The Clifford Symposium: “Making Medicines Essential - The Evolving Role of Pharmaceuticals in Global Health”

Jeremy Greene is assistant professor in the department of the history of science at Harvard, instructor in the division of pharmacoepidemiology and Pharmacoeconomics at Harvard Medical School and an associate physician at Brigham and Women’s Hospital.  With such a deep involvement in medicine in both education and practice, it is safe to say that any persistent question he has come across will be one worth studying.

In fact, at the core of Jeremy Greene’s presentation, there were three:
­— How do we understand the role of drugs in global public health?
­— What makes a medicine essential?
­— How did access to medicines become crucial to global health?

Greene began by giving a brief history on the development of pharmaceuticals, beginning in 1798 with the first vaccine. Not surprisingly, the assumption that drugs can actually work was not always taken as fact.

Now, of course, the distribution and variable effectiveness of drugs are unavoidable topics in the medical field.

“Of the 14 grand challenges for global health,” Greene said, “nine were related to pharmaceuticals.”

This makes the concept of essential medicine all the more concerning. In 1977, the World Health Organization (WHO) reported: “Essential drugs…are of the utmost importance and hence basic, indispensable, and necessary for the health needs of the population … and should be available at all times, in the proper dosage forms, to all segments of society.” A selection of 186 drugs was chosen, one type for each ailment.

This controversial move on the part of the WHO,  raised a plethora of questions surrounding deservingness and viability of distribution as the years went on. As Greene pointed out, in comparing the health kits distributed to American soldiers in various wars, one can see how people’s concepts of “essential” have continued to evolve along with medical advances.
As drugs become more and more of an integral part of health, their commodification, as Greene put it, becomes a more and more relevant topic.