PHA-Exchange> Access to Essential Medicines

[claudio at hcmc.netnam.vn]

 from "Ruggiero, Mrs. Ana Lucia (WDC)" <ruglucia at PAHO.ORG> -----

Interim Report of Task Force 5 Working Group on Access to Essential
Medicines

Coordinator Paula Munderi, Lead Author Graham Dukes - February, 2004

Interim Report - Task Force 5 Working Group on Access to Essential
Medicines

The Millennium Project commissioned by the UN Secretary General as
independent advisory body to United Nations

 

Report 2004 available online as PDF file [120p.] at:
http://www.unmillenniumproject.org/documents/tf5ateminterim.pdf
<http://www.unmillenniumproject.org/documents/tf5ateminterim.pdf>  


Background paper 2003 online as PDF file [85p.] at:
http://www.unmillenniumproject.org/documents/tf05atemapr18.pdf
<http://www.unmillenniumproject.org/documents/tf05atemapr18.pdf>  

 

"......The fact that a very large part of the world's population has
inadequate access or none to essential and often life-saving medicines
is of grave concern. It results in a vast loss of life and much
suffering, more particularly among the poor and underprivileged.. It is
in blatant contradiction to the fundamental principles of human rights.
And, even if one were to set humanitarian considerations side, it
results in serious damage to the economy and to the functioning of
society.

 

The extent of the problem can be illustrated in various ways, both
globally and in individual countries. It has been estimated that one
third of the world's population lacks access to the most basic essential
medicinal remedies, while in the poorest part of Africa and Asia this
figure climbs to one half. Bearing in mind that medicines are society's
primary instrument in curing and alleviating disease and that they are a
prominent tool for its prevention, it is clear that the world cannot
hope to attain its Medium term Development Goals in the area of health
so long as this situation persists. A high proportion of deaths in the
developing world are due to illnesses which are in principle curable
with medicines which currently exist; this is the case, for example,
with tuberculosis, pneumonia and malaria. Many other deaths result from
diseases for which medicinal treatments could, with due effort, be
developed using knowledge already available.

 

The problem of impaired drug access can be solved, and the world has the
resources needed to solve it. Three main areas for action can be
recognized:

*          Firstly, the medicines , which are needed by poor
populations, must be available:
- The research and discovery process must and can be reoriented to place
more emphasis on creating and identifying the medicines needed to treat 
  major diseases of poor populations, such as HIV/AIDS, malaria and
tuberculosis. The private sector can be given incentives to do it, but
contributions 
  can also be made in the public sector and in developing countries.

- By using public, private and non-profit channels in parallel,
procurement and supply systems in developing countries can be made more
effective and 
  reliable

- Unsafe medicines and situations of special risk can and should be more
rapidly identified and eliminated than is the case at present in much of
the  

  world; information sharing can accelerate the process of containing
risk. Where users are unnecessarily injured by medicines, redress must
be provided

*          Secondly, the medicines so urgently needed must be
affordable:

- A basic supply of medicines should be based on giving priority to a
list of "essential drugs" secured from reliable suppliers

- Within a country, a flexible combination of state financing of drugs
and pre-payment systems can ensure that financial barriers to drug
access are 
  progressively eliminated. Appropriate donations (and in exceptional
cases loans), though they can only be a temporary means of ensuring drug

  supplies, are for countries at a low level of development likely to be
needed for many years to come; the level of such financing will for many
countries 
  need to be raised substantially if progress is to be achieved.
  Imposition of user fees on poor populations should be avoided wherever
possible; those already in force should be progressively phased out.
Prices of 
  medicines must be reduced to the minimum sustainable level,
particularly by promoting greater competition, eliminating tax burdens
and making full
  use of the exceptions and flexibilities built into the TRIPS
agreement. An open exchange of pricing and cost information must be
developed.

*          Thirdly, medicines must be more appropriately used:

- Prescribing must be based on "essential drugs" principles and these
principles must be as fundamental part of basic and follow-up training
for health 
  workers at all levels, backed by reliable and impartial information
services in the field

- Prescribers should be protected from temptations to over-prescribe,
such as may arise if they also dispense products for profit, or if they
are subject to
  irresponsible advertising and promotion.

* Prescribing and usage of medicines should be carefully monitored and
policies adjusted to take account of the findings

* To ensure well-informed use of medicines in the home, understandable
information on their use must be made available through appropriate
channels..."

 
The recommendations presented herein are preliminary and circulated for
public discussion. The Task Force will be revising the contents of this
document in preparation of its Final Task Force report, due December
2004. The Final Task Force report will feed into the Millennium
Project's Final Synthesis Report, due to the Secretary-General by June
30, 2005

 


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