GA Proposal: Access To Effective Medications

[Wischland]

Access To Effective Medications

A resolution to modify universal standards of healthcare.

Category: Health

Area of Effect: Healthcare

Proposed by: Xanthorrhoea

The General Assembly:

Recognising the numerous social, humanitarian and economic benefits of a healthy, happy populace, and the importance of access to effective medication in maintaining this health and happiness;

Recalling the efforts of resolutions such as GA 41 Access to Life-Saving Drugs, GA 333 Preserving Antimicrobials, GA 429 Traditional Medicine, and GA 571 Access to Transgender Hormone Therapy to improve access to safe and effective medication worldwide;

Noting, despite these efforts, the ongoing disproportionate distribution of access to effective medications between nations, and between peoples within nations, including the significant impact of poverty and income inequality on this access, and noting the lack of a globally accepted standard of medical treatment;

Seeking to reaffirm and strengthen its commitment to improving the health of all peoples, regardless of World Assembly (WA) membership status, hereby enacts the following:

1. The World Medications Council (henceforth the WMC) is established as a branch of the World Health Authority, with the purpose of improving access to safe, efficacious, and cost-effective medications in all nations. The WMC shall have the following duties:

a. To assess and record the safety, efficacy, and cost-effectiveness of all known medications, defined as any substance used to diagnose, prevent, treat, or manage the symptoms of disease, medical and/or psychological conditions (including for the purposes of disinfection, immunisation, contraception, abortion, hormone therapy, and euthanasia). In assessing a medication, the WMC must consider:

i. A medication’s safety, including the severity and frequency of known adverse effects, the therapeutic range, toxicity, interactions with other medications, and requirements for that medication's safe storage, handling, and administration;

ii. The impact of patient factors on a medication’s safety, including species, pregnancy, intercurrent medical and/or psychological conditions, employment, and lifestyle factors;

iii. A medication’s efficacy for all clinical indications for which it is used, including the magnitude of effect, whether a medication is curative or requires ongoing use, the therapeutic dose, frequency of dosing, duration of therapy, and synergistic or adverse effects when used with other medications;

iv. A medication’s relative cost-effectiveness, including the medication's price, total cost of therapy, costs associated with storage, handling and transport, staff training and safety protocols required for its use, and relative cost and efficacy compared to other available medications used for the same or similar purposes; and

v. Any other factors it deems relevant.

b. To, based on this assessment, create and maintain an Effective Medications List (henceforth the EML), containing those medications that are best suited to meet the needs of an effective health system.

c. To regularly assess and update the EML based upon the current scientific consensus.

d. To undertake activities to promote access to medications on the EML in all WA member nations (henceforth members).

e. To promote access to medications on the EML in non-WA member nations, with the consent of and according to the laws of those nations.

2. All members must provide access to all medications included in the EML to all residents of their nation, unless one of the following exceptions applies. Nations are not required to provide access to a medication:

a. That is illegal, or for purposes that are illegal in that nation, for all of their residents;

b. For purposes other than the diagnosis, prevention, treatment, or management of disease, medical and/or psychological conditions for which that medication has an established clinical use; or

c. That they cannot provide access to for reasons outside their control. In this case, they must provide access to an available similarly effective alternative, and provide access to the unavailable medication as soon as possible.

3. Members must ensure that medications are priced in a way that allows all residents to afford all the medications they require while maintaining an adequate standard of living.

4. Members are encouraged to minimise the cost of medications to patients through all appropriate means, including subsidising common and/or effective medications, standardising prices, enforcing strong anti-trust legislation, and creating special access schemes for vulnerable and disadvantaged groups.

Co-authored by Tinhampton

This is the discussion thread. To cast your vote, go HERE

[Wischland]

Further Resources:

See NS Forum Debate HERE

[The Union Empire]

Thanks Wischland!

[Kananji]

We, the members of the Kananjian Government, believe that this proposal is very unfair to the citizens and has a lot of gray area that could cause major economic issues.

Section 3 states that "Members must ensure that medications are priced in a way that allows all residents to afford all the medications they require while maintaining an adequate standard of living." By this logic, what if a resident is completely broke? Would that mean that a nation must supply that drug for free? This would cause a huge rise in taxation and would force other residents, who worked hard to earn the money they have now, to pay for some homeless man's medication. While this in itself is not necessarily a bad thing, you should not force them to use their money for this if they do not wish to. In addition, what if the resident can barely make ends meet, and the rise in taxation causes them to lose their home or cause them to go hungry? It simply violates the right of the people! There are plenty of charity organizations that provide money for accessible medication, it doesn't need to be a worldwide requirement.

[Xanthorrhoea]

Continuing the conversation from the RMB, I’ll paraphrase the post I made there below:

- Charitable donations are a poor way to fund a health system.

- It’s cheaper to prevent disease than to treat it, and better access to cheaper meds helps this. (See average cost of healthcare in the US vs other developed nations).

- Ethically, higher taxes are better than preventable death.

