10.4 Access to essential medicines and health equity
3 min read•august 9, 2024
is crucial for global health equity. The World Health Organization's guides countries in selecting vital drugs, while generic alternatives make treatments more affordable. and further improve access in low-income nations.
and trade agreements impact medicine availability. The sets global standards, but and provide flexibility. Universal health coverage and addressing are key to reducing disparities in access to care.
Access to Essential Medicines
Essential Medicines and Generic Drugs
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- Essential medicines list created by WHO guides countries in selecting vital medications
- List updated biannually includes around 350 drugs addressing priority health needs
- offer more affordable alternatives to brand-name medications
- Generic drugs contain same active ingredients as brand-name counterparts
- Generic drugs undergo rigorous testing to ensure (same therapeutic effect)
- Generic drugs typically cost 80-85% less than brand-name equivalents
- Increased availability of generic drugs improves access to essential medicines in low-income countries
Drug Donations and Global Health Initiatives
- Drug donations involve pharmaceutical companies providing medications to countries in need
- Drug donation programs address specific health issues (HIV/AIDS, malaria, neglected tropical diseases)
- World Health Organization Good Donation Practices guide responsible drug donation practices
- Global health initiatives coordinate efforts to improve access to essential medicines
- to Fight AIDS, Tuberculosis and Malaria provides funding for treatment and prevention
- focuses on increasing access to vaccines in low-income countries
- supports HIV/AIDS treatment and prevention globally
Intellectual Property and Trade
TRIPS Agreement and Compulsory Licensing
- TRIPS Agreement (Trade-Related Aspects of Intellectual Property Rights) sets global standards for intellectual property protection
- TRIPS Agreement requires WTO members to provide patent protection for pharmaceuticals
- Compulsory licensing allows governments to produce patented drugs without patent holder's consent
- Compulsory licensing used in public health emergencies or to address unmet medical needs
- Countries must negotiate with patent holders before issuing compulsory licenses
- Compulsory licensing helps balance intellectual property rights with public health needs
- Brazil and Thailand have used compulsory licensing to increase access to HIV/AIDS medications
Parallel Importation and Doha Declaration
- Parallel importation involves importing patented drugs from countries where they are sold at lower prices
- Parallel importation allows countries to access more affordable versions of patented medications
- TRIPS Agreement allows countries to determine their own rules for parallel importation
- affirms countries' right to protect public health and promote access to medicines
- Doha Declaration clarifies flexibilities in TRIPS Agreement for developing countries
- Doha Declaration extends deadline for least developed countries to implement pharmaceutical patent protection
- Doha Declaration facilitates use of compulsory licensing and parallel importation to address public health crises
Health Equity
Universal Health Coverage and Access to Care
- Universal health coverage aims to ensure all people have access to essential health services
- Universal health coverage includes financial protection against catastrophic health expenses
- Countries implement universal health coverage through various models (single-payer, multi-payer, national health service)
- Universal health coverage improves access to essential medicines and health services
- Thailand's Universal Coverage Scheme provides comprehensive health coverage to 75% of population
- Rwanda's community-based health insurance program covers over 90% of population
- Universal health coverage addresses barriers to care (financial, geographical, cultural)
Health Disparities and Social Determinants of Health
- refer to differences in health outcomes between population groups
- Social determinants of health influence health disparities (income, education, housing, environment)
- Low-income populations often face greater barriers to accessing essential medicines
- Rural populations may have limited access to healthcare facilities and essential medicines
- Ethnic and racial minorities experience disparities in health outcomes and access to care
- Addressing health disparities requires multifaceted approach (policy, education, community interventions)
- Initiatives to reduce health disparities include targeted outreach programs and culturally competent care
Key Terms to Review (18)
Access to essential medicines: Access to essential medicines refers to the ability of individuals and communities to obtain medications that are necessary for the treatment of prevalent health conditions, ensuring that these medicines are available, affordable, and appropriately used. This concept is critical for promoting health equity, as disparities in access can lead to significant differences in health outcomes among various populations. Ensuring access involves addressing barriers such as cost, availability, distribution systems, and the influence of pharmaceutical companies.
Bioequivalence: Bioequivalence refers to the property wherein two pharmaceutical products, typically a brand-name drug and its generic counterpart, have the same bioavailability, meaning they release the same active ingredient into the bloodstream at similar rates and extents. Establishing bioequivalence is crucial for regulatory approval of generics and biosimilars, ensuring they provide the same therapeutic effect as their reference products while facilitating competition in the market and increasing access to medications.
Compulsory Licensing: Compulsory licensing is a legal mechanism that allows a government to permit the use of a patented invention without the consent of the patent holder, typically to address public health needs or ensure access to essential medicines. This approach balances the rights of patent holders with the need for wider access to healthcare products, which can be particularly significant in developing countries facing health crises or affordability issues.
