A Public Pharma Option for Broader Equity
March 5, 2026
By: UAEM North America Access Team
The pharmaceutical industry exists in a mutually dependent relationship with affluent populations, prioritizing profits over broader accessibility. What value is there in creating life-saving drugs if they remain out of reach from those who need them most? How can we justify millions of preventable deaths from diseases that already have cures? Analyses state that 90 percent of pharmaceutical research and development is directed towards the diseases that affect the wealthiest 10 percent of the global population.[1] This imbalance leaves various disease areas without investment, delaying the development of countermeasures for conditions disproportionately impacting low-income and marginalized communities. And while pharmaceutical companies continue to expand their margins, over 18 million Americans remain unable to afford the medications that they need.[2]
In the United States, private companies have the right to choose where their money is allocated. This begs the question: why should pharmaceutical companies prioritize equity over profits when they choose where to spend their research and development (R&D) dollars? Unknown to many, a large portion of pharmaceutical R&D in the U.S. is funded through tax dollars. In fact, 354 of 356 drugs (99.4%) approved from 2010 to 2019 had received funding from the National Institute of Health (NIH), a total of $187 billion.[3] In practice, public funding often pays for early-stage development and then private companies later set monopoly pricing on it. Additionally, many pharmaceutical therapies for rare or neglected diseases do not make it past early-stage development nor receive robust funding due to their projected lack of return on investment. This bill will provide an avenue to develop such therapeutics that currently don’t have commercial incentives and will maintain downstream affordability as the institute will have control over prices. Ensuring that health care access and pharmaceuticals reach those who need them is imperative; health innovations must reach everyone, not only the privileged few, and public funding should serve public interest.
The Medicines for the People Act, introduced today by Representative Rashida Tlaib, provides a solution to this complex landscape. This revolutionary bill will create a new institution under the NIH for full-cycle research and development, of which is not currently a public option.[4] This will allow the taxpayer-funded NIH money to be directed into high-impact therapies, especially for historically marginalized populations, rather than return-driven ones. Diseases affecting Americans that have long been neglected could be pharmaceutically addressed and the government will be able to maintain their affordable prices. Having a public institute that places public health returns at the forefront of pharmaceutical R&D will lead to a soundly robust public health landscape within the US. This bill also ensures legal technicalities that often lead to downstream problems, such as patents and trade secrets, are managed in a way that is in the interest of the public.[4] Taken together, the Medicines for the People Act is a sustainable solution that will redefine the pharmaceutical industry to improve American public health for generations to come.
There is a place for the private pharmaceutical industry; there is no place for it to hold an oligopoly. Through this industry-redefining bill, America can develop the technologies that are needed most to protect our people, gaps which may never be addressed through the private industry alone.
Read more about the Medicines for the People Act.
References
Joseph E. Stiglitz and Arjun Jayadev, “Medicine for Tomorrow: Some Alternative Proposals to Promote Socially Beneficial Research and Development in Pharmaceuticals,” Journal of Generic Medicines 7, no. 3 (2010): 217–226, https://doi.org/10.1057/jgm.2010.21
Albert Wertheimer, “18 Million in the USA Cannot Afford Needed Drugs,” Journal of Pharmaceutical Health Services Research 12, no. 4 (November 2021): 473, https://doi.org/10.1093/jphsr/rmab065
Ekaterina Galkina Cleary, Matthew J. Jackson, Edward W. Zhou, and Fred D. Ledley, “Comparison of Research Spending on New Drug Approvals by the National Institutes of Health vs the Pharmaceutical Industry, 2010–2019,” JAMA Health Forum 4, no. 4 (April 28, 2023): e230511, https://doi.org/10.1001/jamahealthforum.2023.0511
Tlaib, R. [Office of U.S. Rep. Rashida Tlaib]. (2025). The Medicines for the People Act [Policy brief]. U.S. House of Representatives.