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...