Simply funding a ‘basket’ of 200 medicines identified as ‘essential’ will not necessarily lead to an equitable or patient-centric distribution, according to The Lancet Commission on Essential Medicines Policies. Low income countries were defined using World Bank classifications, and 31 countries fall into this category.
The commission has issued a report, written by 21 experts and led by Corrina Moucheraud, assistant professor of health policy and management at the UCLA Fielding School of Public Health. The report contains some proposals and recommendations. The report also assesses the cost of providing low income countries with a set of medicines regarded as essential for health and wellbeing.
The essential medicines were selected by the World Health Organization. These medicines are aimed at primary and secondary care environments (that is no special units are required). Such medicines include those for the treatment of HIV, diabetes and heart disease.
The model looked at how many people are affected in low income countries from different conditions; where population centres are; and how medicines can be distributed. Funding the necessary medicines to the identified countries would cost between $77 billion to $152 billion per year.
Of the 31 countries that require this spending, 28 do not spend anywhere close to this. In addition, middle income countries that also need to spend equivalent sums, 13 of 47 countries do not spend nearly enough on essential medicines. The report, unsurprisingly concludes there is a surmountable challenge for financing essential medicines. The report does, however, make some policy recommendations.
Governments need to provide adequate financing to ensure the inclusion of essential medicines. This requires a financing needs assessment.
Governments need to put in place policies to reduce the amount of out-of-pocket spending on medicines, which can take up to 50 percent of the spending in low and middle income countries.
Wealthier countries need to support governments of low-income countries in financing a basic package of essential medicines for all.
Governments must invest in the capacity to accurately track expenditures on medicines.
The findings, although posing key questions, provide a basis for policy makers and global health experts to begin to address the issue, seen as some as a fundamental human right, of access to much needed medicines.
