Affordable prices are an important prerequisite for ensuring access to essential medicines in the public and private sectors. This issue is important because resistance to well-known antibiotics, which are widely available as generic products, is increasing. New essential medicines for the treatment of some infectious diseases, such as malaria, tuberculosis and HIV/ AIDS, are often very costly. Key policy issues are:

• government commitment to ensuring access through increased affordability;

• for all medicines: removal or reduction of taxes and tariffs on essential medicines; control of distribution margins; pricing policy;

• for multi-source products (generic medicines and branded generics): promotion of competition through generic policies, generic substitution and good procurement practices;

• for single-source products: price negotiations, competition through price information and therapeutic substitution, and TRIPS-compliant measures such as compulsory licensing, “early workings” of patented medicines for generic manufacturers and parallel imports.