Access to essential medicines in 195 countries: A human rights approach to sustainable development

ABSTRACT

In 2008 the UN Special Rapporteur on the Right to Health published 72 right to health indicators in 194 health systems. We present a follow-up report of eight indicators for access to medicines to serve as a reference point for progress towards SDG Target 3.8 on essential medicines. Data for these eight indicators in 2015 were collected and compared with the 2008 report. Between 2008 and 2015 we observed increased numbers of constitutions recognising access to medicines (7–13 countries), countries with a national medicine policy (118–122) and with a national list of essential medicines (78–107). Public spending on pharmaceuticals decreased or rose modestly in most of the 44 countries. Median availability of a basket of lowest-priced generics increased in the public (63%–70% n = 9 countries) and private (84%–92% n = 10) sectors. Median child immunisation rates remained constant for measles (around 90%) and improved for three doses of diphtheria-tetanus-pertussis (79%–86%). These eight indicators are useful and feasible, but should be further strengthened and expanded. Future monitoring exercises should use these indicators to screen progress and guide national governments’ action to ensure universal access to essential medicines as part of the right to health.

KEYWORDS:

• Access to medicines
• right to health
• universal health coverage
• essential medicines
• immunisation

Acknowledgements

We thank Dr. Marg Ewen, Dr. Tialda Hoekstra, Prof. Brigit Toebes, and Mr. Aäron Blomme.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data that support the findings of this study are available in Figshare at https://figshare.com/s/8cda5bd90602faa5ac9e. These data were derived from the following resources available in the public domain: The Constitute Project (https://www.constituteproject.org/content/about?lang=en); Health Action International’s Medicine Prices, Availability, Affordability & Price Components online database (http://www.haiweb.org/medicineprices/); WHO Development of Country Profiles and monitoring of the pharmaceutical situation in countries (http://www.who.int/medicines/areas/coordination/coordination_assessment/en/); WHO Essential Medicines and Health Products Information Portal (http://apps.who.int/medicinedocs/en/); WHO & UNICEF coverage of DTP3 online database (http://apps.who.int/immunization_monitoring/globalsummary/timeseries/tswucoveragedtp3.html); WHO vaccine-preventable diseases monitoring system (http://apps.who.int/immunization_monitoring/globalsummary); OECD Health at a Glance 2009 – Pharmaceutical expenditure (http://dx.doi.org/10.1787/health_glance-2009-en); OECD Health at a Glance 2015 – Financing of pharmaceutical expenditure (goo.gl/xHuXG6).

ORCID

S. Katrina Perehudoff http://orcid.org/0000-0003-3958-0244

Nikita V. Alexandrov http://orcid.org/0000-0001-5526-532X

Hans V. Hogerzeil http://orcid.org/0000-0003-3414-7724

Additional information

Funding

This research was funded through the authors’ employer, the University Medical Centre Groningen at the University of Groningen, which did not have a role in this study. The authors have had full control of all primary data.