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Ensuring access to essential drugs - framework for action

This framework, published by the World Health Organization in April 2001, highlights the importance of access to essential drugs and outlines key actions to improve availability, affordability, sustainable financing, and reliable health and supply systems. The framework emphasizes the need for rational selection, affordable prices, sustainable financing, and reliable distribution systems.

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Ensuring access to essential drugs - framework for action

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  1. Ensuring access to essential drugs - framework for action World Health Organization April 2001

  2. Access to essential drugs has increased over 20 years - but a huge gap remains

  3. Essential drugs concept widely accepted - a floor not a ceiling National Essential Drugs List 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. < 5 years (127) > 5 years (29) No NEDL (19) Unknown (16) 1. Rational selection 156 countries with EDLS • 1/3 within 2 years • 3/4 within 5 years

  4. Essential drugs concept widely accepted - a floor not a ceiling National Essential Drugs List 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. < 5 years (127) > 5 years (29) No NEDL (19) Unknown (16) 1. Rational selection 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 156 countries with EDLS • 1/3 within 2 years • 3/4 within 5 years

  5. Drug Access Initiative Domestic production Accelerated access initiative February-April 2001 offers 2. Affordable prices

  6. Drug Access Initiative Domestic production Accelerated access initiative February-April 2001 offers 2. Affordable prices 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

  7. Top 5 countries, Africa Mozambique 39 Tanzania 48 Chad 59 Rwanda 59 Ghana 74/75 Bottom 5 countries, Africa Burkina Faso 173/174 Zimbabwe 175 Nigeria 180 Cameroon 182 Sierra Leone 191 3. Sustainable financing Fairness in financial contribution varies greatly - rank order of 191 WHO Member States In 38 countries public drug expenditure is < US$ 2.00 / capita Source for fair financing data: : World Health Report 2000

  8. Top 5 countries, Africa Mozambique 39 Tanzania 48 Chad 59 Rwanda 59 Ghana 74/75 Bottom 5 countries, Africa Burkina Faso 173/174 Zimbabwe 175 Nigeria 180 Cameroon 182 Sierra Leone 191 3. Sustainable financing Fairness in financial contribution varies greatly - rank order of 191 WHO Member States 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 In 38 countries public drug expenditure is < US$ 2.00 / capita Source for fair financing data: : World Health Report 2000

  9. Direct delivery system Primary distributor system Autonomous medical stores 4. Reliable health and supply systems

  10. Direct delivery system Primary distributor system Autonomous medical stores 4. Reliable health and supply systems 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. 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. 1. Rational selection 3. Sustainable financing ACCESS 4. Reliable health and supply systems 2. Affordable prices Ensuring access to essential drugs - framework for collective action and for defining roles and responsibilities

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