ideasIdea
Put cytisine, a cheap plant-based quit-smoking pill, on every essential medicines list
Cytisine costs a few dollars per course and works about as well as varenicline, but is unavailable in most countries. Global approval and procurement would make quitting affordable.
Cytisinicline has randomised evidence of efficacy (ORCA trials) and decades of use in Eastern Europe. Propose WHO Essential Medicines listing, WHO prequalification, and pooled procurement for low- and middle-income countries.
Hypothesis
Availability of cytisine at under $10 per course increases pharmacotherapy-assisted quit attempts in low- and middle-income countries five-fold.
Rationale
Cost is the barrier to pharmacotherapy in poorer countries; cytisine removes it.
What would test it
Run a procurement pilot in three countries with quit-attempt monitoring.
Maturity
being tested at scale
Who has to act
policy
Cost to try
Small (under $1M)
Years to first evidence
3
Bottlenecks it attacks
- Prevention we already have is not deployed · Around four in ten cancers are preventable with tools we already own: vaccines, tobacco control, weight, alcohol, sun and infection control.
- Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.