Access to Essential Drugs in Poor Countries: A Lost Battle?

• Published in: JAMA : the journal of the American Medical Association Vol. 281; no. 4; pp. 361 - 367
• Main Authors: Pécoul, Bernard, Chirac, Pierre, Trouiller, Patrice, Pinel, Jacques
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Medical Association 27.01.1999
• Subjects: Biological and medical sciences; Developing Countries; Drug Industry; Drug therapy; Drug Utilization; Health Services Accessibility; International Agencies; International Cooperation; International institutions; LDCs; Medical sciences; Organizations and institutions for the application of policies; Pharmaceutical Preparations - economics; Pharmaceutical Preparations - standards; Pharmaceutical Preparations - supply & distribution; Pharmaceuticals; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality Control; Human; Antibiotic; Costs; Organization; Poverty; Treatment; Health economy; Parasiticid; Developing countries; Public health; WHO
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.281.4.361

Drugs offer a simple, cost-effective solution to many health problems, provided they are available, affordable, and properly used. However, effective treatment is lacking in poor countries for many diseases, including African trypanosomiasis, Shigella dysentery, leishmaniasis, tuberculosis, and bacterial meningitis. Treatment may be precluded because no effective drug exists, it is too expensive, or it has been withdrawn from the market. Moreover, research and development in tropical diseases have come to a near standstill. This article focuses on the problems of access to quality drugs for the treatment of diseases that predominantly affect the developing world: (1) poor-quality and counterfeit drugs; (2) lack of availability of essential drugs due to fluctuating production or prohibitive cost; (3) need to develop field-based drug research to determine optimum utilization and remotivate research and development for new drugs for the developing world; and (4) potential consequences of recent World Trade Organization agreements on the availability of old and new drugs. These problems are not independent and unrelated but are a result of the fundamental nature of the pharmaceutical market and the way it is regulated.