Are companies’ donations programmes sustaining elimination efforts?
Donations of medicines by pharmaceutical companies can be a route of access to medicine for the poorest populations. Donation programmes play an important role in the management of, among others, neglected tropical diseases (NTDs). These diseases are closely related to poverty due to inadequate sanitation systems, close contact with infectious vectors, domestic animals and livestock, and they cause important burdens at the national or local level.
In 2012, the World Health Organization (WHO) developed a strategy with clear targets to be achieved by 2020 in order to overcome the global impact of NTDs. The purpose of this roadmap was to drive action among the pharmaceutical industry, governments and civil society to help boost prevention, control, elimination and eradication of this diverse group of diseases.
That same year, a group of partners comprised of governments, pharmaceutical companies and donors – now collectively known as Uniting to Combat NTDs – met in London to support the roadmap, signing the London Declaration on Neglected Tropical Diseases. Companies, in particular, donated a range of existing medicines for 10 NTDs that were identified as needing urgent action.
Safeguarding progress against NTDs for the next decade
Despite major progress, not all goals were met by 2020. With the launch of a new 2021–2030 NTD roadmap in April 2020, the London Declaration commitments will need to be renewed to ensure the global response is fully realised. This is why in June 2020, the Government of Rwanda organised an event to join Uniting to Combat NTDs at a high-level global summit in Kigali. Yet as a consequence of the COVID-19 pandemic, the Kigali Summit on NTDs was postponed. Momentum in the form of company commitment to end the NTD burden is now needed to safeguard progress, especially as the COVID-19 pandemic has disrupted health systems globally, posing a severe threat to major NTD interventions.
The Index looks at how companies remain engaged and committed to ensuring access to their donated products for diseases where NTD elimination, eradication and control goals are possible. It considers the scale (geographic scope and timeline) and patient reach of the companies’ donation programmes, whether such commitment has a time limit and whether it has been shared publicly.
What do companies’ NTD programmes look like?
The 2021 Index identified 14 donation programmes for NTDs by 11 companies in scope, running in between one and 74 countries. These structured donation programmes target 11 out of 20 NTDs identified by WHO.
Eisai, GSK, Merck*, MSD** and Sanofi havecommitted to donating their medicines as from 2020 and until elimination, eradication or control goals are achieved for the targeted disease. In six of the programmes, the company expanded its initiatives beyond the 2020 roadmap goals. For example, Merck* has expanded the target population to include all age groups for the treatment of schistosomiasis.
Looking beyond NTDs
For diseases that cannot be eliminated or eradicated such as non-communicable diseases (NCDs) including cancer, diabetes, etc., patients generally need ongoing, long-term and often life-long treatments. Such diseases do not, by definition, allow for long-term sustainable donation programmes. While such programmes are not included in the analysis, the Index highlights these relevant programmes where possible. A total of 20 donation programmes are being run by 12 companies for NCDs, communicable diseases and maternal & neonatal health conditions in between one and 37 countries. For most programmes, there is no planned end date.
Expanding goals to help sustain efforts
Companies have a responsibility to ensure that donation programmes lead to sustainable improvements in access to medicine. This means ensuring populations can continue to access donated products for as long as they are needed. This may involve companies making a firm donation commitment until a disease is eliminated or eradicated, specifically through the renewal of the London Declaration commitment. To date, company commitments are scattered for these donation programmes as there has been no renewal of the London Declaration yet. However, companies can still renew commitments aligning with the WHO Roadmap for NTDs 2021-2030 to reach the goal of ending NTDs by 2030.
Momentum in the form of company commitment to end the NTD burden is now needed to safeguard progress.
To safeguard the path to progress against NTDs and help ensure that progress in ending NTDs is sustained, all companies with an NTD donation programme can expand the donation beyond the WHO-stated goals. For programmes where this is not possible (for example, those targeting NCDs), it may entail establishing transition plans for patients to access the product once the programme ends.
*Merck KGaA, Darmstadt, Germany
**Merck & Co., Inc., Kenilworth, NJ USA