A number of the findings which were discussed within each country framework are also valid from a cross national perspective. These include that it is easier to put structures in place than to ensure they function properly; that nearly everywhere availability and affordability are seen as the first objectives to achieve. The participants also felt that for certain components there is a universal agreement of their importance and of the fact that they should be taken care of everywhere in a kind of standardized approach:

• selection of drugs;

• procurement by tender in INN;

• drug pricing policy: governments have a role to play in this area of drug affordability although modalities can be different in different countries;

• continuous education and training is also a universal requirement although it is in general the least tackled of all the components.

In contrast, it seemed difficult to have a standardized pattern for budget allocations and public distribution systems.

It was also acknowledged that although all components are equally important everywhere, countries will develop different priorities based on what they perceived as their main problems. This will very often depend on the history of the pharmaceutical sector and the political and socio-economic characteristics of the country.

Time did not allow a review of the strengths or weaknesses of each country nor an attempt to explain them taking as a comparative tool the experiences of the other countries. It was agreed that this should be included in the next phases of the research.