May 11

Ray Cummings

Healthy Markets: Essential to Improving Health and Saving Lives

This blog is one of 10 in PATH’s #MarketsMatter expert blog roundup and is cross-posted with permission. Read the others here.


Healthy markets are critical for improving global health. Why? Because too often, lifesaving health products, such as medicines, vaccines, diagnostics and medical devices, do not reach those who need them most. Markets – the systems, structures and institutions that facilitate the buying and selling of health products – and specifically, well-functioning markets, are critical drivers of access to lifesaving and health-improving products.

Market shortcomings are visible even to those who aren’t market experts. Let’s look at access to treatment of cervical precancerous lesions as an example. Today, cervical cancer is the second most common cancer among women in the developing world, and the largest cancer killer among women in most developing countries. Each year, over 500,000 women develop cervical cancer and about 275,000 women die from the disease.*

Effective and affordable methods for screening and treatment have been developed, but access to screening and treatment is limited globally. Without urgent attention, deaths due to cervical cancer are projected to rise by almost 25 percent over the next 10 years.


Read the WHO publication “Comprehensive Cervical Cancer Control: A guide to essential practice” here.

A pharmacist dispenses abacavir sulfate (an anti-retroviral medication).

When people have access to the products, care, and information they need to be healthy, their families, communities, and countries thrive. Photo: PATH/Felix Masi

PATH is working with a range of partners to improve access to and use of products for cervical precancerous treatment in low- and middle-income countries (LMICs). A critical first step in this work is better understanding the need. With funding from the Bill & Melinda Gates Foundation, PATH developed a model, based on 83 LMICs, to estimate the number of devices needed to treat cervical precancerous lesions in women under different scenarios. Results from the model demonstrate that to treat as many women as possible, countries should use single-visit approaches (where diagnosis and treatment occur during the same clinic visit). To do this, countries would need to employ larger numbers of treatment devices or use mobile outreach (where services are provided by a mobile team of trained providers to an area with limited or no services), which can cause devices to go unused. On the other hand, if countries limit the number of facilities where screening and treatment are offered, thereby reducing the number of devices needed, the number of patients treated drops, but treatment devices are better utilized. Such information is critical for supporting ministries of health in planning and effectively expanding their cancer programs to improve access to lifesaving treatment for more women.

In the second phase of our work, we will focus on two countries, Ghana and Uganda, to adapt the demand model based on country-specific costs, cancer program priorities and user preferences, to determine the best deployment strategies and mix of treatment devices. (Current treatment options for cervical precancerous lesions include cryotherapy devices that use extremely cold liquid gas to freeze and destroy abnormal cells, and non-gas devices.) Work in Ghana and Uganda will inform our development of tools to support decision-making and promote access in other countries. We are also working to identify opportunities for further price reductions with manufacturers to make devices more affordable, coordinate efforts with major procurers and donors, and support in-country regulatory authority approval for non-gas devices.

The above case is just one example of how PATH works to expand access to health products. We have worked for nearly 40 years with public- and private-sector partners across the value chain – from product development to introduction and scale-up – to understand and address market-based issues for medicines, vaccines, diagnostics and medical devices, with the goal of improving access to high-quality, lifesaving health products for the world’s most vulnerable populations.


Read the PATH publication “Markets Matter: Improving Access to Maternal Health Products” here.

In 2015, PATH established a central Market Dynamics Department to provide additional capabilities to work with partners around the world, to analyze and monitor markets and address their inefficiencies so that appropriately designed, quality-assured health products are produced and distributed at an affordable price, in sufficient volume, and through the appropriate distribution channels to meet demand.

When people have access to the products, care and information they need to be healthy, their families, communities and countries thrive. This is why we develop and value strong partnerships with public and private organizations around the world. Together, our work ensures a future where lifesaving health products are within reach for everyone.


View the infographic “In Global Health, Markets Matter” here.

* Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. GLOBOCAN 2008, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10. Lyon, France: International Agency for Research on Cancer; 2010. Accessed October 5, 2010.


Ray Cummings is the director of PATH’s Market Dynamics Department.

Top photo: PATH/Gabe Bienczycki

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