OBG talks to Recep Akda ğ, Minister of Health

Interview: Recep Akda ğ

How can the current dispute regarding US access to the Turkish pharmaceuticals market be resolved?

RECEP AKDA Ğ: The US, along with 25 other countries, has a tariff schedule of countries exempt from Customs duties. The general system of preferences (GSP) is prepared each year by the US Congress and approved by the president. This year’s list, which includes Turkey, was approved in 2011 and is valid up to 2013. Some 4000 Turkish products benefit from this arrangement. The current impasse derives from our good manufacturing practice (GMP) certificates, which obstruct US products entering the Turkish market. As a result, the US has threatened to remove Turkey from the GSP listings upon renewal in 2013. Although Turkey does not accept licence applications without a GMP inspection, one solution to the confrontation is to have a parallel application – planning GMP inspection after the licence application while initiating the licence procedure. However, reciprocity is important, and we are looking out for the interests of Turkey’s pharmaceuticals industry. We issued 13 import licences and 517 manufacturing licences in 2010, and another 125 and 870 in 2011, respectively. Clearly, our markets are accessible.

What efforts are being made to improve standards for the clinical testing of drugs and to protect the pharmaceuticals industry from the grey economy?

AKDAĞ: Turkish regulations on clinical trials are in accordance with those currently in force in the EU. For a population of 75m, we have a sufficient number of qualified doctors and researchers, as well as sound infrastructure and hospital equipment. However, Turkey needs to garner a larger share of the world’s pharmaceuticals market. To secure the domestic industry, we have established market surveillance and inspection teams that are tasked with monitoring imported products and tracking packages of drugs. We have built a tracking database that can follow a drug from the time it is produced to the time it is sold in a pharmacy. Since the cost of health care is subsidised by the government, the tracking system keeps illegal products out of the supply chain and customers have a cost-based incentive to purchase from the real market.

What is the government doing to address chronic diseases like cancer, diabetes, and circulatory issues?

AKDAĞ: Health culture in Turkey is experiencing significant changes. Chronic diseases that affect quality of life and cause early death are on the rise. Thus, we need to continue ensuring access to acute treatments while also providing preventive measures against such health complications. This includes addressing key risk factors, such as smoking, alcohol and substance abuse, and stress. The government aims to raise awareness and pass legislation that encourages people to avoid these risk factors. The programmes we are implementing focus on tobacco control, encourage active living and consciousness about harmful levels of salt intake, among other things. The government is actively engaged in a fight against chronic diseases through risk avoidance, early diagnosis and treatment.

How can medical research add value that could be exported in technologies and pharmaceuticals?

AKDAĞ: Pharmaceuticals companies focusing on research and development (R&D) should play a bigger role in developing exportable products. Generic drug producers have begun experimenting with new combinations, and while developing drug release systems and controlled release systems is a direction in which the health industry can grow, pharmaceuticals R&D should focus more on new processes for production, rather than new products. Innovative multinational firms in Turkey should shift clinical research to Turkey, and the government is using new incentives – such as the establishment of Health Care Free Zones – to attract more foreign companies. With the implementation of these incentives, our short-term target is to balance pharmaceuticals imports and exports, which means expanding exports by nine times, to TL550m (€233.8m).