iGovernment
2 December 2008
Geneva, Switzerland

Governments must do more to improve access to essential medicines as part of their efforts to make national health systems more equitable, says a WHO report
Lack of availability of essential medicines in the public sector is rising alarmingly, driving patients to pay higher prices in the private sector or go without the medicines, according to a World Health Organisation (WHO) study.

“Governments must do more to improve access to essential medicines as part of their efforts to make national health systems more efficient and equitable,” the results of the study reported in the online edition of The Lancet confirmed.

The study, analysed data from surveys in 36 countries from all WHO geographical regions and World Bank income groups, showed that an average public–sector availability of only 38 per cent across surveys.

This forces patients to buy medicines from the private sector where treatments are more expensive and frequently unaffordable.

“You should not have to choose between buying medication for an ailing parent or buying food for your children,” WHO Health Systems and Services Assistant Director–General Carissa Etienne said.

“We are calling again for comprehensive primary health care, so that health systems in every country put the real health needs of people and communities first, and families are not impoverished or bankrupted because of health care payments,” Etienne said.

On the pricing side, the study revealed that cuts taken by wholesalers, distributors and retailers plus government taxes and duties are driving prices beyond affordability in many countries.

In some countries, add–on costs can double the public–sector price of medicine, while in the private sector, wholesale mark–ups ranged from two per cent to 380 per cent, and retail mark–ups ranged from 10 per cent to 552 per cent.

“Essentially, multi–layered supply chain costs add up to one thing for patients, no access to essential medicines,” Richard Laing of the Essential Medicines and Pharmaceutical Policies department at WHO said.

“When you pull apart the layers of additional charges, the potential solutions for governments to make life–saving medicines more available and accessible are clear–improve financing and distribution efficiency, promote the use of generic products and control supply chain costs by limiting mark–ups and removing duties and taxes,” Laing said.

The study further asserted that these actions should all be part of national medicine policies that are measured and evaluated against predetermined benchmarks at least every two years, with routine monitoring and reporting more frequently.

The study covered 15 medicines included in at least 80 per cent of surveys, as well as four specific medicines used to treat asthma, diabetes, hypertension and acute infections.

The work is part of an ongoing joint effort between WHO and Health Action International (HAI) to highlight and improve availability and affordability of essential medicines, especially in low– and middle–income countries.