future.
Promoting therapies against neglected diseases
The second focus area of the SHCP strategy is tropical and infectious diseases. Here Bayer places particular emphasis on therapies for neglected tropical diseases that are not at the center of global interest.
Together with the World Health Organization (WHO), for example, the company has focused since 2003 on fighting Chagas’ disease, a widespread illness in Latin America that is primarily transmitted by triatomine bugs and kills approximately 14,000 people each year. The disease is increasingly spreading due to migration; as a result, North America, Europe and the Western Pacific region are now affected as well.
Since 2003, Bayer HealthCare has provided the WHO with free supplies of the drug Lampit®, whose active substance nifurtimox effectively fights the virus that causes Chagas’ disease. Bayer and the WHO are united in their conviction that this disease can be not only cured, but effectively stemmed in the long term. The company is therefore considering with the WHO whether to expand the program.
Bayer is similarly committed to eliminating sleeping sickness, a disease that occurs in Africa and is transmitted by the tsetse fly. It is one of the most complex tropical diseases. The parasite that causes sleeping sickness is particularly widespread among the poorest people living in rural Sub-Saharan Africa. Bayer HealthCare is cooperating in this field with the United Nations-sponsored Special Programme for Research & Training in Tropical Diseases (TDR). Bayer has supported clinical trials designed to investigate the suitability of the active substance nifurtimox for treating African sleeping sickness. In April 2009, the WHO added Lampit® to its Essential Drug List for developing countries as part of a combination therapy for this indication.
In addition, in 2003 Bayer HealthCare began supplying the WHO with a drug containing the active substance suramin to control African sleeping sickness.
Bayer advocates an “Integrated Sleeping Sickness Initiative” intended to bring together resources and skills to manage all aspects of the fight against sleeping sickness, from infection and diagnosis to therapy and prevention.
Effectively fighting malaria
Malaria is still the most dangerous tropical disease, killing approximately 880,000 people a year. Here, too, Bayer has worked together with various partners for many years to limit the spread of malaria and alleviate its effects. In cooperation with developmental aid organizations such as usaid and NetMark, for example, Bayer CropScience developed a mosquito net that is many times more effective than conventional nets due to a special insecticide impregnation technique.
Bayer also participates in further international initiatives and projects such as the Corporate Alliance for Malaria Control in Africa (CAMA) and the Global Collaboration for the Development of Public Health Pesticides (GCDPP). Particularly promising is the Innovative Vector Control Consortium (IVCC), which has been sponsored by the Bill & Melinda Gates Foundation since 2005. Yet another research agreement was recently concluded for an initial period of three years with the aim of finding new active substances for Public Health Products (PHPS) which provide effective protection against insects which transmit diseases and are resistant to conventional medicines.
More effectively treating tuberculosis
There is also a need to act with regard to tuberculosis, which is the world’s most deadly infectious disease. Tuberculosis affects particularly those with a weakened immune system: According to estimates by the University of Lübeck, Germany, patients infected with HIV are 20 times more likely to contract tuberculosis than those WHO do not carry the virus.
Bayer is working together worldwide with the Global Alliance for TB Drug Development, or TB Alliance for short, to develop a tuberculosis drug that significantly reduces the duration of treatment. The third phase of clinical development, which is relevant for the approval of Bayer’s active substance moxifloxacin, is expected to be completed in 2011. The antibiotic moxifloxacin is not yet registered for the treatment of tb. As a member of the Global Business Coalition on HIV / AIDS, Tuberculosis and Malaria (CAMA), Bayer organizes awareness programs and information campaigns on the theme of tuberculosis in India and China, among other countries.
Closing treatment gaps worldwide
The third pillar of Bayer’s SHCP strategy is its programs to provide access to innovative medicines for the treatment of serious and chronic illnesses. These include, for example, the treatment of oncological and hematological indications that so far is very limited in developing and emerging countries. In the future Bayer will systematically develop and promote activities that improve treatment worldwide in these indications.
An access program launched in China in 2007 for the active substance sorafenib to treat renal cell and hepatocellular carcinoma already points in this direction: Through this program, Bayer makes the drug Nexavar® sufficiently available to patients WHO have been diagnosed with kidney liver cancer. The program is now being introduced in India and it is planned to extend it to other Asian countries and also to countries outside Asia.
Bayer offers similar programs in Western countries when patients are not able to access treatment for cost reasons. In the United States, for example, the company provides medicines free of charge to cancer and multiple sclerosis patients WHO are unable to afford treatment.
Sustainable financing for research
Some NGOs are calling for international pharmaceutical companies to provide their products and services at no cost in poor countries or to authorize affordable imitation products. Yet research is very cost-intensive and prolonged – as a research-based pharmaceutical company, Bayer must finance research into future treatment options through the price of established medicines. Patents are essential for further progress in the field of health care. “We currently have 50 pharmaceutical research projects in clinical development,” says Köstlin. “We would not be able to afford such enormous investment in medical innovations if we were to do without patent protection.”
However, this does not mean that medicines and medical innovations cannot be made available in developing countries too at affordable prices. On the one hand, most of the drug products deemed essential by the WHO are no longer patent-protected. And on the other hand, Bayer has developed a differentiated pricing strategy for patent-protected medicines that is based on the economic situation existing in the respective countries. Individual agreements with the governments in question ensure that patients in poorer countries can receive Bayer products too. The company also donates medicines through the WHO.
Bayer in dialogue: family planning symposium
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| Mercy Mkaluma Maghanda, youth advisor at the dsw, talking with Simone Paetow, from the Berlin youth organization “Jugendwerk Aufbau Ost e.V.” Mercy recounted her experiences with pregnant teenagers in Kenya and appealed to the international community not to ignore the issue of teenage pregnancy. |
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| Dr. Ann Ginsberg, Chief Medical Officer, Global Alliance for TB Drug Development (TB Alliance) |
Someone dies of tuberculosis about every 20 seconds – that makes almost 5,000 people every day. The World Health Organization (WHO) estimates that TB killed some 1.8 million people in 2007 alone. Today’s TB drug regimens were developed back in the 1960s and are complex and drawn-out. The duration of therapy is between six and 24 months, hindering patient adherence and fueling drug resistance.
The TB Alliance is developing the largest portfolio of potential new TB treatments ever assembled, the most advanced of which is a Phase III clinical-stage project between Bayer HealthCare and the TB Alliance, which is investigating whether the drug moxifloxacin is capable of significantly shortening TB treatment. A shorter treatment could increase patient compliance, slow the development of drug resistance, and lower TB-related health care expenditure in endemic countries.
Over the next few years, we expect to register the first new shorter regimens for active TB in over 40 years and to further expand our discovery and clinical development programs. We will advance the portfolio towards the goal of improved and innovative treatments against drug-sensitive and drug-resistant TB. The TB Alliance therefore continues to be dependent on close cooperation with partners from industry. We count on companies like Bayer HealthCare, which we have found to be a committed and reliable partner in the efforts to combat one of the world’s most important causers of disease and death.
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