Some two billion people around the world lack access to necessary medicine, according to the World Health Organisation.
Particularly in remote regions, where logistical hurdles and infrastructural limitations can delay the delivery of life-saving treatments by weeks, or even months. The ethical case for reaching these populations is clear, and the need is urgent.
This acute situation is a key driver for the ethical duty shared by the global health community, which agrees pharmaceutical companies and supporting organisations play a pivotal role in ensuring patients everywhere can receive life-saving medicines.
WHO’s recent rural health equity report underscores the pressing need to prioritise healthcare in hard-to-reach areas, which often face compounded health risks from poverty, isolation, and limited resources. However, this moral imperative stands alongside the operational realities that pharmaceutical companies face.
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Unlike NGOs or purely humanitarian organisations, pharmaceutical companies also have a duty to shareholders and other stakeholders, which brings additional considerations, including profitability and regulatory compliance. Maintaining profitability, and therefore stability, is key to ensuring that the medicines they develop can reach the broadest groups of patients who will benefit possible through normal commercial supply chains.
The challenges of reaching distant regions, especially those with limited infrastructure, are compounded by the costs associated with maintaining a presence in remote or politically complex locations. Balancing a commitment to serve every corner of the globe with the practical constraints of their operations can be challenging, if not impossible when acting in isolation.
Complex
Geographically isolated regions, like Bhutan, illustrate the practical and multifaceted challenges faced by pharmaceutical companies in serving patients.
In addition to navigating complex and fragmented global regulatory environments in closing the access gap for life-changing, often unlicensed, medicines for patients with rare diseases, delivering these therapies to remote areas like Bhutan presents significant logistical hurdles due to the country’s remote terrain and unpredictable weather.
A mountainous nation with a population of around 750,000, Bhutan is served by about 20 hospitals and has limited road access, making the logistics of drug distribution incredibly complex.
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The combination of high-altitude terrain, unpredictable weather, and scarce infrastructure creates obstacles that are difficult to overcome through standard delivery methods. During monsoon seasons, roads can become impassable, and transportation by air becomes risky. In such cases, partnerships with local health systems and authorities can be instrumental in finding solutions.
Our LTMI support team worked directly with Bhutanese authorities and healthcare providers to design a robust supply chain, combining local transportation with strategically placed regional hubs, ensuring timely and consistent access.
But territories under sanction, and regions facing political turmoil, represent another set of challenges, compounded by stringent regulations and trade barriers that restrict the movement of goods.
Companies must comply with these laws while attempting to fulfil their ethical obligations to serve patients. This brings significant additional complexity. Beyond legal restrictions, political volatility can create safety risks for personnel and facilities.
Additionally, conflict zones often have compromised infrastructure, which affects everything from communication lines to transportation routes. Even in stable times, operating in these regions demands thorough knowledge of international regulations, which may change frequently. Understanding and working within these restrictions while still prioritising patient access requires expertise and ongoing attention to the local regulatory landscape.
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Establishing partnerships with local organisations, healthcare providers, and logistics specialists is crucial to creating a supply chain that can adapt to the challenges posed by remote and politically sensitive areas.
Such collaborations allow for a nuanced approach to each region’s needs, factoring in available infrastructure, local regulations, and cultural sensitivities. Additionally, employing technology to improve route planning, inventory tracking, and regulatory compliance can help companies ensure medicines are delivered efficiently (and in full compliance with all applicable laws).
Collaborating with organisations with on-the-ground knowledge of these environments, whether they are government agencies, local NGOs, or even other pharmaceutical companies, allows for a layered approach, where each partner brings specific expertise.
Global health organisations continue to call for action, as healthcare disparities in these regions are often more severe. Patients in isolated areas may lack access not only to medicines but to fundamental healthcare services. Although the journey to reach them is filled with challenges, from treacherous terrain to political barriers, the path forward is not insurmountable.
Pharmaceutical companies, by collaborating with regional experts and adapting their supply chains, can honour both their commercial goals and their commitment to patient welfare. The challenges may be significant, but the goal of universal healthcare access equity requires that we do not turn away from hard-to-reach places.
Suzanne Aitken is SVP of Managed Access at Clinigen