On October 14, Brussels hosted a panel discussion titled “Removing Barriers: Ensuring Access to Essential Tuberculosis Medicines in the EU and EEA,” organized by Médecins Sans Frontières (MSF). The event brought together representatives of European institutions, the World Health Organization (WHO), national health authorities, and civil society organizations.

The meeting was held in the context of ongoing EU pharmaceutical law reforms and the preparation of the Critical Medicines Act — initiatives aimed at improving access to essential medicines across the region.

Although tuberculosis (TB) is both preventable and curable, patients in many European countries continue to face barriers to accessing modern medicines for TB treatment and prevention. In EU member states where TB is less common, the rollout of updated WHO guidelines and newer medicines remains slow, while prices stay prohibitively high. According to MSF’s latest technical report, high costs, regulatory hurdles, and a lack of coordination between countries severely restrict access to treatment.

One of the central topics discussed was access to key TB medicines — bedaquiline (Johnson & Johnson) and pretomanid (Viatris). It was revealed that Johnson & Johnson declined to participate in joint procurement negotiations with the European Commission for bedaquiline, while talks with Viatris on pretomanid are ongoing.

Both medicines are recommended by WHO for the treatment of drug-resistant tuberculosis, but according to MSF, the cost of a six-month course of bedaquiline in the EU ranges from €20,000 to €25,000, making it unaffordable for many patients.

Johnson & Johnson stated that the medicine is “available through standard local channels,” but civil society representatives disagreed with this claim.

Denis Godlevskiy, Regional Coordinator at ITPC EECA, noted that there are “definitely problems with access to bedaquiline” in Europe: “The fact that doctors can prescribe the medicine does not mean that all patients who need it can actually obtain it. In many EU countries, access to bedaquiline is restricted by insurance schemes.”

According to Jaime Manzano from the Spanish health NGO Salud por Derecho, the prices paid by EU countries are “artificially inflated” and do not reflect the real cost of production.

Participants emphasized that without political will and transparent pricing mechanisms, access to essential medicines in Europe will remain unequal. “Europe must lead not only in developing innovations, but also in ensuring equal access to them,” said Dr. Marc Biot, MSF Regional Coordinator for Europe and the Middle East, in his closing remarks.