Equitable Access to Essential Medicines: A Framework for Collective Action - WHO Policy Perspectives on Medicines, No. 008, March 2004
(2004; 6 pages) [French] [Spanish] View the PDF document
Table of Contents
Close this folderEquitable Access to Essential Medicines: A Framework for Collective Action, No. 8
Close this folderThe Access Framework
View the document1. Rational selection and use of essential medicines
View the document2. Affordable prices
View the document3. Sustainable financing
View the document4. Reliable health and supply systems
View the documentKey documents

The Access Framework

Improving access to essential medicines is perhaps the most complex challenge for all actors in the public, private and NGO sectors involved in the field of medicines supply. They must all combine their efforts and expertise, and work jointly towards solutions. Many factors define the level of access, such as financing, prices, distribution systems, appropriate dispensing and use of essential medicines. WHO has formulated a four-part framework to guide and coordinate collective action on access to essential medicines (Figure 2). This framework has also been adopted by WHO’s key partners.

Figure 2. Improving access to essential medicines - a framework for collective action in line with Millennium Development Goals, Target 17

Box 3. Key actions: check list for policy makers

Rational selection and use of essential medicines

• Develop national treatment guidelines based on the best available evidence concerning efficacy, safety, quality, and cost-effectiveness;

• Develop a national list of essential medicines based on national treatment guidelines;

• Use a national list of essential medicines for procurement, reimbursement, training, donations and supervision.

Affordable prices

• Use available and impartial price information;

• Allow price competition in the local market;

• Promote bulk procurement;

• Implement generics policies;

• Negotiate equitable pricing for newer essential medicines for priority diseases;

• Undertake price negotiation for newly registered essential medicines;

• Eliminate duties, tariffs and taxes on essential medicines;

• Reduce mark-ups through more efficient distribution and dispensing systems;

• Encourage local production of essential medicines of assured quality when appropriate and feasible;

• Include WTO/TRIPS compatible safeguards into national legislation and apply.

Sustainable financing

• Increase public funding for health, including for essential medicines;

• Reduce out-of-pocket spending, especially by the poor;

• Expand health insurance through national, local, and employer schemes;

• Target external funding - grants, loans, donations - at specific diseases with high public health impact;

• Explore other financing mechanisms, such as debt-relief and solidarity funds.

Reliable supply systems

• Integrate medicines in health sector development;

• Create efficient public-private-NGO mix approaches in supply delivery;

• Assure quality of medicines through regulatory control;

• Explore various purchasing schemes: procurement co-operatives;

• Include traditional medicines in the health care provision.

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