Rational rollout of new medicines for diseases of poverty

Increasing access to medicines for diseases that primarily affect the poor, such as malaria and tuberculosis (TB), involves a complex interplay of private-and public-sector efforts—some of which are often ignored in public debates over how to best improve access. Producing new medicines is a necessary first step, and companies can be given incentives to do so through a variety of mechanisms. But production is only part of the story. Government policies largely determine how or whether effective new medicines are provided to the people most in need, and government requirements for local clinical trials, filing dossiers, and registering new drugs can create high costs and sometimes barriers to access. Governments with high disease burdens must optimize their policies to ensure safe and timely access to new medicines. Western nations could encourage such action at the 2015 World Health Assembly; this is the humanitarian thing to do, but Western self-interest should also drive such an effort. Escalating drug resistance does not respect national boundaries, and extremely drug-resistant variations of some diseases of poverty ultimately threaten the poor and the wealthy alike.