Access to Essential Medicines selection, affordability, financing, supply systems Marthe M Everard Policy, Access, and Rational Use (PAR) Medicines Policy and Standards (PSM) World Health Organization (everardm@who.int)

Access to essential medicines - framework for coordinated action 1. Rational selection 4. Reliable health and supply systems 2. Affordable prices 3. Sustainable financing ACCESS

Access to essential medicines - a framework for coordinated action (1) 1. Rational selection - define what is most needed develop evidence-based treatment guidelines define EML based on treatment guidelines regularly update guidelines based on best evidence use for supply, reimbursement, training 2. Affordable prices - promote competition & reduce costs price information generics policies reduce duties, taxes, markups differential pricing of new essential medicines apply WTO/TRIPS safeguards as appropriate

Access to essential medicines - a framework for coordinated action (2) 3. Sustainable financing - increase sustainable funding increase public funding expand health insurance better use of out-of-pocket spending targeted external funding - grants, loans, donations 4. Reliable health & supply systems - ensure quality & availability integrate medicines in health sector development create efficient public-private-NGO mix assure medicine quality promote rational use of medicines

Disease patterns should guide medicine selection, supply management, use, training/supervision Medicine development Clinical guidelines, formularies Essential Medicines list Choice of medicine and non-drug treatments Training, supervision of health providers Financing, prices, supply management of medicines Patient Information, use of medicines

WHO Essential Medicines Library - Various information sources together WHO clusters WHO/PSM/PAR BNF Clinical guidelines Summary of clinical guidelines Drug Info: - WHO Model Formulary WHO/ExCee; Cochrane Reference info: - Reasons for inclusion - Systematic reviews - Key references WHO Model List WHO/PSM/QSM Quality info: - Basic quality tests - Int. Pharmacopoeia - Reference standards WCCs Oslo/Uppsala MSH-UNICEF-MSF Price/Cost info: - per unit - per treatment - per month - per case prevented Statistics Info: - ATC - DDD

Response - One strategy across WHO malaria tuberculosis other priority health problems HIV/AIDS childhood illness Four strategic objectives 1. Access - selection, financing, pricing, reliable health and supply systems 2. Quality and safety - standards, effective drug regulation, information 3. Rational use - health professionals and consumers, public and private 4. National drug policy - framework for collective action