What are the key factors that result in low availability of essential medicines in resource poor settings? Which of these are the main barriers for the public and private sectors and why:
a. National procurement systems including adequate forecasting of volumes and ability to negotiate prices b. Quality assessment of priority products c. National supply, storage and distribution systems that minimise leakage and other waste d. Human resource capacity e. Facility level ordering, storage and distribution systems (does this differ by level of facility?) f. Other factors
How can the key factors that you have noted be successfully addressed? What constitutes success and what are the binding constraints? Please use evidence, where possible, from sub-Saharan African countries.
Medicines are integral of any healthcare system, and limited access to medicines undermines health systems’ objectives of equity, efficiency and health development. In African countries, where it is estimated that 50–60% of the populace lack ‘‘access’’ to essential medicines, health problems associated with limited drug benefits are more damaging.
The main barriers to essential medicines in Sub Saharan Africa were found to be as follows:
- Inadequate national commitment to making healthcare a priority.
- Inadequate human resources for health.
- The international community has not provided adequate finance nor consistently fulfilled its existing promises to developing countries.
- A persistent lack of coordination of international aid reduces access to medicines.
- The Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement may block access to affordable new medicines and vaccines.
- The current incentive structure is inadequate to promote research and development of medicines and vaccines to address priority health problems of developing countries.
The report then focuses on the solutions to these issues including information on national procurement systems, quality assessment of products, national supply, storage and distribution systems, human resource capacity, facility level ordering, storage and distribution systems and patents.