Protesters demonstrate outside Supreme Court in Pretoria, South Africa Monday March 5, 2001
International Activity Report 2019

Access Campaign: 20 years of advocacy in action

Médecins Sans Frontières medical teams have long faced challenges in getting effective and affordable treatments for people in our care. In the late 1990s, as frustration mounted over people dying from treatable diseases, MSF began to document the problem, joining with patient groups to speak out forcefully and demand action. 

In 1999, MSF publicly launched the Campaign for Access to Essential Medicines, now the Access Campaign, to tackle the policies, and the legal and political barriers, that prevent people from accessing treatment in the communities where we work and beyond. That same year, MSF was awarded the Nobel Peace Prize and put the funds towards improving treatments and boosting research for neglected diseases, merging with the Campaign’s work. 

At the time, the HIV/AIDS epidemic was still raging across the world. While lifesaving antiretroviral medicines had transformed HIV into a manageable chronic condition in wealthy countries, treatment was priced out of reach for almost everyone else. In addition, treatments for neglected diseases such as tuberculosis, malaria and sleeping sickness were often ineffective, toxic, ill-adapted for use in the places we work, or simply did not exist at all. 

For 20 years, MSF has worked with civil society to ensure that pharmaceutical corporations, governments and others prioritise people’s lives and health over patents and profits. The access to medicines movement overcame patent monopolies to make way for generic production and competition of antiretrovirals, and prices dropped 99 per cent over 10 years. This and other achievements of the Campaign, including for hepatitis C, malaria, pneumonia, sleeping sickness and TB, are highlighted below. 

But many new drugs, diagnostics and vaccines are being sold at increasingly high prices, and monopolies are becoming more entrenched. We are still missing the tools we need to control rising antimicrobial resistance and outbreaks of epidemic diseases such as Ebola and COVID-19. MSF, through the Access Campaign, continues to advocate the transformation of the medical innovation ecosystem to better address the health needs of people in our care. For example, given that medical research and development is heavily financed by governments, MSF is calling for increased transparency in drug development and production costs, and a larger role for the public in making sure that medicines are made affordable and accessible. 

The crisis of access to medicines and innovation is no longer affecting only low- and middle-income countries; it is now truly global. Our slogan, Medicines Shouldn’t Be a Luxury, is still valid; together we must drastically step up efforts to expand people’s access to lifesaving health tools.  

Uganda - Tom Stoddart - 1999-2000
2001: Reviving treatments for sleeping sickness. In the late 1990s, the few drugs that could be used to treat sleeping sickness were at risk of going out of – or had already gone out of – production, with companies claiming they weren’t profitable. The disease is fatal without treatment. After lengthy negotiations with MSF and the World Health Organization (WHO), Aventis agreed to resume production of eflornithine. MSF also helped persuade Bayer to restart production of two other drugs used to treat the disease.  Photo: An MSF nurse at Omugo Sleeping Sickness Centre, Uganda 
Tom Stoddart/Getty
The atmosphere in the hospital where we were treating sleeping sickness was very tense because one in twenty of the patients who came to us died simply from the toxicity of the treatment. That’s been my fight ever since, for more than 35 years, to try to bring something better for those patients. Dr Bernard Pecoul, MSF Access Campaign’s first executive director
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2003: 'ACT NOW’ campaign for malaria. In the 1990s, MSF medical teams were starting to observe chloroquine (a drug introduced in the 1940s for the treatment of malaria) becoming less effective. At the time, one to two million people were dying each year from the disease. After conducting studies to document resistance, MSF launched the “ACT NOW” campaign to urge countries to switch to artemisinin-based combination therapy (ACT), which put pressure on WHO to revise its guidelines and led to wider adoption of ACTs.  Photo: A child is tested for malaria in the Niger delta, Nigeria 
Remco Bohle
Accès aux médicaments/DPI
2006: Don’t shut down the pharmacy of the developing world. Swiss drug company Novartis takes legal action to gut India’s section 3(d) patent law. A Novartis victory would have effectively cut the lifeline of affordable newer medicines from India, upon which millions of people rely. MSF’s “Novartis, Drop the Case!” campaign collected nearly half a million signatures, including from Archbishop Desmond Tutu. Novartis lost the case and appealed it all the way to the Supreme Court, but the decision against the corporation was finally upheld in 2013. Photo: Protests against Novartis’s first legal attack on affordable medicine production, New Delhi, India. 
Sheila Shettle
We did everything we could, we shamed the company (Novartis), we went to shareholder meetings, we marched against them, we delivered petitions. I remember being so big and pregnant, and it being so hot, and we were all marching toward the court, and we were so determined. The only thing that we had were our voices. Leena Menghaney, lawyer, MSF Access Campaign, India
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2015: A Fair Shot campaign for affordable vaccines. MSF's “A Fair Shot” campaign kicks off, calling on Pfizer and GSK to reduce the price of the pneumonia vaccine – the most expensive standard childhood vaccine – to $5 per child. In 2016, a price of $9 per child is offered to humanitarian organisations like MSF, for use in emergencies. But millions of children are unvaccinated in countries where the vaccine is still too expensive; we continue to demand an affordable price for all developing countries. Photo: A child is vaccinated in Elliniko refugee camp, Greece.
Pierre-Yves Bernard/MSF
Cambodia Hep-C
2013: Price reductions for hepatitis C medicines. Today’s hepatitis C medicines are very effective, but high prices have prevented access, especially in middle-income countries. MSF and other civil society groups challenged patents and pressured pharmaceutical companies to reduce prices; in 2017, MSF obtained a price of $120 per 12-week treatment – less than a tenth of what we had been paying, and a fraction of the commercial launch price of $147,000. As MSF scaled up hepatitis C treatment, we advocated for all governments to have access the same low price. Photo: A patient holds their medicine at the MSF Hepatitis C clinic at Preah Kossamak Hospital in Phnom Penh, Cambodia, April 2017 
Todd Brown
We were always desperately seeking a cure everywhere. Some people were bragging to me about getting (the new) treatment in Singapore for $10,000 or in Vietnam for $8,000. If I wanted to have treatment, I would need to sell my house. So, I decided to wait and if I died, well at least my kids would be left with the house. I am very grateful to now have this cure from MSF. It gives hope to my children and the chance to see their father's face when they are grown up. Din Savorn, police officer, now cured of hepatitis C, Phnom Penh, Cambodia
50th Union World Conference on Lung Health - Protest
2019: Affordable access to TB treatment.  MSF has joined TB activists and civil society around the globe to demand that critical medicines to treat drug-resistant TB (DR-TB) be made more affordable. DR-TB remains exceedingly difficult and expensive to treat, with severe side effects and dismal cure rates. In 2019, MSF launched a global campaign calling on pharmaceutical corporation Johnson & Johnson (J&J) to lower the price of its TB medicine bedaquiline to no more than US$1 per day for people everywhere who need it, in order to allow scale-up of treatment and reduce deaths.   Photo: Civil society groups protest the high price of lifesaving TB medicines, Hyderabad, India 
Siddharth Singh/MSF
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