Access to medicines versus access to treatment: the case of type 1 diabetes

In recent years considerable attention has been paid to the issue of access to medicines. The topic burst into the global public spotlight in 2000 when 39 pharmaceutical companies took the South African government to court over its introduction of allegedly unlawful legislation, which gave the minister of health the right to import generic versions of patented drugs and allowed generics to be manufactured locally through compulsory licenses. After this trial, the terms parallel importation, compulsory licensing, intellectual prop-erty, generic drugs and TRIPS (the World Trade Organization’s agreement on trade-related aspects of intellectual property rights) became part of the vocabulary of many nongovernmental organizations and policy-makers seek-ing to improve access to medicines in the world’s poorest countries.Since then public-health policy debates have largely focused on patents on medicines as the main barrier to patients’ access to treatment. Advocates of this view blame patents for the high prices of essential medicines, putting them out of reach of many people who need them. Much of this controversy has specifically addressed medicines for communicable diseases such as HIV/AIDS, malaria and tuberculosis. Less attention has been paid to the avail-ability of drugs for noncommunicable diseases, although this group of illnesses including cardiovascular disease, can -cer, chronic lung diseases and diabetes represents the leading causes of death worldwide.