Ensuring stable and adequate financing for health care is becoming increasingly difficult in the face of economic pressures, continued population growth and the growing burden of disease. Countries vary greatly with respect to income levels, population, health care expenditure and national spending on pharmaceuticals which may vary from US$2 to US$ 400 per capita per year. In countries where government policies are not geared to protecting the needs of the poorest people, the poor may be denied access to drugs. Key policy issues are:

• commitment to measures to improve efficiency and reduce waste;

• increased government funding for priority diseases, and the poor and disadvantaged;

• promotion of medicine reimbursement as part of public and private health insurance schemes;

• use of user charges only as a temporary drug financing option;

• limiting the use of development loans within identified national priorities;

• following national or WHO guidelines for medicine donations.