The right to health as the basis for universal health coverage: A cross-national analysis of national medicines policies of 71 countries

Perehudoff, Katrina; Alexandrov, Nikita V.; Hogerzeil, Hans V

doi:10.1371/journal.pone.0215577

Cited by 20 publications

(20 citation statements)

References 21 publications

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“…While several studies have delved into the relationship between healthcare and human rights [4][5][6][7][8][9][10][11][12][13], none examines the knowledge and awareness about the linkage between human rights and healthcare among patients, healthcare providers and members of civil society in Bangladesh. The current study is an attempt to ll this gap.…”

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confidence: 99%

WITHDRAWN: Health and Human Rights Linkage in Bangladesh: Stakeholders’ views from the grassroots

Rahman¹,

Qattan²

2021

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Background: Bangladesh has attained substantial progress in healthcare services and population health. This study examines the knowledge and awareness about the linkage between human rights and healthcare among patients, healthcare providers and members of civil society in Bangladesh. Methods: A questionnaire was distributed between May and August 2018 to 483 respondents among patients (health service users), providers, and other groups (includes members of civil society, politicians, social and religious elites, media personnel, and rights-based groups) in a regional area in Bangladesh. Of these participants, 58% were from urban areas and 42% from rural areas. As many as 78% were male and 22% female. A survey method and descriptive data analysis was performed to complete the study. Results: Participants in the study were aware and had knowledge about the linkage between human rights and health service provision, but they claimed the right to health has not been implemented in practice. The non-implementation of the right to healthcare is suggestive of a lack of political will, which negatively contributes to the social well-being of the larger population. It has undesirable effects on the development of the health system and the population’s health status. This reflects poor monitoring and performance of public institutions which has ramifications on the wider social parameters of social justice, equity, democratic values, transparency, and accountability. Conclusion: The development of population health is rooted in maintaining and promoting the right to healthcare. The ethical principle of human rights lies in the notions of human dignity, equity, equality, and social justice. The government should adhere to these values at societal levels and engage multiple stakeholders to promote the right to health for the benefit of a wider population.

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confidence: 99%

WITHDRAWN: Health and Human Rights Linkage in Bangladesh: Stakeholders’ views from the grassroots

Rahman¹,

Qattan²

2021

Preprint

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“…In this study we observed that some civil law countries (Ecuador, Ukraine) prescribe the structure, function, and responsibilities of these bodies in national law. Common law countries (Ghana, Philippines, South Africa) construct these types of public health infrastructure in policy rather than law [ 58 ]. For example, the national pharmaceutical policy in Ghana establishes the National Medicines Selection Committee and the National Medicines Price Committee; the latter committee sets prices for all reimbursed medicines [ 59 ].…”

Section: Discussionmentioning

confidence: 99%

“…Future research should investigate the effectiveness of legal interventions at enhancing patient-level knowledge about their medicine’s entitlements and lower-priced alternatives. Further studies should also explore which conditions and factors facilitate health providers, public authorities, and economic operators to provide the information about medicines pricing and benefits that they are required to [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

Essential Medicines in Universal Health Coverage: A Scoping Review of Public Health Law Interventions and How They Are Measured in Five Middle-Income Countries

Perehudoff

Demchenko

Alexandrov

et al. 2020

IJERPH

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Very few studies exist of legal interventions (national laws) for essential medicines as part of universal health coverage in middle-income countries, or how the effect of these laws is measured. This study aims to critically assess whether laws related to universal health coverage use five objectives of public health law to promote medicines affordability and financing, and to understand how access to medicines achieved through these laws is measured. This comparative case study of five middle-income countries (Ecuador, Ghana, Philippines, South Africa, Ukraine) uses a public health law framework to guide the content analysis of national laws and the scoping review of empirical evidence for measuring access to medicines. Sixty laws were included. All countries write into national law: (a) health equity objectives, (b) remedies for users/patients and sanctions for some stakeholders, (c) economic policies and regulatory objectives for financing (except South Africa), pricing, and benefits selection (except South Africa), (d) information dissemination objectives (ex. for medicines prices (except Ghana)), and (e) public health infrastructure. The 17 studies included in the scoping review evaluate laws with economic policy and regulatory objectives (n = 14 articles), health equity (n = 10), information dissemination (n = 3), infrastructure (n = 2), and sanctions (n = 1) (not mutually exclusive). Cross-sectional descriptive designs (n = 8 articles) and time series analyses (n = 5) were the most frequent designs. Change in patients’ spending on medicines was the most frequent outcome measure (n = 5). Although legal interventions for pharmaceuticals in middle-income countries commonly use all objectives of public health law, the intended and unintended effects of economic policies and regulation are most frequently investigated.

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“…These principles are: the right to health (n ≤2003 , = 0/32 policies, n ≥2004 = 13/39 policies, p = 0.000), government financing (n ≤2003 , = 6/32 policies, n ≥2004 = 18/39 policies, p = 0.015), efficient spending/cost-effectiveness (n ≤2003 , = 14/32 policies, n ≥2004 = 29/39 policies, p = 0.009), and financial protection of vulnerable populations (n ≤2003 , = 4/32 policies, n ≥2004 = 13/39 policies, p = 0.041). Full results are reported elsewhere [55].…”

Section: National Medicines Policiesmentioning

confidence: 99%

Universal access to essential medicines as part of the right to health: a cross-national comparison of national laws, medicines policies, and health system indicators

Perehudoff

2020

Global Health Action

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Background: Access to essential medicines for the world's poor and vulnerable has made little progress since 2000, except for a few specific medicines such as antiretrovirals for HIV/ AIDS. Human rights principles written into national law can create a supportive environment for universal access to medicines; however, systematic research and policy guidance on this topic is lacking. Objective: To examine how international human rights law and WHO's essential medicines policies are embedded in national law for medicines affordability and financing, and interpreted and implemented in practice to promote universal access to essential medicines. Methods: This thesis consists of (1) a cross-national content analysis of 192 national constitutions, 71 national medicines policies, and legislation for universal health coverage (UHC) from 16 mostly low-and middle-income countries; (2) a case study of medicines litigation in Uruguay, and (3) a follow-up report of eight right to health indicators for access to medicines from 195 countries. Results: Some, but not all, of the 12 principles from human rights law and WHO's policy are embedded in national UHC law and medicines policies (part 1). Even the most rights-compliant legislation for access to medicines is subject to the unique and inconsistent interpretation of domestic courts, which may be inconsistent with the right to health in international law (part 2). Many national health systems for which data were available still fail to meet the official targets for eight indicators of access to medicines (part 3). Conclusions: International human rights law and WHO policy are embedded in national law for essential medicines and practically implemented in national health systems. Law makers can use these findings and the example texts in this thesis as a starting point for writing and monitoring governments' rights-based legal commitments for access to medicines. Future research should study the effect of national law on access to medicines and population health.

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The right to health as the basis for universal health coverage: A cross-national analysis of national medicines policies of 71 countries

Cited by 20 publications

References 21 publications

WITHDRAWN: Health and Human Rights Linkage in Bangladesh: Stakeholders’ views from the grassroots

WITHDRAWN: Health and Human Rights Linkage in Bangladesh: Stakeholders’ views from the grassroots

Essential Medicines in Universal Health Coverage: A Scoping Review of Public Health Law Interventions and How They Are Measured in Five Middle-Income Countries

Universal access to essential medicines as part of the right to health: a cross-national comparison of national laws, medicines policies, and health system indicators

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