Ensuring that Essential Medicines are also Affordable Medicines: Challenges and Options. Discussion Paper UNITAID
(2016; 52 pages)


This paper provides an overview of key historical developments, focused on the experience of increasing access to HIV medicines. Using the Essential Medicines List as a guide for prioritization, it then discusses some of the recent challenges and possible approaches to address them.

In May 2015, the World Health Organization (WHO) added several important medicines, including for the treatment of cancer, tuberculosis and hepatitis C, to its Model List of Essential Medicines, commonly known as the Essential Medicines List (EML). The uniqueness of these medicines – aside from their value as treatments for devastating illnesses – is their high price. Now that WHO has named these medicines as essential, they must be made both available and affordable. As innovative new medicines are increasingly patented around the world, and are thus available only at monopoly prices that prevent widespread access, a public policy response is needed to address the intellectual property challenges associated with essential treatments.

When the EML was first conceived as a tool for governments and health-care providers seeking to meet the health needs of their populations, medicines were added to the list when scientific data demonstrated their importance and when they could be made widely available at low cost. However, with new medically necessary treatments priced to break the budgets of health-care systems worldwide, both in high-income countries and in developing ones, it is time to acknowledge that the paradigm for the EML has shifted.

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