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Essential Medicines Are More Available than Other Medicines around the Globe

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  • Yaser T Bazargani
  • Margaret Ewen
  • Anthonius de Boer
  • Hubert G M Leufkens
  • Aukje K Mantel-Teeuwisse

Abstract

Background: The World Health Organization (WHO) promotes the development of national Essential Medicines Lists (EMLs) in order to improve the availability and use of medicines considered essential within health care systems. However, despite over 3 decades of international efforts, studies show an inconsistent pattern in the availability of essential medicines. We evaluated and compared the availability of essential medicines, and medicines not included in national EMLs, at global and regional levels. Methods: Medicine availability in the public and private sector were calculated based on data obtained from national and provincial facility-based surveys undertaken in 23 countries using the WHO/HAI methodology. The medicines were grouped according to their inclusion (‘essential’) or exclusion (termed ‘non-essential’) in each country’s EML current at the time of the survey. Availability was calculated for originator brands, generics and any product type (originator brands or generics) and compared between the two groups. Results were aggregated by WHO regions, World Bank country income groups, a wealth inequality measure, and therapeutic groups. Findings: Across all sectors and any product type, the median availability of essential medicines was suboptimal at 61·5% (IQR 20·6%–86·7%) but significantly higher than non-essential medicines at 27·3% (IQR 3·6%–70·0%). The median availability of essential medicines was 40·0% in the public sector and 78·1% in the private sector; compared to 6·6% and 57·1% for non-essential medicines respectively. A reverse trend between national income level categories and the availability of essential medicines was identified in the public sector. Interpretation: EMLs have influenced the provision of medicines and have resulted in higher availability of essential medicines compared to non-essential medicines particularly in the public sector and in low and lower middle income countries. However, the availability of essential medicines, especially in the public sector does not ensure equitable access.

Suggested Citation

  • Yaser T Bazargani & Margaret Ewen & Anthonius de Boer & Hubert G M Leufkens & Aukje K Mantel-Teeuwisse, 2014. "Essential Medicines Are More Available than Other Medicines around the Globe," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-7, February.
    • Handle: RePEc:plo:pone00:0087576
    DOI: 10.1371/journal.pone.0087576
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    Cited by:

    1. Josephine Walker & Betty B Chaar & Numa Vera & Alvish S Pillai & Jessy S Lim & Lisa Bero & Rebekah J Moles, 2017. "Medicine shortages in Fiji: A qualitative exploration of stakeholders’ views," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-16, June.
    2. Tomasz Zaprutko & Dorota Kopciuch & Krzysztof Kus & Piotr Merks & Monika Nowicka & Izabela Augustyniak & Elżbieta Nowakowska, 2017. "Affordability of medicines in the European Union," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-13, February.
    3. Felix Khuluza & Lutz Heide, 2017. "Availability and affordability of antimalarial and antibiotic medicines in Malawi," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-15, April.
    4. Simon Schäfermann & Richard Neci & Edward Ngah Ndze & Fidelis Nyaah & Valentin Basolanduma Pondo & Lutz Heide, 2020. "Availability, prices and affordability of selected antibiotics and medicines against non-communicable diseases in western Cameroon and northeast DR Congo," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-16, January.
    5. Yaser T Bazargani & Anthonius de Boer & Hubert G M Leufkens & Aukje K Mantel-Teeuwisse, 2014. "Selection of Essential Medicines for Diabetes in Low and Middle Income Countries: A Survey of 32 National Essential Medicines Lists," PLOS ONE, Public Library of Science, vol. 9(9), pages 1-8, September.

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