Availability

Availability can be restricted by a variety of factors, ranging from cost of medicines to transport problems and from fraud and inefficiency in the supply chain (for example in 2008 the Uganda Minister of Health told reporters that half the medicines bought by the government for the public health system were being siphoned off)  to doctors’ lack of knowledge about specific drugs. Weak health systems, a common deficiency in developing countries, can mean that staff and infrastructure to prescribe, dispense and deliver medicines are not available.

A vivid example of what availability means in practice is the treatment of AIDS. The development of a class of drugs known as anti-retrovirals (ARVs) promised to turn AIDS from a certain killer to a potentially manageable chronic illness. Partly because of their cost, they were available to some HIV-positive people in industrialised countries but to only a lucky few in the developing world. A concerted international effort is changing the situation. Data from Botswana suggest that in the year after anti-retroviral treatment was made widely available in the country, adult deaths fell eight per cent. UNAIDS/WHO reported that scaling up antiretroviral treatment in low- and middle-income countries in the four years to 2006 saved about two million life-years.

Inequity in securing access to drugs is matched by an imbalance in the way international pharmaceutical companies undertake research. Over 90 per cent of medicines research and development focuses on the medical conditions of the richest 20 per cent of the world’s population. New medicine is needed for diseases that disproportionately affect the poor, especially neglected diseases.

Increased transparency and accountability can ease all these problems and bottlenecks. MeTA’s approach is to organise multi-stakeholder groups – committees of people representing all organisations with an interest in health provision – and for participants to then harness the power of information to tackle the problems.

MeTA believes its work can add real value to the work that participating countries and their international partners are already doing to increase access to medicines and improve health.