Doha Declaration: The Doha Declaration is a landmark agreement established during the Fourth Ministerial Conference of the World Trade Organization (WTO) in 2001, which emphasizes the importance of public health and access to essential medicines, especially for developing countries. This declaration addresses the challenges posed by intellectual property rights under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), ensuring that countries can take measures to protect public health and promote access to affordable medicines.
Drug Donations: Drug donations refer to the process of providing pharmaceuticals and medical supplies, often at no cost, to individuals or organizations in need, particularly in underserved areas. This practice is aimed at improving access to essential medicines, especially in low-income or developing regions, thereby promoting health equity and addressing disparities in healthcare access.
Essential Medicines List: The Essential Medicines List is a compilation of the most effective, safe, and cost-efficient medications necessary to address the priority health care needs of a population. This list serves as a guideline for governments and health organizations to ensure access to essential treatments, thereby promoting health equity and improving health outcomes for communities worldwide.
Gavi Alliance: The Gavi Alliance, also known as Gavi, is a global health partnership founded in 2000, dedicated to increasing access to vaccines in lower-income countries. It aims to improve health equity by ensuring that children everywhere can receive essential vaccines, thereby preventing diseases and improving health outcomes. Gavi works with various partners, including governments, international organizations, and the private sector, to strengthen immunization programs and facilitate access to affordable vaccines.
Generic drugs: Generic drugs are medications that are equivalent to brand-name drugs in dosage, strength, administration, and intended use but are sold under their chemical names rather than trademarked names. They play a crucial role in improving access to essential medicines and promoting health equity, particularly in low-income populations where cost is a significant barrier to treatment.
Global Fund: The Global Fund is an international financing organization dedicated to combating AIDS, tuberculosis, and malaria, providing support for health programs in over 100 countries. It plays a critical role in improving access to essential medicines and promoting health equity by funding various initiatives that ensure treatment and prevention services reach those in need, especially in low- and middle-income countries.
Global health initiatives: Global health initiatives are coordinated efforts, often involving multiple stakeholders, aimed at improving health outcomes on a worldwide scale. These initiatives address critical health challenges such as disease prevention, treatment access, and health system strengthening, often balancing the needs of public health with economic considerations. They play a crucial role in ensuring that health priorities are met in diverse contexts, bridging gaps between profit motives and public health requirements.
Health Disparities: Health disparities refer to the differences in health outcomes and access to healthcare that are often seen among different population groups, especially those defined by socioeconomic status, race, ethnicity, and geographic location. These disparities highlight significant inequities in the distribution of health resources and the quality of care received, impacting overall health equity in society.
Intellectual Property Rights: Intellectual property rights (IPR) are legal protections granted to creators and inventors for their inventions, designs, and artistic works. These rights enable holders to control the use of their creations, thereby incentivizing innovation and creativity, especially in healthcare sectors where research and development costs are high. The framework of IPR affects various aspects of the healthcare industry, influencing how new drugs and medical devices are developed, marketed, and accessed across different regions.
Parallel importation: Parallel importation refers to the practice of importing a product, typically pharmaceuticals, from one country to another without the consent of the manufacturer. This occurs when products are sold in one market at a lower price than in another, allowing third parties to buy and sell them across borders. This practice can enhance access to essential medicines, particularly in lower-income regions, while also raising concerns regarding quality control and intellectual property rights.
President's Emergency Plan for AIDS Relief (PEPFAR): PEPFAR is a United States government initiative established in 2003 to address the global HIV/AIDS epidemic, providing funding and resources to combat the disease primarily in low- and middle-income countries. By focusing on prevention, treatment, and care, PEPFAR aims to improve access to essential medicines and health services, contributing significantly to health equity for those affected by HIV/AIDS.
Social Determinants of Health: Social determinants of health refer to the conditions in which people are born, grow, live, work, and age that significantly influence their health outcomes. These factors include socioeconomic status, education, neighborhood and physical environment, employment, social support networks, as well as access to healthcare. They play a critical role in shaping health equity and determining how effectively individuals can access essential medicines and services.
TRIPS Agreement: The TRIPS Agreement, or the Agreement on Trade-Related Aspects of Intellectual Property Rights, is a landmark international treaty administered by the World Trade Organization (WTO) that establishes minimum standards for the protection and enforcement of intellectual property rights across member countries. This agreement connects to various aspects of international trade, healthcare innovation, and access to medicines by harmonizing intellectual property laws among nations.
Universal Health Coverage (UHC): Universal Health Coverage (UHC) is a health care system where all individuals have access to essential health services without suffering financial hardship. It emphasizes the importance of providing equitable access to quality health care, including essential medicines, preventive services, and treatment options, ensuring that no one is left behind due to economic constraints.
World Health Organization (WHO): The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. It aims to promote health, keep the world safe, and serve vulnerable populations by coordinating responses to health emergencies and setting global health standards. WHO plays a crucial role in historical trends of healthcare markets, overseeing post-market safety monitoring for medical products, and working towards equitable access to essential medicines worldwide.