Dalla Lana School of Public Health

DR. JENNIFER SELLIN
Access to Medicines in the Netherlands: Issues & Strategies

Access to medicines – or the lack thereof – is no longer a concern only for low- and middle-income countries. It is now regularly a topic of debate in high-income countries, including in the Netherlands. The Dutch Minister of Health has, for example, announced that it is time to “change the rules of the game” to tackle what he called “absurd” medicines pricing. He also clashed with Novartis after the pharma company increased, by fivefold, the price of one of its cancer medicines. Pharmaceutical Accountability (a Dutch NGO) was recently established specifically with the view to address the issue of unreasonably high medicine prices.
In a different case it requested the Dutch Authority for Consumers & Markets to examine whether the price hike of a medicine (from €306 to €153.000 pppy) constitutes an abuse of the pharma company Leadiant’s dominant market position. Jennifer is a member of the Advisory Council of Pharmaceutical Accountability

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DR. MARK GASPAR
A Tale of Two Epidemics: Gay Men’s Mental Health and the Biomedicalisation of HIV Prevention and Care in Toronto

Drawing on critical theories of biomedicalisation, this presentation will discuss how gay, bisexual, and other men who have sex with men (GBM) are understanding the relationship between HIV and their mental health given biomedical advances in HIV prevention and care. This analysis derived from qualitative interviews with 24 GBM living in Toronto. Participants understood biomedical advances, such as undetectable viral load and pre-exposure prophylaxis (PrEP), as providing some relief from HIV-related distress. However, they offered ambivalent perspectives on the biomedicalisation of HIV. Some considered non-HIV-specific
stressors (e.g. unemployment, racial discrimination) more significant than HIV-related concerns. Others emphasised the ongoing mental health implications of HIV (e.g. enduring risk and stigma). We note a tension between the optimistic responses to biomedicine’s ability to ease the psychosocial burdens associated with HIV and the inability for biomedicine to address the social and economic determinants driving the dual epidemics of HIV and mental distress among GBM.

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