Pandemics and access to medicines: A 2020 assessment

Event report

Safe and affordable access to medicines represents fundamental human rights and a part of sustainable development goals (SDGs). The COVID-19 pandemic has accelerated the trend of transforming the Internet into a tool to access medicines. Filling prescriptions online has become the new norm for many of us, however, the world currently lacks an international regulatory framework to regulate this emerging market and protect the health and safety of citizens from dangerous websites that sell falsified or substandard medicines, also known as rogue online pharmacies.

Traditionally, medicines are highly regulated goods because the issues of licensing manufacturers, distributors, and prescribers of medicines significantly affect the health of citizens if poorly regulated. Such a notion is reflected in law-making of each jurisdiction to ensure that falsified or poor-quality medicines do not circulate in the market. Mr Bertrand de La Chapelle (Co-Founder & Executive Director, Internet & Jurisdiction Policy Network) pointed out that the borderless nature of the Internet is attributed as the challenge of developing a regulatory framework at the global level on the issue of access to medicines using the Internet. He also addressed the question of who should become a global regulator for the intersectional issue of medicines and the Internet. Even if the international community is able to come to consensus on the rules, it may be challenging to identify or establish an international body to take regulatory actions, such as taking down rogue pharmacies or licensing cross-border sales of drugs, since such actions will involve authorisations from other entities. Mr Aria Ahmad (Global Health, Foresighting Fellow, York University) noted the legitimacy of the World Health Organization (WHO) as an international body to develop norms related to health and medicines, suggesting that countries may work to harmonise their respective laws with norms and rules established within the WHO. He further noted that capacity within the WHO is fairly limited when it comes to technical knowledge on the Internet, which indicates that the norm-setting process will require a multidisciplinary and multistakeholder participation.

The Brussels Principles on the Sales of Medicines Over the Internet (BP) were developed through the collaboration among academia, civil society, companies, Internet policy experts, etc. to encourage policies and practices that maximise access to safe and affordable medicines using the Internet while curtailing access to rogue online pharmacies. Although the establishment of such principles shared by a wide range of stakeholders is a necessary step, governments have a lot of catching up to do to realise the future. Bringing a perspective from the MENA region, Ms Zina Hany (Clinical Consultant, BD) explained that the region’s diversity in the healthcare system, economic status, and policy will likely impede efforts to make cross-border sales of medicines available online. Furthermore, she underlined that governments in the region are protective about local drug manufacturers and are, therefore, reluctant to support the idea of a cross-border online platform for medicines, which may kill local manufacturing businesses. Nonetheless, she called on such gatekeepers to think more about potential positive effects on public health and to catalyse their efforts for the creation of a comprehensive and integrated platform.

The consensus among the panellists was that facilitating access to medicines through the Internet will help the world make progress towards SDGs. It is crucial for all stakeholders to overcome individual interests and bring their respective expertise to the table, while pivoting on public health perspectives.