An analysis of the global un-met need for morphine shows there is a substantial
market for Afghan-village made medicines. Research indicates that the current INCB-administered
raw poppy materials supply system should be complemented by an
additional second-tier system for the supply of finished poppy-based medicines.
Leveraging the expertise and resources of farmers in Afghanistan to produce and
export Afghan locally-produced morphine, this additional second-tier system, by
making available affordable medicines, could help meet the needs of the 80% of the
world’s population who currently have little or no access to these essential painkilling
|The need for a second tier of medicines supply to complete current system
As the current system supplies demand levels as reported by the INCB but does not
cover the global actual need, there is room for a complementary ‘second tier’ system
of supply that would be based on the production of poppy-based medicines offered at
affordable prices. This second tier supply system is needed to help meet the
developing world’s growing need for inexpensive poppy-based medicines.
While only a limited number of countries are authorised by the INCB to export the
raw materials used in the manufacture of poppy-based medicines, any country is
allowed to manufacture such medicines, regardless of whether these medicines are for
internal use or for export. Thus a second-tier supply system based on the export of
finished poppy-based medicines rather than the export of raw poppy materials could
easily be established. So as to not disrupt the current global supply system or attempt
to replace current suppliers of raw poppy materials, a second-tier system would only
supply finished poppy-based medicines to less economically developed countries
lacking access to these essential medicines.
Two-tier systems are currently in place around the world for commodities as diverse
as generic HIV/AIDS medicines and bananas. Multi-level systems of product supply
are used to channel like products to distinct markets. A second tier system of product
supply is most useful where a significant sector of consumers are disconnected from
the overall market for that product, having been either priced out, or ignored
altogether. Two-tier product supply structures are particularly useful for making
essential medicines more widely available.
In particular, supplies of HIV/AIDS and malaria medicines are sold through two
different systems of supply: brand-name, higher cost drugs are made available to
wealthier markets; cheaper, generic medicines are supplied to less well-developed
economies. For example, in Sub-Saharan Africa, the bulk of the medicines
consumed by HIV/AIDS patients are generic medicines, sold at prices much lower
than those charged for branded drugs, which are generally only used if generic ‘first
line’ medicines fail.
Likewise, two-tier supply systems are used to enhance the availability of medicines
used in the treatment of those so-called ‘neglected diseases’ most prevalent in
emerging or transitional economies, such as malaria. Because the supply of potent
malaria-treatment drugs was not reaching many patients who most needed them, a
new system of supply was developed to meet these un-met needs.