Global Health Community (GHC)

Let's keep the conversation going from last week's Wondering Wednesday. 

We were discussing the translational gap, and the barriers to access, for gene therapies in low and middle-income countries. @Kieran Crowley highlighted the exceptionally high cost for these therapies, and the likely need for prioritization on funds in LMICs to access much less expensive and well-proven medicines as a barrier to providing these treatment options even as costs are reduced in the future. We often think about the impact of pharmaceutical access in the global health setting from this perspective - what gives you the "biggest bang for the buck," to steal Kieran's phrase. And this does make sense, but to me this thinking is a symptom of how far we are from equitable and global access to pharmaceutical interventions - that we have to think about access on the population level rather than considering how to provide life-changing or life-saving options for individuals. 

Someone asked me last week at NBC how we define Global Health - where does Public Health end and Global Health start? Of course one could answer based on geography, but is that really the right way to consider this when it comes to the role of pharmaceutical access and development? How often are the questions we're asking and solutions we're discussing relevant to access and treatment in LMICs also relevant to low and middle income communities in this country?

When it comes to cell and gene therapies at least, the barrier to access globally is also a barrier to access locally. Take a look at this initiative to see one way that our healthcare system is considering lowering the cost barrier Cell and Gene Therapy (CGT) Access Model.

Do programs like this make sense for the global health setting? We've been highlighting cost as a major barrier to access for these treatments, but what other barriers do we need to overcome to make access a reality? If the cost per dose could be overcome, would the infrastructure, supply chain, and cold-chain options be able to support these therapies? As our sophistication in these emerging pharmaceutical areas advances, do we focus primarily on the cost per dose or do we also need to focus on product development to enable global access?

I'm sure that we've recently learned a great deal about this in our recent experiences with vaccine development and distribution - please consider sharing your perspectives and references!

Let's keep the conversation going from last week's Wondering Wednesday. 

We were discussing the translational gap, and the barriers to access, for gene therapies in low and middle-income countries. @Kieran Crowley highlighted the exceptionally high cost for these therapies, and the likely need for prioritization on funds in LMICs to access much less expensive and well-proven medicines as a barrier to providing these treatment options even as costs are reduced in the future. We often think about the impact of pharmaceutical access in the global health setting from this perspective - what gives you the "biggest bang for the buck," to steal Kieran's phrase. And this does make sense, but to me this thinking is a symptom of how far we are from equitable and global access to pharmaceutical interventions - that we have to think about access on the population level rather than considering how to provide life-changing or life-saving options for individuals. 

Someone asked me last week at NBC how we define Global Health - where does Public Health end and Global Health start? Of course one could answer based on geography, but is that really the right way to consider this when it comes to the role of pharmaceutical access and development? How often are the questions we're asking and solutions we're discussing relevant to access and treatment in LMICs also relevant to low and middle income communities in this country?

When it comes to cell and gene therapies at least, the barrier to access globally is also a barrier to access locally. Take a look at this initiative to see one way that our healthcare system is considering lowering the cost barrier Cell and Gene Therapy (CGT) Access Model.

Do programs like this make sense for the global health setting? We've been highlighting cost as a major barrier to access for these treatments, but what other barriers do we need to overcome to make access a reality? If the cost per dose could be overcome, would the infrastructure, supply chain, and cold-chain options be able to support these therapies? As our sophistication in these emerging pharmaceutical areas advances, do we focus primarily on the cost per dose or do we also need to focus on product development to enable global access?

I'm sure that we've recently learned a great deal about this in our recent experiences with vaccine development and distribution - please consider sharing your perspectives and references!