Patients are struggling to get vital medicines for ailments while others are compelled to switch to substitutes due to lack of enough stock and high costs.

There are some Rwandans who cannot afford their prescribed drugs simply because it is not covered by their health insurance scheme.

This means that some Rwandans are in pain for longer because of these outrageously highly priced medicines.

This is linked to an ongoing rift between pharmacies and insurance companies over drug pricing.

As this battle goes on, ordinary people continue to feel the pinch as they cannot access essential medicines.

While this issue is relatively new in Rwanda, it reflects the bigger global debate about big pharmaceutical companies mainly located in Western countries that have made it impossible for essential medicines to be available on demand in developing countries and at affordable prices.

Criticism

India, which is currently the drug factory for the developing world has over the years come under fierce criticism over its policies, which make it affordable to manufacture drugs that are not only consumed locally but also exported mainly to the developing world.

Yet, according to the World Health Organisation (WHO), the costs of many new medical products are becoming unsustainable for even the wealthiest countries in the world.

For instance, of the 12 drugs recently approved for various cancer indications, 11 were priced above $100,000 per patient per year, a price that is beyond the reach for the majority.

In fact, as the former director general of WHO noted at joint WHO/WIPO/WTO technical symposium on medical innovation in 2013, the current system of incentives and rewards for product innovation is driven by market forces, and not by global health priorities.

For the poor, the need for a new products may be huge, but the market fails because of limited capacity to pay.

Mismatch

The result is a great mismatch between products that can have a major impact on global health and what is actually on the market or in the pipeline.

This is a mismatch between products that turn the biggest profit and products that save the most lives in poor countries.

Current procedures for drug discovery and the development of new medicines are inefficient. Companies and universities jealously guard their data.

Sharing is rare, and much work is duplicated. While national governments don’t have control over big pharmaceuticals in Europe, they have the ability to incentivise innovation that reduces the cost of medicines to facilitate access.

For instance, Rwanda can take lessons from India which incredibly managed to come up with favourable policies that make medicines available and affordable to the majority of its population.