Access to medicines

One of the key building blocks of a well-functioning health system is ensuring equitable access to essential medical products, vaccines and technologies of assured quality and cost-effectiveness. But this is far from being achieved in developing countries. For large sections of the global population essential medicines even if available are unaffordable.

According to the World Health Organization (WHO), up to 90% of the population in developing countries purchase medicines through out-of-pocket payments, making medicines the largest family expenditure item after food. In Uganda, a recent survey estimated that the annual cost of purchasing effective medicines to treat just malaria was equivalent to 62 days of household basic food costs.

Studies have also shown that availability of essential medicines is often poor in the public sector where prices are usually cheaper, forcing patients to resort to the more expensive private sector.

We work across a wide range of areas to improve access to medicines as part of health systems.

Global action on access to medicines was catalysed at the beginning of the century by the challenge of making then very expensive antiretrovirals (ARVs) available to millions of HIV/AIDS sufferers in developing countries. Since then there have been significant improvements, including more than 3 million people in developing countries on ARV treatment in 2008 at a cost per head as much as 99% lower than in 2000.

But much more remains to be done in respect of HIV/AIDS, and in making accessible the full range of products needed to prevent and treat conditions that affect developing countries, including both infectious and non-communicable diseases and maternal and child mortality. Where products do not exist for particular conditions, investment in the development of new products is essential.

What DFID is doing

The UK Government has played a leading role in this international action. In July 2001, the Prime Minister established a high-level Working Group on Increasing Access to Essential Medicines in the Developing World. The group reported in November 2002, with recommendations focusing on affordable pricing and research and development into new medicines.

In June 2004, the Government released Increasing access to essential medicines in the developing world: UK Government policy and plans. This set out four strategies for UK action:

Support for access to medicines through the development assistance programme;
Engagement in trade policy to support access to medicines within the context of international agreements;
Engagement with the pharmaceutical industry to strengthen its contribution to increasing access to medicines; and
Support for increased investment in research and development (R&D) for health technologies that meet the needs of developing countries.

Actions taken since 2004 include:

Supporting the Global Fund to Fight AIDS, Tuberculosis and Malaria (up to £1 billion in the period 2008-2015), UNITAID, the international drug purchase facility, (up to £790 million over 20 years) and the Global Alliance for Vaccines and Immunisation (committing £1.38 billion to the International Finance Facility for Immunisation over twenty years). In 2008, £50 million was committed over five years to fight neglected tropical diseases, and £40 million to the Affordable Medicines Facility for Malaria
Piloting the Medicines Transparency Alliance (MeTA) as a multi-stakeholder initiative to increase transparency and accountability in pharmaceutical systems on the price, quality and availability of medicines
Launching an innovative partnership with the Clinton Foundation to reduce the price of selected drugs for HIV/AIDS and malaria through providing technical assistance to suppliers and purchasing governments
Publication of Increasing people’s access to essential medicines in developing countries: a framework for good practice in the pharmaceutical industry, the subject of a review of progress in 2008
Addressing the contentious area of intellectual property rights and access to medicines, including support for the WHO Commission on Intellectual Property, Innovation and Public Health
Committing to double DFID’s overall research budget to £220 million by 2010, including increased and more diverse funding to public-private partnerships for developing products needed to prevent and treat diseases mainly affecting developing countries
Pledging $485 million to the Advance Market Commitment for pneumococcal vaccines to accelerate the introduction of new vaccines adapted to the needs of developing countries