A Global Accountability Mechanism for Access to Essential Medicines
(2018; 3 pages)

www.thelancet.com Vol 392 December 8, 2018

Resumen

Access to affordable, quality-assured essential medicines is a prerequisite for effective universal health coverage. Efforts to ensure comprehensive access to essential medicines have been hindered by a dearth of information. Most monitoring efforts have focused on measurement of a prespecified list of essential medicines in health facilities. Measures of affordability in private and public health facilities have relied on periodic surveys, usually by non-governmental organisations (NGOs) or academia. The quality of medicine products and of prescribing practice, as well as patients’ use of essential medicines, have been assessed even less often. Pharmaceutical expenditure in the public and private sector is not prioritised in national systems, and is rarely reported. Without systematic data reporting on national pharmaceutical expenditure, there is a lack of attention to access to essential medicines in major reports such as the World Health Statistics. The 2015 Millennium Development Goals Task Force report concluded that tracking progress on access to essential medicines was impossible, given the absence of country-level data.

When target measurements are used to improve access, a robust monitoring and accountability system is needed—eg, the three-step framework recommended by Paul Hunt, former UN Special Rapporteur on the Right to Health, that involves appropriate collection of data, independent review, and the necessary corrective action. The Lancet Commission on Essential Medicines Policies made an initial proposal for such a framework. Independent review and corrective action are important components of an accountability mechanism, as shown by UNAIDS’ HIV progress reports and work in reproductive, maternal, newborn, child, and adolescent health.

 
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