Patents are not the issue when it comes to access to medicines and vaccines in developing countries, according to Sanofi's Dr Robert Sebbag.
Dr Sebbag, Vice President of Access to Medicines at Sanofi, was recently in Australia to attend and speak at the International Congress for Tropical Medicine and Malaria.
He spoke to BiotechDispatch about some of the ongoing challenges for access in developing countries and what companies like Sanofi are doing to help overcome the issue.
Last year, Sanofi was awarded one of the US Commerce Department’s 'Patents for Humanity' awards in recognition for a patent that covers an innovative chemical and industrial process for producing semi-synthetic artemisinin, which is used in anti-malarial therapies.
Artemisinin is derived from the sweet wormwood plant (Artemisia annua) grown predominantly in China and Vietnam, and more recently in some African countries, including Madagascar and Kenya.
Growing cycles, variations in yield and other factors can produce variable supplies, making it difficult to obtain.
Sanofi's new process for semi-synthetic artemisinin produces a high quality, stable supply that complements the existing plant-derived source, helping to minimize the risk of shortages and reducing production lead times.
Dr Sebbag, who still works in a hospital one day per week, leads a team of around 40 people with the mandate to work on a number of diseases with a particular prevalence in developing countries, including malaria, tuberculosis, other neglected tropical diseases, and even two chronic diseases, epilepsy and mental health.
"A presence in developing countries is in the history of Sanofi, which means you have to be prepared to tackle these diseases - we believe it's very important and part of our corporate social responsibility," said Dr Sebbag.
In terms of barriers to access, he challenges the view patents undermine patient access in developing countries, arguing the majority of relevant compounds are off-patent.
"Drugs are only part of the solution. The main problem is the lack of healthcare professionals in developing countries - the brain drain. Thousands of trained doctors leave to go to other countries so all the best drugs in the world cannot overcome the challenge this creates in terms of distribution.
"The problem it creates is acute in diseases like TB, where the treatment is free but must be taken over six months. Many patients do not take their therapy every day, which is a situation not helped by the lack of doctors supervising treatment. It's the same issue for HIV."
According to Dr Sebbag, he has been particularly frustrated by the challenge of distribution during visits to some small villages in Africa where the absence of medicines contrasts with the wide availability of mobile phones and coca-cola.
“How can this be the case? My main concern has to be distribution, finding local partners and working with governments to make it a policy focus. We also need the support of local people."
He said the Asia Pacific region is not immune to the challenge given the impact of TB and malaria. "Many Australian key opinion leaders are already involved in the managements these types of diseases and their experience is similar to my own."