Access to Essential Medicines Access to Essential Medicines selection, affordability, financing, selection, affordability, financing, supply systems supply systems Marthe M Everard Policy, Access, and Rational Use (PAR) Essential Drugs and Medicines Policy (EDM) World Health Organization
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Access to Essential Medicines selection, affordability, financing, supply systems Marthe M Everard Policy, Access, and Rational Use (PAR) Essential Drugs.
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Access to Essential MedicinesAccess to Essential Medicinesselection, affordability, financing, supply selection, affordability, financing, supply
systemssystems
Marthe M EverardPolicy, Access, and Rational Use (PAR)
Essential Drugs and Medicines Policy (EDM)World Health Organization
2 WHO Access.ppt (Apr 11, 2023)
Opportunities
InequitiesInequitiesInequitiesInequities
Access to essential medicines: staggering inequities - unparalleled opportunities
3 WHO Access.ppt (Apr 11, 2023)
Economic inequityEconomic inequity - percent of population below the poverty line has changed little in 2 decades
Inequities
Percent of population below poverty line (US $1 per day)
0 10 20 30 40 50
South Asia
Sub-Saharan Africa
East Asia
Latin America
Middle East & North Africa
E. Europe & Central Asia1993
1977
Source: WHO/HFA (1997)
4 WHO Access.ppt (Apr 11, 2023)
Health status inequityHealth status inequity - infant mortality still varies 10-fold among regions of the world
0 20 40 60 80 100
Sub-Saharan Africa
South Asia
Arab States
East Asia
Latin America
E. Europe & Central Asia
High Income Countries
Deaths per 1000 live births
Source: WHO/HFA (1997)
Inequities
5 WHO Access.ppt (Apr 11, 2023)
Based on average worldwide price and nationalper capita income. Source: WHO/EDM
Affordability inequityAffordability inequity - number of working hours to pay full treatment course
Hours
500
20 1.4
460
20 1.4
120
6 0.40
100
200
300
400
500
600
Tanzania Thailand Switzerland
Tuberculosis
Shigellosis
Gonorrhoea
Inequities
6 WHO Access.ppt (Apr 11, 2023)
AzerbaijanDrugs61%
Fees, Other39%
Bangladesh
Drugs73%
Fees, Other27%
Mali
Fees, Other20%
Drugs80%
Source: Azerbaijan - UNICEF-Bamako Technical Report No. 35 ; Bangladesh 1995 - National Accounts 1996/97Mali (1986) - Diarra K and Coulibaly S. Financing of recurrent health costs in Mali. Health Policy and planning; 1990, 5(2);126-138
Medicines are the largest health expenditure for poor households
Financing inequityFinancing inequity - the burden falls heaviest on those least able to pay
Inequity in health and pharmaceutical financing:High income countries: 50-90 % publicly fundedLow/middle income countries: 50-90 % out-of-pocket
Inequities
7 WHO Access.ppt (Apr 11, 2023)
R&D inequityR&D inequity - expenditures grow, new medicines are launched, few specific for tropical diseases