Health Action International

Last updated

Health Action International Inc
Formation1981;43 years ago (1981)
TypeNonprofit NGO
PurposeAccess to medicines
Headquarters Amsterdam, The Netherlands
Region served
International
Official language
English
Executive Director
Dr Tim Reed
Staff
17
Website haiweb.org

Health Action International (HAI) is a non-profit organization based in The Netherlands. Established in 1981, HAI works to expand access to essential medicines through research, policy analysis and intervention projects. The organization focuses on snakebite envenoming, access to insulin and developing European policies on medicines. HAI is listed by the World Health Organization (WHO) as an official non-state actor. [1]

Contents

History

HAI was founded in Geneva in early 1981 [2] following an International Baby Food Action Network [3] (IFBAN) conference and before a global conference on International Women and Health meeting to be held in Geneva. [4] : 71  [5] After limiting marketing of infant formulas to the third world, three groups came together to co-sponsor this meeting, the International Organization of Consumers Unions (IOCU), [6] the BUKO Pharma-Kampagne, an organization that watches over the marketing practices of German pharmaceutical companies and the United Nations Non-Governmental Liaison Service (NGLS), [7] [5] [8] [4] : 71  and brought together 50 anthropologists, physicians, pharmacists and organizers [3] from 27 countries to form an "international antibody" [3] against pharmaceutical marketing practices and used "innovative techniques to get their message to the delegates". [9] : 139  It was similar to IFBAN but was organized to replace branded drugs with generics. [4] : 72  [10] The US Pharmaceutical Manufacturing Association said "we take this as a serious potential problem, both from a marketing threat here and now and for a WHO resolution in the future." [4] : 72 

HAI was immediately criticized by the pharmaceutical industry who implied a connection with Moscow [11] The German Pharmaceutical Manufacturing Association (BPI) published an article on the formation of HAI and connected it to a conference in November 1981 in Moscow of the World Federation of Trade Unions. [4] : 72-74  Claus Roepnack, then CEO of a German pharmaceutical company, Hoechst AG, asked whether the activists of HAI meant to overthrow "existing social and economic systems in favor of authoritarian regimes". [4] : 72  [12] In 1987, the Thai newspaper The Nation made similar allegations. [4] : 72 

In 1982, HAI proposed a draft for “an international code on pharmaceuticals” [13] at the 35th World Health Assembly (WHA) meeting in an attempt to regulate the conduct of multinational drug companies, [4] : 80-82  especially in developing countries. [10] The attempt was unsuccessful, [3] and the WHA declined to discuss the proposal. [10] [8] [14]

In 1984, HAI produced a video, Hard to Swallow, in collaboration with Oxfam about the experiences of Dianna Melrose of pharmaceutical sales rep practices in Peru. [4] : 16  That same year, HAI lobbied the WHA delegates and published a number of publications to incorporate responsible drug use into the WHO's Essential Drugs Monitor. Not all of HAI's initiatives against the pharmaceutical industry were appreciated by the WHO. [4] : 83-93 

At one point, Asian operations were housed in Penang, Malaysia and a European operation was located in The Hague in the 90's but moved its headquarters to Amsterdam. [15]

A two-year project started in 1986 helped to reduce the use of Neomycin in antidiarrhetic products globally from 12% down to 7%. [4] : 78 

At the 41st World Health Assembly in 1987, HAI organised a large lobby of delegates to advocate for stronger controls on advertising by the pharmaceutical industry. [16] It advocated for an independent drug code similar to the US FDA but under the WHO which would replace the International Federation of Pharmaceutical Manufacturers & Associations drug marketing code. [15]

In 1988, HAI began discussions around issues with the Bamako Initiative. [4] : 126-129  This initiative was a plan for UNICEF and other donors to supply drugs to Sub-Saharan African countries which would be sold a little above cost. The profits from these sales would be used to buy more drugs in a self-sustaining way. This work modified HAI's purpose to move towards health policy rather than just responsible medicine use. [4] : 128 

In 1989, the organization testified in front of the FDA arguing against the approval of Norplant, a hormone capsule implant developed by Wyeth-Ayerst Laboratories and designed as a long-acting contraceptive. It was approved and used by about a million women. HAI claimed that the implant had not been rigorously scientifically tested and warned of serious problems, among them its removal, infection at the implant site, and unknown long-term side effects. [17]

