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Readings on Access to Essential Medicines

Expanding drug access in Brazil: lessons for Latin America and Canada (2006) [1] (pdf)

Cohen C.

Canadian Journal of Public Health, Nov-Dec 2006.

This paper discusses Brazil’s efforts to provide essential medicines for its population while meeting international trade obligations.  The paper also discusses how Canada can facilitate improving drug access in Latin America through helping Brazil expand its role as a manufacturer and providing medicines to countries without manufacturing capabilities.

What Strategies to Boost Production of Affordable Fixed-Dose Anti-Retroviral Drug Combinations for Children in the Developing World? (2007) [2] (pdf)

Dionisio et al.

Current HIV Research, March 2007.

This study explores key issues, implications and interaction dynamics to boost production of easy-to-use and affordable fixed-dose combination (FDC) ARVs for children in the developing world. Potentials for equitable solutions are examined including priority steps and actions, appropriate treatment options and reliable forecasting methods for paediatric ARVs, as well as combination incentives to generic companies against market unattractiveness and enforced intellectual property (IP) rights.

Improving access to essential drugs for rural communities in Nigeria: the Bamako Initiative re-visited (2006) [3]

Chukuwani, Chinyere, A Olugbohi, E Ugbene. 

Pharmacy World and Science, April 2006.

This paper reviews offers a review of the pioneering Bamako Initiative (BI) which was introduced by WHO/UNICEF in the late 1980’s to improve access to essential drugs for the most vulnerable in the society and thus improve the health outcomes. However, almost 20 years post-inception, the outcomes and/or impact of the BI on the health indices of many implementing African countries remains varied, with not so significant improvement in health status being registered in a majority of countries. The authors ascribe the weak impact on health outcomes on poorly coordinated implementation and service delivery.

Approaches to rationing antiretroviral treatment: ethical and equity implications (2005) [4] (pdf)

Bennet, S, C Chanfreau.

Bulletin of the World Health Organization, July 2005.

This paper reviews the eligibility and targeting criteria used in four case-study countries [Mexico, Senegal, Thailand and Uganda] at different points in the scale-up of ART, with the aim of drawing lessons regarding ethical approaches to rationing.  Criteria include biomedical factors, adherence to treatment, prevention-driven factors, social and economic benefits, financial factors and factors driven by ethical arguments.  The effects of rationing mechanisms upon equity are critically dependent upon the implementation processes which should be closely monitored.