Overcoming Obstacles To Enable Access To Medicines For Noncommunicable Diseases In Poor Countries.
The modern access-to-medicines movement grew largely out of the civil-society reaction to the HIV/AIDS pandemic three decades ago. While the movement was successful with regard to HIV/AIDS medications, the increasingly urgent challenge to address access to medicines for noncommunicable diseases has lagged behind-and, in some cases, has been forgotten. In this article we first ask what causes the access gap with respect to lifesaving essential noncommunicable disease medicines and then what can be done to close the gap. Using the example of the push for access to antiretrovirals for HIV/AIDS patients for comparison, we highlight the problems of inadequate global financing and procurement for noncommunicable disease medications, intellectual property barriers and concerns raised by the pharmaceutical industry, and challenges to building stronger civil-society organizations and a patient and humanitarian response from the bottom up to demand treatment. We provide targeted policy recommendations, specific to the public sector, the private sector, and civil society, with the goal of improving access to noncommunicable disease medications globally.
Sandeep P. Kishore (sunny.kishore@gmail.com) is a fellow at Yale University, in New Haven, Connecticut, and president of the Young Professionals Chronic Disease Network, in Boston, Massachusetts.
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Kavitha Kolappa is a resident in psychiatry at Massachusetts General Hospital, in Boston, a and board member for the Young Professionals Chronic Disease Network.
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Jordan D. Jarvis is executive director of the Young Professionals Chronic Disease Network and a former postgraduate research fellow at the Harvard Global Equity Initiative, in Boston.
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Paul H. Park is director of noncommunicable diseases for Partners in Health-Rwanda and a member of Universities Allied for Essential Medicines, in Washington, D.C.
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Rachel Belt is a member of Universities Allied for Essential Medicines.
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Thirukumaran Balasubramaniam is a Geneva representative at Knowledge Ecology International, in Switzerland.
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Rachel Kiddell-Monroe is a special adviser for the Universities Allied for Essential Medicines, a board member for the Young Professionals Chronic Disease Network, and a member of the International Board for Médecins sans Frontières, in Geneva.
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D002908:Chronic Disease / Q000188:drug therapy / Q000191:economics*; D003141:Communicable Diseases / Q000188:drug therapy / Q000191:economics; D003906:Developing Countries; D016527:Drug Costs; D004345:Drug Industry / Q000458:organization & administration; D018954:Drugs, Essential / Q000008:administration & dosage / Q000191:economics; D005260:Female; D014943:Global Health; D017408:Guidelines as Topic; D017048:Health Care Costs; D018166:Health Care Reform; D006291:Health Policy; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D008297:Male; D011050:Policy Making; D011203:Poverty; D017149:Private Sector / Q000191:economics; D017150:Public Sector / Q000191:economics; D012959:Socioeconomic Factors
D018954:Drugs, Essential
Access To Care; Chronic Care; Health Economics; International/global health studies