Why the World Needs Universal Access to Medications

Secondary prevention found to be unavailable and unaffordable in 94,919 communities across the world.

Health economists Louis Niessen and Dr. Jahangir Khan recently outlined the importance of universal access to medications in the control of neglected diseases, other major infections, and chronic diseases.

Professor Niessen and Dr. Khan argue in an editorial in The Lancet that medications should be more available and affordable to increase use in low- and middle-income countries. There is a double burden of infectious and chronic diseases, while awareness of the benefits of prevention and treatment has grown.

Their comments follow results of the McMaster University-lead Prospective Urban Rural Epidemiology (PURE) study on the availability and costs of cardiovascular medicine across 18 countries.

The groundbreaking study showed that secondary prevention is unavailable and unaffordable in the surveyed 94,919 communities across the world. The health economists contend the findings are crucial to the formulation of policies on universal health coverage and the mobilization and use of resources in relation to infectious and chronic diseases.

They found that it is unlikely surplus household income is available for prevention. Household spending relates to all major health events, including strokes, infarctions, neglected tropical diseases, major infections, injuries, and cancers.

Many households suffer dire financial straits due to income loss from illness. Health safety nets such as insurance in advancing systems provide broader coverages. In particularly vulnerable communities, societal safety nets may cover all types of events such as food shortages and disasters.

Secondly, they explain that use of medicines is influenced by general awareness, health literacy, service quality, and the quality of workers. All of this is important as increased availability may lead to misuse.

Niessen and Khan acknowledge that the promotion of universal access to medication has to address multiple obstacles in the provision of appropriate care to communities.

At the national level, some of these obstacles include price control measures, price management of generic medicines and promotion of market entry through flexible TRIPS arrangements and licensing, and internal reference pricing of generics.

Increasing the international coordinated actions, such as mass production of low-cost antiretroviral drugs and the mass drug provision in the control of neglected tropical diseases is a necessity. Low cost treatments are possible for many conditions through mass production.

Niessen and Khan call for more efforts to develop national regulating mechanisms and on pricing closer to drug production costs. The analysis found that universal access to medicines can be achieved by improving health financing and better availability of affordable medicines targeting major diseases among the poor.