Op-ed: When Geopolitics Meets Pharmaceuticals, Global Health Pays the Price

Jayasree K. Iyer, CEO of the Access to Medicine Foundation, explains how a rising global trend toward nationalism is reshaping the global health landscape, raising concerns about the reliability of access to medicine globally.

She asserts that the potential of the Trump administration to introduce new tariffs is driving an increasing emphasis on “onshoring” of the production of medicines. She cites that at least 15 of the world’s largest pharmaceutical companies “have recently invested billions to shift their manufacturing to the US.”

The effects will not be confined to poorer regions but will also affect the resilience of health systems in high-income countries, including the United States, she notes.

US pricing reforms – e.g. President Trump’s most-favoured-nation (MFN) initiative, which aims to match US drug prices to those paid in other developed nations – add another layer of strain, Jayasree writes.

She mentions solutions companies can employ including voluntary licensing as a way to lower the cost of goods and expand access, as demonstrated by the success of deals for HIV and hepatitis C across underserved regions that have enabled increased regional manufacturing. Regional initiatives could also help stabilise access, e.g. African Medicines Agency’s initiative to harmonise regulatory standards and bolster local capacity, she writes.

Jayasree concludes that companies that invest in global health are better positioned to navigate the changing landscape. With emerging markets already comprising 20-30% of revenues for some pharmaceutical companies, she cites, failing to invest not only undermines access globally, but stands to weaken growth prospects.