In response to 2001 WHA resolution, HAI together with the WHO a established a survey methodology to assess global drug prices and accessibility. [18] [19] [20] [21] [22]

Purpose

HAI works to increase access to essential medicines and encourage responsible medicine use. [8] [2] [7] [23] [10] [24] [3] Projects included neglected tropical diseases, access to insulin, sexual and reproductive health commodities, controlled medicines and transparency of medicine prices. According to Silverman et al. (1992), HAI and IOCU are the two organizations that have had the greatest impact on drug company activities in the third world. [15]

Snakebites

World distribution of snakes.svg
Map showing the approximate world distribution of snakes.
Number of snake envenomings (2007).svg
Map showing the global distribution of snakebite morbidity.

HAI works in Kenya, Uganda, Zambia and at the global level with WHO to gather snakebite incidence and treatments, including research and community education on first-aid and prevention. [25] HAI also works with local governments for policies to improved access to effective and safe antivenoms, and proper training for healthcare workers. [26] [27] At the global level, HAI works with international partners such as the WHO Neglected Tropical Disease (NTD) Department and the Global Snakebite Initiative. [28] [29] [30] HAI played an important role in including snakebite as a WHO Category A Neglected Tropical Disease (NTD) status in, a WHO resolution and development of global strategy to decrease burden of snakebite . [31] [30] [32]

Access to insulin

HAI produced a study of the global insulin market in 2018. [33] It then developed policies and tools to increase insulin access, and studied the cost of insulin production and estimated the number of people with type 2 diabetes. [34] HAI received a $3.5 million grant from The Leona M. and Harry B. Helmsley Charitable Trust in 2018 to study insulin access in low and middle income countries. [35]

European policy

HAI works to expand access to affordable medicines, promote medicine safety and enhance therapeutic value. HAI uses the TRIPS Agreement, [36] [37] issuing policy recommendations on health technology assessment (HTA) and raising awareness on the impact of pharmaceutical marketing on prescribing behaviours. [38] [39]

In 2011, HAI received a 218,000 Euro grant from the EU to look at strategies to improve access to medicines. [40]

Related Research Articles

An orphan drug is a pharmaceutical agent that is developed to treat certain rare medical conditions. An orphan drug would not be profitable to produce without government assistance, due to the small population of patients affected by the conditions. The conditions that orphan drugs are used to treat are referred to as orphan diseases. The assignment of orphan status to a disease and to drugs developed to treat it is a matter of public policy that depends on the legislation of the country.

<span class="mw-page-title-main">Pharmaceutical industry</span> Industry involved with discovery, development, production and marketing of drugs

The pharmaceutical industry is an industry in medicine that discovers, develops, produces, and markets pharmaceutical drugs for use as medications to be administered to patients, with the aim to cure and prevent diseases, or alleviate symptoms. Pharmaceutical companies may deal in generic or brand medications and medical devices. They are subject to a variety of laws and regulations that govern the patenting, testing, safety, efficacy using drug testing and marketing of drugs. The global pharmaceuticals market produced treatments worth $1,228.45 billion in 2020 and showed a compound annual growth rate (CAGR) of 1.8%.

Pharmaceutical marketing is a branch of marketing science and practice focused on the communication, differential positioning and commercialization of pharmaceutical products, like specialist drugs, biotech drugs and over-the-counter drugs. By extension, this definition is sometimes also used for marketing practices applied to nutraceuticals and medical devices.

<span class="mw-page-title-main">Diazoxide</span> Medication used to treat low blood sugar and high blood pressure

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<span class="mw-page-title-main">World Health Assembly</span> Governing body of the World Health Organization

The World Health Assembly (WHA) is the forum through which the World Health Organization (WHO) is governed by its 194 member states. It is the world's highest health policy setting body and is composed of health ministers from member states.

<span class="mw-page-title-main">Global health</span> Health of populations in a global context

Global health is the health of the populations in the worldwide context; it has been defined as "the area of study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide". Problems that transcend national borders or have a global political and economic impact are often emphasized. Thus, global health is about worldwide health improvement, reduction of disparities, and protection against global threats that disregard national borders, including the most common causes of human death and years of life lost from a global perspective.

