Baseline assessment of WHO's target for both availability and affordability of essential medicines to treat non-communicable diseases
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Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
Public Library of Science
Abstract
BACKGROUND:
WHO has set a voluntary target of 80% availability of affordable essential medicines, including
generics, to treat major non-communicable diseases (NCDs), in the public and private
sectors of countries by 2025. We undertook a secondary analysis of data from 30 surveys in
low- and middle-income countries, conducted from 2008±2015 using the World Health
Organization (WHO)/Health Action International (HAI) medicine availability and price survey
methodology, to establish a baseline for this target.
METHODS:
Data for 49 medicines (lowest priced generics and originator brands) to treat cardiovascular
diseases (CVD), diabetes, chronic obstructive pulmonary diseases (COPD) and central nervous
system (CNS) conditions were analysed to determine their availability in healthcare
facilities and pharmacies, their affordability for those on low incomes (based on median
patient prices of each medicine), and the percentage of medicines that were both available
and affordable. Affordability was expressed as the number of days' wages of the lowestpaid
unskilled government worker needed to purchase 30 days' supply using standard treatment
regimens. Paying more than 1 days' wages was considered unaffordable.
FINDINGS:
In low-income countries, 15.2% and 18.9% of lowest-priced generics met WHO's target in
the public and private sectors, respectively, and 2.6% and 5.2% of originator brands. In
lower-middle income countries, 23.8% and 23.2% of lowest priced generics, and 0.8% and
1.4% of originator brands, met the target in the public and private sectors, respectively. In
upper-middle income countries, the situation was better for generics but still suboptimal as
36.0% and 39.4% met the target in public and private sectors, respectively. For originator
brands in upper-middle income countries, none reached the target in the public sector and
13.7% in the private sector. Across the therapeutic groups for lowest priced generics, CVD
medicines in low-income countries (11.9%), and CNS medicines in lower-middle (10.2%)
and upper-middle income countries (33.3%), were least available and affordable in the public
sector. In the private sector for lowest priced generics, CNS medicines were least available
and affordable in all three country income groups (11.4%, 5.8% and 29.3% in low-,
lower-middle and upper-middle income countries respectively).
INTERPRETATION:
This data, which can act as a baseline for the WHO target, shows low availability and/or
poor affordability is resulting in few essential NCD medicines meeting the target in low- and
middle-income countries. In the era of Sustainable Development Goals, and as countries
work to achieve Universal Health Coverage, increased commitments are needed by governments
to improve the situation through the development of evidence-informed, nationallycontextualised
interventions, with regular monitoring of NCD medicine availability, patient
prices and affordability.
Description
Keywords
WHO, Affordable essential medicines, Non-communicable diseases (NCDs)
Citation
Ewen, M. et al. (2017). Baseline assessment of WHO's target for both availability and affordability of essential medicines to treat non-communicable diseases. PLoS ONE, 12(2): e0171284.