THE CHALLENGES

1
THE CHALLENGES OPORTUNITIES OF ACCESS TO
MEDICINES IN AFRICA

• Dr Pascoal MOCUMBI, orig Mozambique,High
  Representative EDCTP
• ABRASCO/WFPHA

2
Access to essential drugs is increasing -yet too
many people still lack access
3
INEQUITABLE ACCESS

• About 30 of worlds population lacks regular
  access to essential medicines
• Over 50 are in poorest parts of Africa Asia
• In low and middle income 50 -90 of medicines
  are paid for by patients themselves, whereas in
  many high-income countries 70 are publicly
  funded

4
Africas Problems

• Poverty
• Heavy disease burden
• Poor and inadequate infrastructure
• Lack of capacity to RD medicines

5
OPPORTUNITIES

• AU/NEPAD Strategy to accelerate Africas
  self-sustained growth and promote long-term
  sustainable human development health systems
  development
• Innovative knowledge based partnerships to
  accelerate development of new medicines/technologi
  es for poverty related diseases, such as, AMANET,
  EDCTP, The Global HIV Vaccine Enterprise,
  DNDI,etc
• Positive Results in some countries adoption and
  implementation of strategies for securing access
  to medicines and technologies

6
Strategy For Securing Access To Essential Drugs

• Assessment development therapeutic access
• Affordability financial access
• Availability supply access

7
Drug financing alternatives

• Public financing
• Out-of-pocket spending
• Health insurance
• Donor financing
• Development loans

8
Meeting drug financing challenges

• Improving health services public financing
• Reducing out-of-pocket purchases
• Improving health insurance
• Making ODA and loans sustainable, through
  investment in sustainable drug services

9
Managing drug prices

• Generic drugs competition quality
  professional public acceptance
• Patented new drugs containing prices while
  promoting innovation exploring price reduction
  for countries most in need
• All drugs increasing financial resources
  reducing mark ups

10
Supply to public health facilities

• Central medical stores (CMS)
• Autonomous medical stores privatised CMS
• Primary distributor system centralised,
  privatised
• Direct delivery system decentralised, private
• Fully private

11
Private Sector Supply Systems

• Driven by profit
• Mainly urban based for profit wholesalers and
  retail pharmacies
• A number of not-for-profit generic wholesale
  agencies e.g. UNICEF, IDA,
• Funding mainly out-of-pocket expenses
• Affordability is a major challenge

12
Future Challenges optimising public/private mix

• Public sector financing supply system
  appropriate supply systems health sector
  reforms\improving efficiency and reducing waste
  e.g. decentralization
• Private sector geographic coverage in low income
  countries affordability/costs and local
  production

13
CONCLUSIONS

• Governments role is crucial
• Strategies with proved success must be used
  effectively
• Creativity is needed, especially for managing
  prices and improving supply systems
• An optimal public-private mix is needed for drug
  development, financing, and supply
• THANKS!