'We have to infuse equity into every part of the system': A Q&A with Priti Krishtel

Priti Krishtel is a health justice lawyer who has spent nearly two decades exposing structural inequities that limit access to medicines and vaccines across the Global South and the United States. She is the co-founder and co-executive director of I-MAK (Initiative for Medicines, Access & Knowledge), a nonprofit organization building a more just and equitable medicines system. An Echoing Green Global Fellow, TED speaker, Presidential Leadership Scholar, and Ashoka Fellow, she is a frequent contributor to leading international and national news outlets on issues of domestic and global health equity.

PND asked Krishtel about inequity across the globe as it relates to COVID-19 vaccines, challenges in the United States of ensuring an equitable medicines system, the drug pricing crisis, and what funders can do to bring about change. Here is an excerpt:

Philanthropy News Digest: I-MAK states that a global pandemic, economic and racial awakening, and skyrocketing costs of medicine have created a crucial mandate for equity in the drug development system, especially with growing inequity across the globe as it relates to COVID-19 vaccines. What action do you believe leaders of national governments should be engaged in to mitigate those disparities? And what are the most significant barriers to improving vaccine access worldwide?                       

Priti Krishtel: I cannot stress this point enough: In a pandemic, no country is safe until every country is safe. Today, vaccinations are readily available in wealthy countries like the U.S. However, it's a completely different situation for most of the world's population: so far, less than 2 percent of residents in low-income countries have been vaccinated. Until we employ an equitable system to make sure that vaccines are available everywhere, that all countries have access to the vaccine, and that everyone who is willing and able is vaccinated, variants will not stop. Governments — and wealthy nations in particular — have to stop taking a country-by-country, nationalistic approach to pandemic responses and instead start looking at the system holistically. With every passing day, the risk of a mutated COVID-19 variant that is resistant to vaccines grows.

The Delta variant teaches us that we have to radically and rapidly rethink our approach to recover from this pandemic and adequately prepare for the next. We can't do this by relying on market incentives alone. Right now, pharmaceutical companies are incentivized to lock up knowledge to maximize profits to serve shareholder interests rather than share that knowledge and bring this pandemic to an end.

Philanthropy can play a catalytic role in this moment. Philanthropy is the only sector with the resources, capacity, and global connections to resource organizations and individuals leading the fight for a globally more just and equitable medicines system. It can and must play a connective and transformative role in stemming the gap in places where countries, communities, and individuals are being left behind....

Read the full Q&A with Priti Krishtel.