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Abstract
In the space of five months, federal regulators approved the first checkpoint-inhibitor immunotherapy, the first treatment for an aggressive form of thyroid cancer, the first personalized drug for the skin cancer melanoma, the first in an innovative class of targeted agents for lung cancer, and a 'weaponized' antibody therapy that delivers a drug to tumour cells in people with lymphoma. According to a 2017 analysis7 by Hannah Brennan and her colleagues at Yale Law School in New Haven, Connecticut, the US Department of Defense relied on this to obtain antibiotics and other drugs at steep discounts throughout the 1960s and early 1970s. In a bid to pressure pharmaceutical companies into making expensive medications available to all people in low- and middle-income countries - as happened with HIV drugs in the 2000s - Shulman and an international team of leading cancer researchers worked with the World Health Organization (WHO) in 2015 to expand its list of essential medicines8. Since 2001, and essentially in parallel with the drug's first approval for use in chronic myeloid leukaemia (CML), Novartis has made the treatment available - at no cost - to the poorest people of the developing world through the Glivec International Patient Assistance Program.