Access to essential medicines in developing countries: Defining Canadian and global responsibilities

In 2002, 33% of worldwide deaths were caused by starvation and easily preventable and/or treatable conditions. Virtually all of these deaths occurred in developing countries. The key task of the global health community is to close the gap between those who benefit from modern medicine and health promoting social and economic arrangements, and those currently excluded. This situation, in which market forces rather than public health priorities govern access to essential medications, represents not only a market failure but, perhaps more deeply, a political and moral one. The potential impact of access to essential medications in reducing this global health gap is remarkable. The objective of this study is to provide a coherent understanding of the ethical responsibilities of the various actors- individual, national, corporate and supra national- who are involved in ensuring access to medications for currently existing drugs, drug research, and development for priority diseases. This study will approach these issues by attempting to clarify, reshape, and explain the moral debate surrounding these issues, and to provide a basis for constructive institutional reform. The end result will hopefully lead to a better understanding of the ethical responsibilities involved in the debate over global access to medications, and aid in defining recommendations for Canada, and other actors, to achieve needed change in the regulatory framework of the pharmaceutical market. I