Learn about how CELT Global Health are creating open-access systems to help everyone include community in their medical development work.
World Wellbeing Week is the last week of June. It’s a global awareness initiative focused on improving health and wellbeing throughout wider society. It highlights the importance of physical health, mental wellbeing, connection, purpose, and sustainable ways of working. The aim is to spotlight turning good intentions into visible, meaningful action.
While this sits very much within the Centre of Excellence for Long-acting Therapeutics – Global Health’s (CELT Global Health) values, we’re using it to highlight our global health access project, sponsored by global health agency Unitaid.
We spoke to Layla Davies, our Global Health Access Coordinator, who leads the project, to explore her journey and delve into the work and what we want to achieve.
What led you to this role?
I came to global health the long way round, through a Masters in public health and years spent in local authority, working with refugees and asylum seekers. What ties it all together is a persistent interest in who gets left out, and why.
At CELT Global Health, I lead Access, and I'm currently working on an access framework called Access by Design. It's the project I want to tell you about.
What is Access by Design?
Most new medicines are designed first, then someone works out how to get them to the people who need them. Access becomes an afterthought. A logistics problem. A funding gap. Something to solve later.
Access by Design flips that. We want to build access into the science from the very beginning.
The framework focuses on long-acting therapeutics, things like injectables and implants that can treat or prevent conditions for weeks or months at a time. They're a genuine breakthrough for HIV, TB, malaria, contraception and a plethora of other indications. These medicines hold promise to be transformational for global healthcare equity, but breakthroughs don't help people who can't get them.
So, we're asking different questions and earlier. What does a rural health worker need to administer a medication? What works for a pregnant woman in a community where stigma shapes every clinic visit? What happens to a cold chain when the road washes out?
The answers shape the product, not the rollout plan.
How are we doing the work?
We're running the work across three countries: Rwanda, Ghana, and Senegal. Each has a co-investigator embedded locally. Pierre Gashema leads in Rwanda through the Rwanda Biomedical Centre. Osei Boateng leads in Ghana through OKB Hope Foundation. Our Senegal lead is being confirmed.
Community workshops sit at the heart of it. We're talking to end users, health workers, and community leaders, not as a tick-box exercise but as people whose input shapes the design choices that come next.
What have we produced so far?
Fieldwork hasn't started yet. Ethics submissions are in progress across all three sites. But the foundations are built:
- The Access by Design protocol, which governs everything else we do
- Ethics protocols and participant materials for each country
- A fieldwork plan and budget
- A country collaboration brief is now in its final form
- I presented the Access by Design framework at the Reimagining Academia’s Role in Closing Access Gaps Across the Research & Development-to-Delivery Continuum conference, organised by Johns Hopkins University and Unitaid, in Washington DC in April.
The framework itself is becoming something other people want to use, which is where the real shift starts.
Why is the Access by Design framework important?
A medicine that works brilliantly in a clinical trial but never reaches a woman in a village in rural Senegal hasn't worked. Not for her.
Long-acting therapeutics could change millions of lives. Whether they do depends entirely on whether we design them for the people who need them most, as well as for the markets that are easiest to reach.
Access by Design is a small but firm argument that we can do better. That lived experience belongs in the research and design, not just the launch plan. That equity isn't a phase, it's a principle. That's what gets me to my desk in the morning.
#worldwellbeingweek
The Global Health Access project is funded by global health agency Unitaid.
