Availability, prices and affordability of the World Health Organization’s essential medicines for children in Guatemala

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Several World Health Organization (WHO) initiatives aim to improve the accessibility of safe and effective medicines for children. A first step in achieving this goal is to obtain a baseline measure of access to essential medicines. The objective of this project was to measure the availability, prices, and affordability of children’s medicines in Guatemala. Methods An adaption of the standardized methodology developed by the World Health Organization and Health Action International (HAI) was used to conduct a cross sectional survey to collect data on availability and final patient prices of medicines in public and private sector medicine outlets during April and May of 2010. Results A subset of the public sector, Programa de Accesibilidad a los Medicamentos (PROAM), had the lowest average availability (25%) compared to the private sector (35%). In the private sector, highest and lowest priced medicines were 22.7 and 10.7 times more expensive than their international reference price comparison. Treatments were generally unaffordable, costing as much as 15 days wages for a course of ceftriaxone. Conclusions Analysis of the procurement, supply and distribution of specific medicines is needed to determine reasons for lack of availability. Improvements to accessibility could be made by developing an essential medicines list for children and including these medicines in national purchasing lists.

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Publié le 01 janvier 2012
Nombre de lectures 10
Langue English
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Ansonet al. Globalization and Health2012,8:22 http://www.globalizationandhealth.com/content/8/1/22
R E S E A R C H
Open Access
Availability, prices and affordability of the World Health Organizations essential medicines for children in Guatemala Angela Anson1*, Brooke Ramay2, Antonio Ruiz de Esparza3and Lisa Bero4
Abstract
Background:Several World Health Organization (WHO) initiatives aim to improve the accessibility of safe and effective medicines for children. A first step in achieving this goal is to obtain a baseline measure of access to essential medicines. The objective of this project was to measure the availability, prices, and affordability of childrens medicines in Guatemala. Methods:An adaption of the standardized methodology developed by the World Health Organization and Health Action International (HAI) was used to conduct a cross sectional survey to collect data on availability and final patient prices of medicines in public and private sector medicine outlets during April and May of 2010. Results:A subset of the public sector, Programa de Accesibilidad a los Medicamentos (PROAM), had the lowest average availability (25%) compared to the private sector (35%). In the private sector, highest and lowest priced medicines were 22.7 and 10.7 times more expensive than their international reference price comparison. Treatments were generally unaffordable, costing as much as 15 days wages for a course of ceftriaxone. Conclusions:Analysis of the procurement, supply and distribution of specific medicines is needed to determine reasons for lack of availability. Improvements to accessibility could be made by developing an essential medicines list for children and including these medicines in national purchasing lists. Keywords:Guatemala, Essential medicines for children, National formulary, Availability, World Health Organization
Backgroundthe WHO constructed the first Essential Medicines List Children in poorer countries are more likely to die from for Children (EMLc) and launched theMake Medicines treatable conditions than those in higher resource settings Child Sizeeffort in December of 2007. This initiative because they do not receive appropriate or timely medica- aims to improve the accessibility of safe, effective and tions [1]. This is also true in Guatemala, where poverty quality medicines for children by promoting awareness contributes to the countrys high mortality rate for chil- and action through research, regulatory measures and dren under the age of five [2]. Millennium Development changes in government policy. Goal 4 (MDG4) states that a two-thirds reduction in mor- A vital first step to improving medicine access for chil-tality from 1990 to 2015 in children younger than five dren is measuring the availability and prices of essential years is essential for global development [3]. Compared to medicines present on pharmacy shelves and in national the rate of mortality in 1990, Guatemala will need to in- medicines lists. Data on medicine stock deficits and un-crease the rate of decline in childhood deaths from 75.8 to affordable prices creates an evidence base to inform the 25.3 deaths per 1000 to achieve the MDG goal by 2015 development of national and regional policies. A recent [4]. To assist member countries with achieving MDG4, survey of essential medicines for children in Africa exposed the severe lack of medicines for children in cen-* Correspondence: anganson21@gmail.com Equal contributors CA California, San Francisco oftalsospirmac,phadnaneiaslaemitnoaltrenicidemh,serotss[5].Theobjectivecidilinesist4dn1effitnernuoceirt ent of Clinical Pha iversit 91,441yrmacy,UnepSDAtmar063-,U22study is to measure access to childrenof this s medicines Full list of author information is available at the end of the article
© 2012 Anson et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.