PD 22 - Access to Essential Medicines in LMICs

Limited access to essential medicines is one of the key barriers to health. This is particularly true for the majority of low-and middle-income countries (LMICs). The barriers are varied and include weak health systems, no or lack of proper infrastructure, insufficient numbers of health workers, insufficient knowledge among health workers, no surveillance systems, lack of diagnostics. Price, of course, is a key barrier.

The price of patented medicines is becoming an increasing challenge in all countries, but in LMICs the proportion of healthcare spend on medicines is higher, at least a quarter and up to 67% of the entire healthcare budget, and this continues to increase. As a result, the price of medicines could make the implementation of Universal Health Coverage (UHC) unaffordable.

The answer to this challenge is to make medicines available and affordable, but the next question is how. A number of access models have been tried, including voluntary public health licensing, donation programs, tiered pricing, bilateral deals between originators and generic companies, and as a last resort compulsory or government licensing. The appropriateness of each model will depend on the specific circumstances but all should be judged against the major public health standards of transparency, sustainability, and benefit.