THESE DAYS it is hard to find a government that is not struggling with the high price of medicines. In England, the government is fighting Vertex, a drug company, over the cost of a drug for cystic fibrosis, Orkambi. In America, diabetics have died because of the high cost of insulin. In the Netherlands, the government for a time stopped buying the immuno-oncology drug, Keytruda, because it was too expensive—even though it had helped to develop it. The list price of Orkambi is about $23,000 a month in America, and Keytruda is about $13,600 month (for as long as treatment continues). It has taken such rich-world dramas to force the unaffordability of medicines to the top of the global health agenda, even though poorer countries have complained about it for decades.

On May 20th governments started tackling the issue at the World Health Assembly (WHA), an eight-day policy forum where health ministers define the goals for the World Health Organisation for the coming year. There is a lot for them to discuss, including the expansion of universal health care, antimicrobial resistance, the impact of climate change on health and the deepening crisis of Ebola in the Democratic Republic of Congo. Yet the hottest topic is the high price of new medicines, particularly cancer drugs.

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