Ensuring access to essential drugs - framework for action World Health Organization April 2001
Ensuring access to essential drugs - framework for action World Health Organization April 2001.
Mar 27, 2015
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Ensuring access to essential drugs - framework for action
World Health OrganizationApril 2001
2 World Health Organization
Number of people (billions)
0
1
2
3
4
5
6
1977 1987 1997
No regularaccess
Regularaccess toessentialdrugs
Access to essential drugs has increased over 20 years - but a huge gap remains
3 World Health Organization
1. Rational selection
156 countries with EDLS
• 1/3 within 2 years
• 3/4 within 5 years
National Essential Drugs List
< 5 years (127)> 5 years (29)No NEDL (19)Unknown (16)
Countries with an official selective list for training, supply, reimbursement or related health objectives. Some countries have selective state/provincial lists instead of or in addition to national lists.
Essential drugs concept widely accepted - a floor not a ceiling
4 World Health Organization
1. Rational selection
156 countries with EDLS
• 1/3 within 2 years
• 3/4 within 5 years
National Essential Drugs List
< 5 years (127)> 5 years (29)No NEDL (19)Unknown (16)
Countries with an official selective list for training, supply, reimbursement or related health objectives. Some countries have selective state/provincial lists instead of or in addition to national lists.
Essential drugs concept widely accepted - a floor not a ceiling
Key action - define what is needed • develop evidence-based treatment guidelines • base essential drug list on treatment guidelines • regularly update using best evidence• use for supply, reimbursement, training, education• ensure development of needed new drugs
5 World Health Organization
Annual cost per person for triple therapy in Africa(US $)
$0
$2,000
$4,000
$6,000
$8,000
$10,000
$12,000
1991 1993 1995 1997 1999 2001 2003
Drug Access Initiative
Domestic production
Accelerated access initiative
February-April 2001 offers
2. Affordable prices
6 World Health Organization
Annual cost per person for triple therapy in Africa(US $)
$0
$2,000
$4,000
$6,000
$8,000
$10,000
$12,000
1991 1993 1995 1997 1999 2001 2003
Drug Access Initiative
Domestic production
Accelerated access initiative
February-April 2001 offers
Key action - reduce costs and promote competition• price information• generics policies• reduce duties, taxes, distribution and dispensing costs• equity / differential pricing - especially for newer drugs• apply WTO/TRIPS safeguards as appropriate
2. Affordable prices
7 World Health Organization
In 38 countries public drug expenditure is < US$ 2.00 / capita
3. Sustainable financing
Top 5 countries, Africa Mozambique 39 Tanzania 48 Chad 59 Rwanda 59 Ghana 74/75
Fairness in financial contribution varies greatly- rank order of 191 WHO Member States
Bottom 5 countries, Africa Burkina Faso 173/174 Zimbabwe 175 Nigeria 180 Cameroon 182 Sierra Leone 191
Source for fair financing data: : World Health Report 2000
8 World Health Organization
In 38 countries public drug expenditure is < US$ 2.00 / capita
3. Sustainable financing
Top 5 countries, Africa Mozambique 39 Tanzania 48 Chad 59 Rwanda 59 Ghana 74/75
Fairness in financial contribution varies greatly- rank order of 191 WHO Member States
Bottom 5 countries, Africa Burkina Faso 173/174 Zimbabwe 175 Nigeria 180 Cameroon 182 Sierra Leone 191
Key action - develop all viable funding sources• appropriate public funding• expand health insurance coverage & drug benefits• extend employer role in health financing• better use of out-of-pocket spending expand external funding - grants, donations
Source for fair financing data: : World Health Report 2000
9 World Health Organization
4. Reliable health and supply systems
Direct delivery system
Primary distributor system
Autonomous medical stores
10 World Health Organization
4. Reliable health and supply systems
Direct delivery system
Primary distributor system
Autonomous medical stores
Key action - ensure availability and quality• integrate drug management in health systems development• create efficient public-private-NGO mix • assure drug quality through production & distribution chain• promote rational prescribing, dispensing, use by patients
11 World Health Organization
UN framework for action -Access to HIV-Related Drugs
1. Rational selection review of HIV-related drugs in treatment guidelines
2. Affordable prices UNICEF-UNAIDS-WHO list of prices for HIV-related drugs
3. Sustainable financing advocacy for substantial increases in external financing
4. Reliable health and drug systems operational research on optimal monitoring of ARV therapy
Developed by Interagency Task Team on Access to HIV Drugs, consisting of UNAIDS,
WHO UNICEF, the World Bank, UNFPA, UNDCP, UNDP, UNESCO, WIPO
12 World Health Organization
Ensuring access to essential drugs - framework for collective action and
for defining roles and responsibilities
1. Rational
selection
4. Reliablehealth and
supplysystems
2. Affordable
prices
3. Sustainable
financing
ACCESS
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