Pharmaceuticals have a major impact on health, on government and household spending, and on
health systems. Despite the fundamental role of pharmaceuticals, there remains a profound gap
between the benefit which pharmaceuticals have to offer and the reality that for millions of
people -- particularly poor and disadvantaged people -- medicines are unavailable,
unaffordable, unsafe or improperly used. This World Bank Pharmaceuticals Discussion Paper
provides a pragmatic analysis of some of the causes for this gap and strategic directions to help
close this gap.
The strategic directions outlined in this Pharmaceuticals Discussion Paper complement and
reinforce the objectives outlined in the WHO Medicines Strategy: 2000-2003 (World Health
Organization, Geneva, 2000, WHO/EDM/2000.1). The WHO strategy describes specific
objectives, expected outcomes, and progress indicators in the areas of drug policy, access to
essential drugs, quality and safety, and rational use of medicines. Both the World Bank and the
WHO initiatives rest on a fundamental commitment to work with governments, nongovernmental
organizations, the private sector, professional bodies, and other key actors to help
strengthen the pharmaceutical sector and its ability to contribute to improved health outcomes.
Since 1996, UNICEF, WHO, the World Bank, and, more recently, UNFPA have worked
closely together through the Interagency Pharmaceutical Coordination Group (IPC) to develop
common policy approaches in areas such as pharmaceutical procurement, to exchange
information in critical areas such as drug financing and quality assurance, and to better
coordinate support to individual countries. Though some differences in perspective remain, this
process has led to greater synergy within the UN family and to complementary efforts, such as
this discussion paper...