THE CHALLENGES & OPORTUNITIES OF ACCESS TO MEDICINES IN AFRICA Dr Pascoal MOCUMBI, orig Mozambique,High Representative EDCTP ABRASCO/WFPHA.

THE CHALLENGES & OPORTUNITIES OF ACCESS TO

MEDICINES IN AFRICA

Dr Pascoal MOCUMBI, orig Mozambique,High Representative

EDCTP ABRASCO/WFPHA

Access to essential drugs is increasing -yet too many people still lack access

1 = <50% (36)2 = 50-80% (68)3 = 80-95% (33)4 = >95% (41)5 = No data available (1)

INEQUITABLE ACCESS

About 30% of world’s population lacks regular access to essential medicines

Over 50% are in poorest parts of Africa & Asia In low and middle income 50% -90% of medicines are

paid for by patients themselves, whereas in many high-income countries 70% are publicly funded

Africa’s Problems

Poverty Heavy disease burden Poor and inadequate infrastructure Lack of capacity to R&D medicines

OPPORTUNITIES

AU/NEPAD Strategy to accelerate Africa’s self-sustained growth and promote long-term sustainable human development + health systems development

Innovative knowledge based partnerships to accelerate development of new medicines/technologies for poverty related diseases, such as, AMANET, EDCTP, The Global HIV Vaccine Enterprise, DNDI,etc

Positive Results in some countries – adoption and implementation of strategies for securing access to medicines and technologies

Strategy For Securing Access To Essential Drugs

Assessment & development – therapeutic access Affordability – financial access Availability – supply access

Drug financing alternatives

Public financing Out-of-pocket spending Health insurance Donor financing Development loans

Meeting drug financing challenges

Improving health services public financing Reducing out-of-pocket purchases Improving health insurance Making ODA and loans sustainable, through investment

in sustainable drug services

Managing drug prices

Generic drugs: competition + quality; professional & public acceptance

Patented new drugs: containing prices while promoting innovation; exploring price reduction for countries most in need

All drugs: increasing financial resources; reducing mark ups

Supply to public health facilities

Central medical stores (CMS) Autonomous medical stores = “privatised CMS” Primary distributor system: centralised, privatised Direct delivery system: decentralised, private Fully private

Private Sector Supply Systems

Driven by profit Mainly urban based for profit wholesalers and retail

pharmacies A number of not-for-profit generic wholesale agencies:

e.g. UNICEF, IDA,… Funding: mainly out-of-pocket expenses Affordability is a major challenge

Future Challenges: optimising public/private mix

Public sector: financing supply system; appropriate supply systems; health sector reforms:\improving efficiency and reducing waste e.g. decentralization

Private sector: geographic coverage in low income countries; affordability/costs and local production

CONCLUSIONS

Governments role is crucial Strategies with proved success must be used effectively Creativity is needed, especially for managing prices and

improving supply systems An optimal public-private mix is needed for drug

development, financing, and supply THANKS!