The meeting was opened by Dr Godfrey Walker of the WHO Representative's Office. Dr Walker thanked the Thai Food and Drug Administration for organizing the meeting. He then read a message from Dr Uton Muchtar Rafei, Regional Director of WHO/SEARO, which emphasized the changing scenarios in the national health systems in the Region and the role of both the public and private sectors in providing equitable health care services. Privatization has become an important issue and some countries are implementing such policy. This is a result of the observation that a centralized economic system does not necessarily provide equitable health services and public sector financing alone is not adequate for the attainment of the goal of Health For All.
Advocates of privatization argue that private health care and drug financing would lead to equitable, effective and efficient care by having the well-off pay for services while the underprivileged are subsidized by government allocation. Opponents, on the other hand, argue that privatization would lead to commercialization of services which could result in cost escalation without quality improvement. Therefore, a compromise between the two views needs to be identified to bring together the benefits of both, to ensure equity and quality of health care.
To ensure equity and availability of essential drugs, different drug financing strategies are available, such as redistribution of public resources, introduction of user fees and community cost-sharing schemes. Appropriate drug financing strategies should be considered for countries in South-East Asia where essential drugs are indispensable tools in the prevention, control and treatment of diseases. It is the primary role of ministries of health to be the architects of national drug policy, based on the essential drugs concept, within the context of overall health policy. To achieve this, government takes the initiative in strengthening policy and regulation, advocacy, provision and dissemination of information, price control, distribution of sufficient amounts of quality drugs, and related services.
Furthermore, the complementary roles of the public and private sectors need to be strengthened and harmonized through realistic policy instruments, such as incentives, regulation and other measures, for a successful symbiotic relationship. (The full text of the Regional Director's message is contained in Annex D).
Dr Chalermchai Chumuang, Deputy Secretary-General of the Thai Food and Drug Administration (FDA) also welcomed all participants to the meeting. He urged exchange of knowledge and experiences for better understanding and contributions to the development of drug financing policy and management in the Region.
Dr Jonathan Quick, Director of the Drug Action Programme, WHO/HQ, in his opening statement emphasized that drug financing is a universal problem. In many parts of the world, drugs are still not sufficiently available to all who need them. Dr Quick apprized that different drug financing schemes are available; government taxes, insurance, user fees, donations or even loans. However, WHO suggests that policy for drug financing should meet the following five criteria: equity according to need, access (availability and affordability), rational drug use, efficiency and sustainability. While WHO recommends that countries develop national drug policies, these do not improve health if drugs are not adequately financed.