Objective: To document the inclusion of key medicines for children in
national essential medicines lists (EMLs) and standard treatment guidelines, and
to assess the availability and cost of these medicines in 14 countries in
Methods: Surveys were conducted in 12 public and private sector medicine outlets
in each country’s capital city. Data were collected on medicine availability on
the survey day and on the cost to the patient of the lowest priced medicine in
Findings: The proportion of survey medicines in national EMLs ranged from 50% to
90%. In only three countries were more than 50% of such medicines available from
central medical stores (range: 15–75%). Availability in nongovernmental
organization stores was not consistently better (range: 10–65%) but tended to be
higher in teaching hospitals, although the range was similar (15–70%). District
hospitals (range: 10–80%) had slightly better availability than teaching
hospitals, while primary health care clinics generally had poorer availability
(range: 18–48%). Retail or private pharmacies tended to have more survey
medicines available (range: 38–62%). There was considerable variability in
prices, which tended to be higher in retail pharmacies.
Conclusion: The availability of key essential medicines for children was poor.
Better understanding of the supply systems in the countries studied and of the
pattern of demand for medicines is needed before improvements can be made.
Medicines must be available, affordable and acceptable to patients. Substantial
progress towards Millennium Development Goals will not occur without a major
effort to improve access to medicines for children.