BUKO Pharma-Kampagne is an independent organization based in Bielefeld, Germany, which watches over the marketing practices of German pharmaceutical companies.

The pharmaceutical industry in India was valued at an estimated US$42 billion in 2021 and is estimated to reach $130 billion by 2030. India is the world's largest provider of generic medicines by volume, with a 20% share of total global pharmaceutical exports. It is also the largest vaccine supplier in the world by volume, accounting for more than 60% of all vaccines manufactured in the world. Indian pharmaceutical products are exported to various regulated markets including the US, UK, European Union and Canada.

<span class="mw-page-title-main">Essential medicines</span> WHO formulary

Essential medicines, as defined by the World Health Organization (WHO), are the medicines that "satisfy the priority health care needs of the population". These are the medications to which people should have access at all times in sufficient amounts. The prices should be at generally affordable levels. Since 1977, the WHO has published a model list of essential medicines, with the current (2019) list for adult patients containing over 400 medicines. Since 2007, a separate list of medicines intended for child patients has been published. Both the WHO adult and children's lists contain a notation indicating that a particular medication is "complementary", thus essentially there are two lists, the "core list" and the "complementary list". The core list presents a list of minimum medicine needs for a basic health care system, listing the most efficacious, safe and cost-effective medicines for priority conditions. Priority conditions are selected on the basis of current and estimated future public health relevance, and potential for safe and cost-effective treatment. The complementary list presents essential medicines for priority diseases, for which specialized diagnostic or monitoring facilities are needed. In case of doubt medicines may also be listed as complementary on the basis of higher costs or less attractive cost-effectiveness in a variety of settings. The list is important because it forms the basis of national drugs policy in more than 155 countries, both in the developed and developing world. Many governments refer to WHO recommendations when making decisions on health spending. Countries are encouraged to prepare their own lists taking into consideration local priorities. Over 150 countries have published an official essential medicines list.

<span class="mw-page-title-main">Drugs for Neglected Diseases Initiative</span> Non-profit organization

The Drugs for Neglected Diseases initiative (DNDi) is a collaborative, patients' needs-driven, non-profit drug research and development (R&D) organization that is developing new treatments for neglected diseases, notably leishmaniasis, sleeping sickness, Chagas disease, malaria, filarial diseases, mycetoma, paediatric HIV, cryptococcal meningitis, hepatitis C, and dengue. DNDi's malaria activities were transferred to Medicines for Malaria Venture (MMV) in 2015.

<span class="mw-page-title-main">Neglected tropical diseases</span> Diverse group of tropical infectious diseases which are common in developing countries

Neglected tropical diseases (NTDs) are a diverse group of tropical infections that are common in low-income populations in developing regions of Africa, Asia, and the Americas. They are caused by a variety of pathogens, such as viruses, bacteria, protozoa, and parasitic worms (helminths). These diseases are contrasted with the "big three" infectious diseases, which generally receive greater treatment and research funding. In sub-Saharan Africa, the effect of neglected tropical diseases as a group is comparable to that of malaria and tuberculosis. NTD co-infection can also make HIV/AIDS and tuberculosis more deadly.

<span class="mw-page-title-main">Health policy</span> Policy area that deals with the health system of a country or other organization

Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society". According to the World Health Organization, an explicit health policy can achieve several things: it defines a vision for the future; it outlines priorities and the expected roles of different groups; and it builds consensus and informs people.

Medication costs, also known as drug costs are a common health care cost for many people and health care systems. Prescription costs are the costs to the end consumer. Medication costs are influenced by multiple factors such as patents, stakeholder influence, and marketing expenses. A number of countries including Canada, parts of Europe, and Brazil use external reference pricing as a means to compare drug prices and to determine a base price for a particular medication. Other countries use pharmacoeconomics, which looks at the cost/benefit of a product in terms of quality of life, alternative treatments, and cost reduction or avoidance in other parts of the health care system. Structures like the UK's National Institute for Health and Clinical Excellence and to a lesser extent Canada's Common Drug Review evaluate products in this way.

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Access to medicines refers to the reasonable ability for people to get needed medicines required to achieve health. Such access is deemed to be part of the right to health as supported by international law since 1946.

