A ‘Health’ Nobel for Obama

The delivery of the Nobel Prize for peace to President Obama, who is working on health reform that can ensure equal access to health care for all his fellow citizens, is an occasion to focus on the right to health in the world. The Nobel is a political recognition. Its value over time depends on how those who received it agree to wear it. You can exit the great hall of Oslo with the pace of those who feel accepted in the “parlor” of global moral leadership, or you may decide to invest the reputation and the strength that spring from it to direct the spotlight on a privileged topic of your own social and political mission.

In 1999, Doctors Without Borders used the visibility and economic contribution of the Nobel Prize for peace to launch the ‘Campaign for Access to Essential Medicines,’ focusing on one factor, easily measured in economic and medical terms, that influences the access to treatment: drugs. MSF has never been a campaign against anyone, but when the road was obstructed by a mechanism – international agencies and regulations, economic interests of pharmaceutical companies, developed countries’ politics – it has not hesitated to point it out and propose an alternative. It was weird to hear, during the conference ‘Right to Health: Organizational Models and Access to Care’ in Milan, some of the same actors (representatives of international organizations, academies, pharmaceutical companies) explain their contribution to the cause of the fundamental right to health by supporting arguments that they fought against in previous years. In particular, the various representatives pointed out the adaptation of treatment guidelines and protocols to different socio-economic contests, the changed pricing for medical services and medicines, and the health expenditure restructuring programs in developing countries.

While considerable progress in all areas of health was achieved in the richest countries, it was difficult to respond effectively to disease outbreaks in poor places. The production of certain drugs was abandoned because it was not considered viable, as in the case of sleeping sickness treatment. Other products had lost their therapeutic power due to resistance developed by the pest, as in the case of malaria. As for tuberculosis, too many restrictive treatment protocols favored the appearance of resistant forms of the disease. Research and development to identify new treatments are inadequate on all these fronts. People’s memory of “our” Nobel helps to promote the logo of MSF. In addition, the campaign that came with it is more topical than ever because there are still many barriers to overcome in order to achieve real access to care for the entire world population. The story about new treatments against AIDS being financially inaccessible to the most affected populations is still unchanged. Six million people living with HIV are not yet on antiretroviral therapy, and their access to second line drugs and pediatric formulations is at risk.

Perhaps the Nobel given to Obama can bring attention to the right to health, not only for his fellow citizens, but also for those millions of people for whom that right is still a mirage. This would not be far from Italy’s ten-year battle for universal access to medical care because the right to be treated must not remain a right denied to the most vulnerable, everywhere.