Article 9

Eight Lessons Learned​

Last year, Dr. Kaakeh gave a TEDx titled “The Struggle to Access Medications,” where she shared eight key lessons highlighting what we need moving forward as we tackle the issue of lack of access to medications. This was conducted before COVID-19; however, these lessons still hold true today. The eight lessons are outlined below.

Lesson 1: This issue is NOT just healthcare’s problem. Patients (i.e., everyone) ultimately receive/need a medication(s) and therefore play an integral role in helping craft the solutions. The current reality and interdependency of the pharmaceutical supply chain necessitates collective action from everyone – including local, national, and international partners.
 
Lesson 2: What you give for “free” makes a difference.  The affordability of medications continues to be a significant barrier to accessing medications.  As individuals and agencies build safety-net programs and initiatives with an underlying “free” component and there are multiple options (e.g., like in the case of brand vs. generic drug samples), they must also evaluate the influence and burden of such programs on access, quality, cost, and outcomes. 
 
Lesson 3: Continuous access to all the medications needed is not a guarantee – regardless of location or how vital the drug may be.   The struggle to access medications exists in all low-, middle- or high-income countries (to varying degrees). This is true now more than ever. Experiencing disruptions in the supply chain can lead to not only drug shortages but delays or halting of clinical trials, creating a barrier for future innovation.
 
Lesson 4: Individuals need more information, transparency, and accountability. The more information one has, the more they can do. The United States has been able to avert numerous shortages with the help of early notification and more information. More information also helps health systems manage drug shortages. There is a need to continue to concentrate efforts on improving what and how we communicate beneficial information.   Adapt and expand policies and practices – on multiple levels – to allow for greater transparency and accountability.
 
Lesson 5: This is not a “one discipline” problem – therefore, everyone must continue to find new creative ways to work together to ensure all the diverse stakeholders involved have a seat on the table to create solutions. Understand various stakeholder incentives, identify shared interests, and create a collective plan forward. Our solutions will not just come through the healthcare space – there is a need for experts and innovators in the world of business, technology, engineering, science, law, communication, arts, and many more to work side by side to create solutions.
 
Lesson 6: This issue is complex – with no “one solution that will fix it all.”  There is a need to identify the appropriate strategies to address multiple issues and realities at the same time, both locally and globally.  Evaluate the ripple effects of each decision and intervention on the whole system – to see if it enables or hinders access and at what cost.
 
Lesson 7: Our goal should be to achieve better health and not just provide better healthcare.  Merely having access is not a guarantee for improved health.   This necessitates that everyone step up and address the numerous social determinants of health that are negatively impacting our well-being.  Do not lose sight of any new or existing health disparities that may exacerbate the situation. Health is the driver; healthcare is just the support.
 
Lesson 8: Everyone has a role. There are several diverse stakeholders and players that have stepped up and are at the forefront of addressing access to medications concerns– and their efforts to minimize the impact of this crisis must be recognized.   However, everyone has a role in helping create solutions by providing insights, experiences, and perspectives to help shape policies.

https://www.ted.com/talks/rola_kaakeh_the_struggle_to_access_medications
​https://www.youtube.com/watch?v=0aVmTLU0sWo

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Alarms during the pandemic and beyond – Part III of III

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Strategies during turbulent times – Part I of III

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