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.
• 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.
• 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.