Improving Access to Medicines in Low‐Income Countries: A Review of Mechanisms

Abstract

Individuals in low‐income countries (“LICs”) often lack access to appropriate medicines. The multi‐disciplinary nature of this problem requires a holistic approach. Whereas, other writings on the topic tend to focus on one or a small number of issues, often from the perspective of a single discipline, this paper seeks to consider the major issues from a multi‐disciplinary perspective. It first considers mechanisms for improving the availability of medicines in LICs, through grants, prizes, treaties, advance market commitments, priority review and product development partnerships to incentivize and fund R&D for neglected diseases. The paper then assesses mechanisms for improving affordability of medicines in LICs, such as differential pricing mechanisms, monopsonies, patent law flexibilities and human rights obligations. Next, the paper reviews mechanisms for improving the efficacy of medicines in LICs, including authentication, criminalization, international and national enforcement and communication and education. Finally, the paper examines mechanisms for improving the obtainability of medicines in LICs, through low‐cost intervention, task‐shifting, efficient regulation, grass‐roots service provision and education. The paper concludes by identifying areas warranting further research.

Association between gender inequality and population-level health outcomes: Panel data analysis of organization for Economic Co-operation and Development (OECD) countries

“…Given the above findings, can we quantify the effect of gender inequality on population-level health parameters? We certainly have resounding evidence of the link between gender inequalities and health outcomes [ 1 , 8 , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , 13 , 14 , [16] , [17] , [18] , [19] , [20] , [21] ], and several studies have measured the effect of these inequalities on parameters such as life expectancy (LE), obesity, cancer, and risk behaviors [26] , [27] , [28] , [29] . However, to our knowledge, no study has provided a comprehensive quantitative analysis of the association between gender inequality and other parameters such as healthy life expectancy (HALE), years of life lost (YLL), years lived with disability (YLD), disability-adjusted life years (DALYs), or mortality for specific causes such as suicide, lung cancer, or cervical cancer.…”

Prevalence of Substandard Amoxicillin Oral Dosage Forms in the National Capital District of Papua New Guinea

“…Combating the prevalence of poor-quality medicines has been a focus of regulatory authorities for more than two decades, with initiatives to address this issue well documented in the literature. [1][2][3] Despite such efforts, poor-quality medicines remain a global health issue, with their use being associated with the development of drug resistance, patient morbidity and mortality, and a loss of confidence in health systems. [4][5][6] Monitoring the quality of medicines in poorer countries is problematic because of a range of issues including insufficient controls on supply chains, inadequate pharmaceutical regulatory systems, limited financial resources, and limited laboratory capacity.…”

“…Combating the prevalence of poor-quality medicines has been a focus of regulatory authorities for more than two decades, with initiatives to address this issue well documented in the literature. 1 – 3 Despite such efforts, poor-quality medicines remain a global health issue, with their use being associated with the development of drug resistance, patient morbidity and mortality, and a loss of confidence in health systems. 4 – 6 …”

Are public-private partnerships the solution to tackle neglected tropical diseases? A systematic review of the literature

“…(14)(29); (ii) their tendency to alter existing medicines rather than creating new ones(30)(29); and the lack of coordination between sectors and partners resulting in duplicated efforts(28). PDPs' generalized lack of transparency, for instance, is a potential reason for the dearth of empirical research conducted on thetopic.…”