Access to medication is a critical factor for ensuring healthy lives and promoting the well-being of all people across all ages.
Thanks to modern medical science, treatment in the form of medication now exists for almost all ailments, but essential medicine is still inaccessible to many people for reasons beyond their control.
Affordability can be a barrier; the medicine may be in short supply due to delivery issues in distribution channels, making continuity of treatment difficult; it may be of sub-standard quality, making it less effective and potentially dangerous.
The sentinel role of countries in terms of access to medicine has become more challenging than ever before, given the nature of the pathogens and reduction in time and space on travel.
The rising concern of non-communicable diseases requiring life course management makes access to medicine key for good health and prosperity.
Ensuring that all people everywhere can access essential medicines is one of WHO South-East Asia’s priority areas of work and a key tool for achieving the Sustainable Development Goals agenda 2030 of health and well-being for all.
In recent years, many countries have made notable progress in this regard. Affordability of priority medicines has increased, and supply has become steadier.
Flexibilities in global trade agreements have been leveraged to reduce prices in several countries; there are numerous regional examples of improved public sector purchasing.
The countries in the region have updated their Essential Medicines lists; supply-chain management systems have improved to be more effective and reliable.
And action by countries to improve quality of medicines has accelerated. Many countries have included health as the top priority in national goals. But we could do better.
Certain persistant inadequacies are yet to be addressed: Out-of-pocket spending -- including on essential medicines -- remains high; further, supply chains in some areas remain weak and countries lacking manufacturing capacity often cannot leverage competitive prices from suppliers.
Despite challenges, the region’s economic status is changing for the better, a positive sign that, however, will lead to reduced access to external financing for medicines and vaccines. This calls for self-reliance and collaboration among the countries in the region.
WHO takes initiative
The Southeast Asia region member countries, supported by WHO, launched South-East Asia Regulatory Network (SEARN) to enhance information sharing, collaboration and convergence of medical product regulatory practices across the region to guarantee access to high-quality medical products to their people.
There are three key areas of action: First, countries keep their Essential Medicines List (EML) and medicines policy current. By developing clear accountability systems for medicine selection and procurement, health authorities can harness opportunities for access to affordable medicines.
In response to the rising anti-microbial resistance, WHO experts have made major revisions in the antibiotics section of the EML, so countries in the region can follow the directions for proper antibiotic use.
The region’s economic status is changing for the better, a positive sign that, however, will lead to reduced access to external financing for medicines and vaccines
Also, across the region, countries are yet to capitalise on the massive drop in prices for a range of game-changing medicines -- most notably for Hepatitis C.
Second, guarantee quality and affordability of medicines.
The role of the National Regulator should be redefined to that of a facilitator for quality production.
This entails providing adequate technical assistance and handholding for achieving quality standards at the level of manufacturing as well. Countries should continue with targeted quality control and testing of medicines that are sub-standard or falsified.
From manufacture to sale, locally produced medicines should always meet international standards.
For affordability, the emphasis is on promoting competition, implementing a series of price control measures, encouraging doctors to prescribe generics, and regulating wholesale and retail mark-ups.
Developing pricing strategies linked to health insurance programs, especially where national schemes are in place, is equally important. Further, countries can actively exploit flexibilities in global trade agreements and bargain collectively when negotiating with medicine manufacturers.
The SEARN can help make regulation more efficient by developing the region’s diverse capacities and strengths, with significant gains.
Third, generating high-quality information on access to essential medicines within the countries so that the problems may be better addressed.Knowing where and why people are facing shortages, where unsafe or ineffective medicines are being sold, is essential to developing lasting solutions.
From smart-phone apps to household surveys, the array of tools at health authorities’ disposal is extensive.By using them effectively, authorities can gather the information needed to make smart, high-impact interventions that drive life-changing gains.
Essential medicines should be accessible to all, to achieve universal health coverage. Supported by a clear vision, the dream of health equity and the Sustainable Development Goals of health and wellbeing for all are within reach.
A healthier, more equitable and sustainable Southeast Asia Region can be ours.
Dr Poonam Khetrapal Singh is the Regional Director of the World Health Organization South-East Asia Region.