This statement outlines Wellcome’s approach to maximising access to healthcare interventions for people worldwide, with a focus on low- and middle-income countries (LMICs).
The statement covers our approach within our funding and policy work, and will guide us when considering new ideas and opportunities.
It is intentionally high level – more detail on implementation is provided in complementary policy papers and contractual mechanisms.
The UN Sustainable Development Goals(opens in a new tab), which support the implementation of universal health coverage by 2030, recognise that more equitable and timely access to health interventions such as medicines, vaccines, diagnostics and therapies is an important driver of good health and improved lives.
Currently, access to healthcare is not equitable. According to the World Health Organization, 30 per cent of the world’s population, and over 50 per cent of the population in parts of Africa and Asia, do not have regular access to essential medicines. Around 2 billion people lack access to life-changing medicines and other interventions.
Recent years have seen significant progress, made through collaboration between different actors and using various mechanisms and business models. These include equitable pricing, more flexible approaches to intellectual property (IP), product development partnerships, increased donor funding, more efficient procurement, and effective advocacy by civil society. They have significantly increased the range of interventions available and the number of people who can access them.
However, there is much more to do. The barriers to equitable access are many and varied. They include inadequate healthcare systems, lack of infrastructure, funding gaps, pricing practices, and sub-optimal regulatory and procurement processes. IP is also a barrier if rights are not secured and managed in a manner that enables equitable access. To overcome these barriers, stakeholders must be committed to action and working together.
Wellcome will lead efforts to deliver equitable access. It is our mission and obligation to maximise the public benefit delivered from our funding. This will only be achieved if the interventions we fund reach those who need them.
Wellcome already makes an important contribution to access. We spend around £1 billion each year supporting some 14,000 researchers in over 70 countries to advance ideas, drive reform and support innovation to improve health. We also partner with others to fund new approaches. These include CEPI(opens in a new tab) (the Coalition for Epidemic Preparedness Innovations), which finances and coordinates the development of new vaccines to prevent and contain infectious disease epidemics, and CARB-X(opens in a new tab), which aims to accelerate the development of new antimicrobials.
We will do more through our funding, advocacy and direct activities. Across the public and private sectors, and in civil society, we will work with others where they have greater expertise or impact, for example in healthcare infrastructure and funding. Our approach will be applied globally across Wellcome’s activities, but with a focus on initiatives that will particularly benefit vulnerable populations in LMICs.
We recognise that levels of access, barriers and the rate of change possible will vary significantly between different countries and regions. So, we will adopt approaches tailored to specific diseases, technologies and geographies.
To accelerate equitable access, we will work throughout the product development life cycle – from discovery, development and manufacturing to the scaling up of health interventions and health systems. This will ensure that interventions are fit for purpose for different settings and available for different populations to purchase and use.
To broaden vulnerable populations’ access to new and existing high-quality interventions, products whose development we support must be affordable, appropriate, adapted and available, particularly in LMICs.
We will achieve this through four key principles:
We will use a range of tools to promote equitable and timely access, tailored to the nature of the funding, products and organisations involved.
Contractual mechanisms will be used on a case-by-case basis for those we fund and may include:
Too many people around the world lack access to essential medical interventions and knowledge. The approach outlined in this statement will allow Wellcome to maximise the impact of our funding, partnerships and policy work to increase timely equitable access and contribute to the goal of universal health coverage.
We will support research that delivers improvements in health and healthcare delivery. We are committed to enabling everyone, particularly vulnerable populations in LMICs, to have access to the life-changing benefits research delivers.