[Deleted]

I think people’s lives are worth a bit more than somewhat elevated taxes.

[The Union Empire]

Nations can decide where the tax burden actually falls, but unless you have a 100% income tax rate, there’s probably a bit more burden the rich or corporations can shoulder. It’s the economically sensible thing to do, and the right thing to do; voting in favour!

[Vivolkha]

I have my reservations over clauses 3 and 4. Clause 4 is not a mandate, so I'm willing to let it pass, but I find that clause 3 can easily impose excessive price controls on medicines, forcing producers to cut supply instead or shut down outright if it is not viable to keep producing the necessary medicines. Interestingly, this proposal doesn't explicitly say anyhting about supply (closest it comes is clause 2c). As a result, while I find the rest of provisions of the proposal pretty positive, I'm on the fence on it overall, and I think clause 3 should have been reworded to instead impose limits on abusive corporate practices (no tripling the price of drug X overnight, for example) rather than such a heavy-handed price control.

And no, nothing about this has anything to do with taxation.

[Xanthorrhoea]

Oct 28, 2021 12:20:58 GMT -5 Vivolkha said:

I have my reservations over clauses 3 and 4. Clause 4 is not a mandate, so I'm willing to let it pass, but I find that clause 3 can easily impose excessive price controls on medicines, forcing producers to cut supply instead or shut down outright if it is not viable to keep producing the necessary medicines. Interestingly, this proposal doesn't explicitly say anyhting about supply (closest it comes is clause 2c). As a result, while I find the rest of provisions of the proposal pretty positive, I'm on the fence on it overall, and I think clause 3 should have been reworded to instead impose limits on abusive corporate practices (no tripling the price of drug X overnight, for example) rather than such a heavy-handed price control.

And no, nothing about this has anything to do with taxation.

I find your argument confusing. If people are not able to afford a medication anyway, then how would lowering the price for those people decrease demand? You can’t go below zero, and if you can’t afford it, you ain’t buying. The clause is deliberately written in an open manner to allow countries to come up with their own solutions. If the way a nation chooses to comply kills their pharma industry, then that’s entirely on them. The means of achieving the mandated ends are up to you

There are many options to achieve this, some of which are suggested in clause 4. Some of them involve nations subsidising medications, which is where tax would come in. As a side note, given that many countries do have price controls IRL and seem to still be able to access meds, I’m not sure how likely your scenario is anyway.

[Vivolkha]

Oct 28, 2021 14:37:40 GMT -5 Xanthorrhoea said:

Oct 28, 2021 12:20:58 GMT -5 Vivolkha said:

I have my reservations over clauses 3 and 4. Clause 4 is not a mandate, so I'm willing to let it pass, but I find that clause 3 can easily impose excessive price controls on medicines, forcing producers to cut supply instead or shut down outright if it is not viable to keep producing the necessary medicines. Interestingly, this proposal doesn't explicitly say anyhting about supply (closest it comes is clause 2c). As a result, while I find the rest of provisions of the proposal pretty positive, I'm on the fence on it overall, and I think clause 3 should have been reworded to instead impose limits on abusive corporate practices (no tripling the price of drug X overnight, for example) rather than such a heavy-handed price control.

And no, nothing about this has anything to do with taxation.

I find your argument confusing. If people are not able to afford a medication anyway, then how would lowering the price for those people decrease demand? You can’t go below zero, and if you can’t afford it, you ain’t buying. The clause is deliberately written in an open manner to allow countries to come up with their own solutions. If the way a nation chooses to comply kills their pharma industry, then that’s entirely on them. The means of achieving the mandated ends are up to you

There are many options to achieve this, some of which are suggested in clause 4. Some of them involve nations subsidising medications, which is where tax would come in. As a side note, given that many countries do have price controls IRL and seem to still be able to access meds, I’m not sure how likely your scenario is anyway.

The problem is not with demand, but rather with supply. If prices are lowered beyond the point it is comercially viable to continue selling the medicines, then producers will cut supply instead to cut their losses (the power shortages in China are a case of this). This is worrying because the proposal doesn't explicitly say anything about keeping an adequate supply of medicines to meet the necessities of patients.

In general, I think this resolution has the fatal flaw of believing that the state can impose any regulations without consequences, which is an overly idealistic and unrealistic approach. Clause 3 is too rigid and heavy-handed, when it should be limited to cracking down om abusive pricing practices in the private sector. I should probably point out that the solutions proposed in clause 4 are unaffordable or unfeasable for more underdeveloped nations as well, which I find is an issue for clause 3 (as clause 4 is not a mandate) as it shows how overly broad its mandate really is.

There is, of course, the issue with national and especially economic sovereignty when it comes to clause 4, which is what Kananji was pointing out. And it is a perfectly legitimate argument. I just don't happen to share Kananji's vision on welfare and economics, so it's not a concern for me specifically, but will secure opposition from other nations.

With this in mind and after much deliberation, my vote will be firmly Against.