External reference pricing (ERP), also known as international reference pricing, is the practice of regulating the price of a medication in one country, by comparing with the price in a "basket" of other reference countries. It contrasts with internal reference pricing, where the price of one drug is compared to the domestic price of therapeutically related drugs, and with cost-plus pricing, where the price involves negotiating an acceptable markup to the unit cost to develop and produce.

The WHO/Health Action International Project on Medicine Prices and Availability was a partnership between the World Health Organization and Health Action International. It developed a system and methodology for measuring the price, availability and affordability of medicines. The project surveyed over 50 countries. It also created guidance for low-and-middle-income countries to help their governments and associated health organisations to implement policies on drug prices.

<span class="mw-page-title-main">Proprietary drug</span>

Proprietary drug are chemicals used for medicinal purposes which are formulated or manufactured under a name protected from competition through trademark or patent. The invented drug is usually still considered proprietary even if the patent expired. When a patent expires, generic drugs may be developed and released legally. Some international and national governmental organizations have set up laws to enforce intellectual property to protect proprietary drugs, but some also highlight the importance of public health disregarding legal regulations. Proprietary drugs affect the world in various aspects including medicine, public health and economy.

Vaccine equity means ensuring that everyone in the world has equal access to vaccines. The importance of vaccine equity has been emphasized by researchers and public health experts during the COVID-19 pandemic but is relevant to other illnesses and vaccines as well. Historically, world-wide immunization campaigns have led to the eradication of smallpox and significantly reduced polio, measles, tuberculosis, diphtheria, whooping cough, and tetanus.

