Licence to Heal: How to Make Healthcare Accessible to Everyone

License to heal co-signers at LYMEC GA, Sofia (2017)

“Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it’s the only thing that ever has” – Margaret Mead

This quote is the motto of the License to Heal working group. A group of young political youth party members fighting for the right for access to essential drugs: a pressing issue that requires action right now.  This sense of urgency was also felt during the last general assemblies of IFLRY and LYMEC this year and resulted in an overwhelming support for the resolution of License to HealIf you were at the last IFLRY or LYMEC General assembly, you probably heard me speak about the resolution. With this article, I’d like to let you know more about License to Heal and why and how this resolution was established.

Health is a fundamental human right, this includes access to affordable medicines and care. Unfortunately, not all countries are able to live up to this expectation. Estimates expect that about one third of the world population does not have access to essential medicines, which results in up to 10 million annual deaths worldwide that could have been prevented.

Depressingly, a lack of access to affordable medicines is not only a problem in low and middle-income countries. In developed countries, we see an increasing trend in the health industry asking extremely high prices for innovative medicines, resulting in the fact that patients don’t get access to medication simply because they are too expensive.

Why are these drugs so expensive?

About a quarter of the available drugs were discovered by academic institutions such as universities. The government finances medical scientific research, but sets no conditions on the price and accessibility of the discovered medication; leaving pharmaceutical companies free to ask high prices, that cannot be accounted for by research and development (R&D) costs. The biggest pharmaceutical companies have profit margins of 19,5% (compared to 7% (oil and gas) and 8% (auto industry).

The pharmaceutical industry claims the costs of drugs are so high because of the high R&D costs that come with the development of medication. However studies prove that there is no correlation between the asking price of drugs and R&D expenditures. In fact, the industry spends more (sometimes 19 times more!!) money on marketing than on R&D.

Also, pharmaceutical companies are monopoly players in this (billion dollar) market. This gives them the opportunity to ask any price they wish, leaving countries that try to negotiate with them powerless. Either you pay the price, or you don’t get the drugs.

What can we do about it?

A group of political youth party members started a working group and worked together with seven other Dutch youth parties, several professors within the field and numerous NGO’s, and established a manifesto: License to Heal.

Working group discussing different solutions (Utrecht, 2016)

This manifesto was presented to Members of the Healthcare Committee of the Dutch Parliament in December 2016. The Minister of Health was pleasantly surprised by the manifesto and asked the Council for Public Health and Society (RVS), a government body that advises both the Dutch Government and Parliamen,t to research the solutions proposed in the manifesto. They have just come out with their report (in English), which you can find here: https://www.raadrvs.nl/uploads/docs/Recommendation_Development_of_New_Medicines.pdf

 

Working group president Dave van der Kruijsen presents the
manifesto to the health committee of parliament (The Hague, 2016)

What are the solutions?

The manifesto provides different types of solutions providing better access to medicines. In short:

  1. Work together!

The pharmaceutical industry operates on an international level. Therefore, it is necessary for countries to work together with other countries in the reimbursement process to gain bargaining power which is needed to negotiate with the companies to lower the price of medicines.

  1. Implement measures on a national level

Countries should take responsibility and implement measures within their own countries to enhance accessibility. License to Heal proposes the implementation of criteria for the licensing of new active pharmaceutical substances that are discovered in publicly financed research institutions.

Preferably by incorporating the following criteria in the license agreements:

  • Require the licensee to be transparent about the added value and cost structure of a drug (including marketing costs, public R&D investments and tax rebates);
  • To require the licensee to ensure access to the drug originating from such institutions by asking a responsible price;
  • In developing countries: allow licenses to be given to more than one licensee. This will result in market competition.

The second solution will have the most impact when countries implement these measures simultaneously, as this won’t give pharmaceutical companies the option playing countries off against each other, by cutting off the provision of a drug in a country that takes action, while still selling to those countries that don’t.

Dutch parliament committee on health care discussing the manifesto (The Hague, 2017)

License to Heal goes international
The working group members of License to Heal are convinced that these proposed measures will only have an impact when they are implemented on an international level. Therefore, together with JOVD, we created the License to Heal resolution, to give us an opportunity to discuss the initiative during the IFLRY and LYMEC GA. We are very grateful for all the parties who co-signed and/or worked together with us: JNC Catalunya (Catalonia), Keskustanuoret (Finland), Radikal Ungdom (Demnark), Venstres Ungdom (Denmark), Junge Liberale (Germany), Vesna (Russia), Jong VLD (Belgium), Federation Etufiants Liberal (Belgium) and Ógra Fianna Fáil (Ireland). And of course all the different parties that voted in favor of this resolution as well. We are delighted that JNC already got the resolution adopted during their own GA this year!!!!

Happy co-signers at IFLRY GA (Thessaloniki, 2017)

Also, another version of the License to Heal resolution was adopted during the GA of YEPP, the network of Christian Democrats political youth organizations, and will be submitted for debate at the network organizations of the green movement, the Christian political youth and the young socialists youth network by other License to Heal working group members.

We need your help!
In the resolution we call upon all member organizations to propose these solutions to their own government. We would like to ask you to, like JNC, write resolutions based on License to Heal and submit them at the GA of your own (mother)party. Also, please let us know if there are any new issues in your country with access to drugs.

If you want to keep updated about License to heal please go to our website https://www.licensetoheal.nl/en.html or follow us on Facebook and twitter.

Finally, if you want to become an active member of License to heal pleas me send me a on Facebook PMJ, or email me at: carlijn.oldereuver@gmail.com If you need any help or have questions, please feel free to contact me!!

Carlijn Olde Reuver is the international officer of the License to Heal Board. She holds a Masters degree in Health Sciences and Administration, and is currently working as a Project manager for a company that measures and compares the quality of health care in different countries around the world.  She is also an active member of D66 and Jonge Democraten, and is active in their International and Health Care working groups.