Laudato Si’: a bridge towards access to medicines Laudato Si’: uma ponte para acesso a medicamentos

Pope Francis’ Encyclical Laudato Si’, albeit not explicitly, has drawn attention worldwide to the access to medicines as a fundamental human right, as it raises awareness about the current situation of the world and the poor. The reflections set forward by the Encyclical Laudato Si’ bring us to the intersections between trade and health care, and how to correctly frame the need for innovation, affordable and accessible health technologies to those in need and how to reach the poorest of the poor. The issues of how to provide access, promote innovation, stimulate reasonable competitive market forces and ensure viable supply are central to the question of how to address Universal Human Rights. Also in this context, intellectual property has gained particular significance with increased attention to new essential medicines for the treatment of diseases of global incidence, including communicable and non-communicable diseases. This article intends to bring elements for a reflection on the debate on universal access to medicines.


INTRODUCTION
Pope Francis' Encyclical Laudato Si' 1 stands out by a critique of consumerism and irresponsible development, besides making a plea for change and global unification of actions to combat social inequality and environmental degradation. While underscoring the importance of scientific development as a way to increase the welfare of people 2 , we realize that the incorporation of modern technologies has not been integrated with the enhancement of the concepts of human rights. Rather, trade has been priority over public health and access to medicines 3 .
In fact, the issues of how to provide access, promote innovation, stimulate reasonable competitive market forces and ensure via-

Barriers to access to medicines
Despite all progress in health care, there still are disabling inequalities in access to medicines and health services and billions of people live without access to the necessary health products. There is also an awareness that access to medicines is a broad issue that affects people and health systems worldwide 6 .
Barriers to access to medicines have different roots, but they are deeply interrelated, such as global R&D and production with a focus on potentially more profitable products; intellectual property system plus multilateral and bilateral trade agreements interest conflicts. The current R&D system of new medicines does not adequately meet the needs of the majority of the world's population 6,7 .
Such needs include affordable medicines for diseases with global incidence, new treatments for neglected diseases, new antimicrobials and other essential medicines for conditions that disproportionally affect the poor.
IP has gained particular significance with increased attention to new essential medicines for the treatment of diseases of global incidence, including communicable and non-communicable diseases.
New monopoly medicines, like those for Hepatitis C or Cancer, are being launched at unaffordable prices, bringing health systems near collapse whenever new technologies are made available.
Effective tools for global governance are required to generate medical R&D as a global public good, based on the understanding that a politically and financially sustainable system will require both fair contributions from all, and fair benefit-sharing for all 6 .

Lessons from Laudato Si' and other teachings of Pope Francis
Contemporary issues such as access to medicines, pollution, climate change or global equality are confronted with weak political responses and submit politics to technology and finance 1 .
Nonetheless, Technology has remedied countless evils which used to harm and limit human beings. How can we not feel gratitude and appreciation for this progress, especially in the fields of medicine, engineering, and communications? How could we not acknowledge the work of many scientists and engineers who have provided alternatives to make development sustainable? 1 .
As stated in Laudato Si', "Politics and economy tend to blame each other when it comes to poverty and environmental degradation. It is hoped that they can acknowledge their own mistakes and find forms of interaction directed to the common good" 1 .
Pope Francis has drawn attention to the full exercise of human dignity and the cruel consequences of a globalized economy.
Based on the Pope thoughts we can conclude that he is challenging us to reflect on the development of nations and of health care, through a discussion on trade agreements and access to medicines. The purpose of this discussion could be to claim that certain health issues, including the elimination of specific diseases, require urgent political attention, above and beyond all other commercial or political interests 8,9 .
The Encyclical Letter points to the "intimate relationship between the poor and the fragility of the planet, the conviction that everything in the world is connected, the critique of new paradigms and forms of power derived from technology, the call to seek other ways of understanding the economy and progress, the value proper to each creature, the human meaning of ecology, the need for forthright and honest debate, the serious responsibility of international and local policy, the throwaway culture and the proposal of a new lifestyle" 1 .
As known: "science and technology are not neutral" 1 , but it is our moral obligation to seek, fight and build a better future for those behind us and for the generations we will deliver to. We need to recover the expectations that initiatives like these awake in humanity. "There is also the fact that people no longer seem to believe in a happy future; they no longer have blind trust in a better tomorrow based on the present state of the world and our technical abilities. There is a growing awareness that scientific and technological progress cannot be equated

Human dignity, human rights and the way forward
Even if Pope Francis's Encyclical does not specifically mention medicines, it truly talks about technology and challenging situations directly related to areas of health. The reflections set forward by Laudato Si' lead us to realize the connections that exist between trade and health. They also give us elements to correctly frame the need for having innovation in medicines affordable and accessible to those in need. The concern for the poorest of the society is also a fundamental point from the Encyclical Additionally, we understand that the recommendations derived from the UNSG HLP Report, as moving to remedy the policy incoherence between individual rights and collective rights, eliminating barriers and pledging to leave no one behind, are completely aligned with the progress conceived on health care worldwide.
As mentioned before, effective tools for ensuring adequate global governance are necessary to seek the balance between health and trade and address innovation and new health technologies reaching the poorest of the poor, addressing policies that will be able to eliminate regulatory and IP barriers. Laudato Si' is undoubtedly a major pledge on the need to ensure a human rights approach. Access to medicines is a way of alleviating suffering and ensuring prevention, promotion and treatment of diseases and other conditions that affect human beings globally, with a stronger impact on neglected and vulnerable populations.