References

  1. ↑ "Listing of HAI by the WHO as an official actor" (PDF). Retrieved 14 May 2019.
  2. 1 2 Lee PR, Lurie P, Silverman MM, Lydecker M (1991). "Drug promotion and labeling in developing countries: an update". J Clin Epidemiol. 44 (Suppl 2): 49S–55S. doi:10.1016/0895-4356(91)90113-n. PMID   2045842.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  3. 1 2 3 4 5 Greene, Jeremy (2011). "Making medicines essential: The emergent centrality of pharmaceuticals in global health". BioSocieties. 6 (1): 10–33. doi: 10.1057/biosoc.2010.39 . S2CID   144971333.
  4. 1 2 3 4 5 6 7 8 9 10 11 12 13 Chetley, Andrew (1990). A Healthy Business?: World Health and the Pharmaceutical Industry (1st ed.). Zed Books. pp. 71–73. ISBN   978-0862327354.
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  6. ↑ "Encyclopaedia Britannica Entry on Consumers International". Encyclopaedia Britannica. Retrieved 17 May 2019.
  7. 1 2 Reich, Michael R. (1987). "Essential drugs: economics and politics in international health". Health Policy. 8 (1): 39–57. doi:10.1016/0168-8510(87)90129-1.
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  15. 1 2 3 Silverman, Milton; Lydecker, Mia; Lee, Philip (1992). Bad Medicine: The Prescription Drug Industry in the Third World (1st ed.). Stanford University Press. pp.  185–188. ISBN   978-0804716697.
  16. ↑ "World Health Organization Essential Drugs Monitor" (PDF). apps.who.int. 1988. Archived from the original (PDF) on 25 July 2017.
  17. ↑ Duncan, Laura (November 1995). "Norplant: The Next Mass Tort". ABA Journal. 81.
  18. ↑ Van Puymbroeck RV (2010). "Basic survival needs and access to medicines--coming to grips with TRIPS: conversion + calculation". J Law Med Ethics. 38 (3): 520–49. doi:10.1111/j.1748-720X.2010.00510.x. PMID   20880239. S2CID   30614257.
  19. ↑ Fang Y, Wagner AK, Yang S, Jiang M, Zhang F, Ross-Degnan D (2013). "Access to affordable medicines after health reform: evidence from two cross-sectional surveys in Shaanxi Province, western China". Lancet Glob Health. 1 (4): e227-37. doi: 10.1016/S2214-109X(13)70072-X . PMID   25104348.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  20. ↑ Anson A, Ramay B, de Esparza AR, Bero L (2012). "Availability, prices and affordability of the World Health Organization's essential medicines for children in Guatemala". Globalization and Health. 8: 22. doi: 10.1186/1744-8603-8-22 . PMC   3503802 . PMID   22747646.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  21. ↑ Cameron A, Ewen M, Ross-Degnan D, Ball D, Laing R (2009). "Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis". Lancet. 373 (9659): 240–9. doi:10.1016/S0140-6736(08)61762-6. PMID   19042012. S2CID   916706.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  22. ↑ Sharma A, Bhandari PM, Neupane D, Kaplan WA, Mishra SR (2018). "Challenges constraining insulin access in Nepal-a country with no local insulin production". Int Health. 10 (3): 182–190. doi:10.1093/inthealth/ihy012. PMID   29617832.{{cite journal}}: CS1 maint: multiple names: authors list (link)
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  24. ↑ "Campaigning for Stronger Drug Policies". The Lancet. 322 (8364): 1435–1436. 1983. doi:10.1016/S0140-6736(83)90975-3. ISSN   0140-6736. S2CID   54255965.
  25. ↑ Ratcliffe, Rebecca (24 May 2018). "Mambas, medicine and one girl's race to survive Kenya's biting problem". The Guardian. The Guardian. Retrieved 14 May 2019.
  26. ↑ Eveleens, Ilona (21 August 2018). "Slangenbeten zijn een vergeten ziekte ten zuiden van de Sahara" (in Dutch). de Verdieping Trouw. de Verdieping Trouw. Retrieved 14 May 2019.
  27. ↑ "La morsure de serpent, un fléau oublié qui empoisonne toujours l'Afrique" (in French). Le Monde. Le Monde. 19 March 2019. Retrieved 14 May 2019.
  28. ↑ Chakraborty, Ajanta (23 February 2019). "New WHO strategy aims to halve the global impact of snakebite". The Times of India. The Times of India. Retrieved 14 May 2019.
  29. ↑ MCFARLING, USHA LEE (12 June 2017). "Snakebite finally makes a WHO list of top global health priorities". STAT. Retrieved 14 May 2019.
  30. 1 2 Harrison RA, Casewell NR, Ainsworth SA, Lalloo DG (2019). "The time is now: a call for action to translate recent momentum on tackling tropical snakebite into sustained benefit for victims". Trans R Soc Trop Med Hyg. 113 (12): 835–838. doi: 10.1093/trstmh/try134 . PMC   6903789 . PMID   30668842.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  31. ↑ "Striking Back: Snakebites Gain Global Attention". plos.org. 8 May 2018. Retrieved 14 May 2019.
  32. ↑ Bhaumik, Soumyadeep; Zwi, Anthony B.; Norton, Robyn; Jagnoor, Jagnoor (1 August 2023). "How and why snakebite became a global health priority: a policy analysis". BMJ Global Health. 8 (8): e011923. doi:10.1136/bmjgh-2023-011923. ISSN   2059-7908. PMC   10445399 . PMID   37604596.
  33. ↑ Boseley, Sarah (20 November 2018). "Insulin shortage could affect 40 million people with type 2 diabetes". The Guardian. The Guardian. Retrieved 14 May 2019.
  34. ↑ Lay, Kat (25 September 2018). "NHS paying too much for insulin". The Times. Retrieved 14 May 2019.
  35. ↑ "$3.5 million grant from The Leona M. and Harry B. Helmsley Charitable Trust". The Leona M. and Harry B. Helmsley Charitable Trust. Retrieved 17 May 2019.
  36. ↑ Lee, Kelley; Buse, Kent; Fustukian, Suzanne (2002). Health Policy in a Globalising World (1st ed.). Cambridge: Cambridge University Press. p. 91. ISBN   978-0521009430 . Retrieved 15 May 2019.
  37. ↑ Fletcher, Elaine (16 May 2018). "TRIPS Flexibilities in High Demand". Health Policy Watch. Retrieved 14 May 2019.
  38. ↑ Ed Silverman, Ed (20 March 2018). "Pharma payments to docs in Europe are often inadequately reported or hard to find". STAT. Retrieved 14 May 2019.
  39. ↑ Francesca Bruce, Francesca (1 February 2018). "Mandatory Joint Clinical Assessments For EU HTAs May Be 'Counterproductive'". Pink Sheet Pharma Intelligence. Retrieved 14 May 2019.
  40. ↑ "EU Health Programme: 2011 Call for Proposals, Abstracts of Actions selected for funding" (PDF). European Commission. Retrieved 17 May 2019.
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