The Need to Reform Current Drug Registration Processes to Improve Access to Essential Medicines in Developing Countries
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CURRENT OPINION
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The Need to Reform Current Drug Registration Processes to Improve Access to Essential Medicines in Developing Countries Jens Van Roey and Myriam Haxaire Tibotec, Mechelen, Belgium
Abstract
A new or improved regulatory pathway is necessary to facilitate access to medicines developed specifically for developing countries. The main focus of the US Food and Drug Administration (FDA) and European Medicines Agency (EMEA) is the registration of new drugs for use in the US and European markets and drugs that have been developed or tested domestically, not the registration of drugs intended for use in developing countries. Furthermore, the FDA and EMEA processes are time consuming and do not consider benefits or risks beyond their domestic contexts. This complicates drug registration throughout the world, as many countries approve medicines on the basis that they have been licensed and used in the US or Europe. Because of the technical complexity of the registration process, coupled with the insufficient capacity of many regulatory authorities in developing countries, access to new medicines is almost always delayed. In order to offer life-saving medicines in a timely manner to patients in developing countries and to ensure that the medicines are of high quality and efficacious, the current regulatory system needs to undergo major reforms. Current efforts, including the FDA tentative approval process for AIDS relief, EMEA Article 58 of Regulation (EC) No. 726/2004 and the WHO Prequalification Project, are important steps towards improving the efficiency of registration, yet they do not provide an ideal solution. Potential options to consider include: increasing the capacity of regulatory authorities in developing countries, constructing regional bodies, using an external entity, or harmonizing the regulatory process. It is likely that strong political support and a multipronged solution will be required to improve capacity in developing countries and reduce or eliminate redundancy in international registration. A new approach needs to be taken in order to guarantee prompt access to innovative and life-saving medicines in developing countries.
The World Health Organization (WHO) estimates that onethird of the world’s population is unable to obtain access to basic medicines and in the most resource-limited areas in Africa and Asia, this figure increases to nearly half the population.[1,2] Essential medicines and vaccines could greatly reduce the impact of diseases in these countries. While there has been a tremendous and visible effort to increase access to antiretrovirals in developing nations, simple and inexpensive products that treat ailments that cause considerable morbidity and mortality, such as diarrhoea and malnutrition, may not be available. Prompt diagnosis and treatment of such conditions could prevent approximately 4 million deaths each year in Africa alone.[3]
New initiatives have been implemented in recent years to catalyse the developm
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