who medicines strategy - libdoc.who.int - World Health Organization

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WHO MEDICINES STRATEGY 2004-2007 | 14Figure 2: Estimated global share ofpharmaceutical consumption (by value) in low-,middle-, and high-income countriesEssential medicines also have a huge economicimpact on countries and on households. Indeveloping countries today, because of highprices, medicines account for 25%-70% oftotal health care expenditures, compared toless than 15% in most high-income countries.For governments and NGOs providing primaryhealth care, medicines are the largest expenseafter personnel costs. For households in lowincomecountries, medicines represent 50%-90%of out-of-pocket spending on health. Yet in somecountries, less than half of people living in poorhouseholds receive all the medicines they needfor acute illness – and one-third receive none ofthe medicines they need. Source: World Medicines Situation,WHO (forthcoming).Despite considerable progress in access toessential medicines over the last 25 years, anestimated 1.7 billion people today still have noregular access to quality essential medicines.While this is a smaller percentage of the globalpopulation than in 1977, when the first WHOModel List of essential medicines was published,gross inequity in access to medicines remains theoverriding feature of the world pharmaceuticalsituation.From 1985 to 1999, the global share ofpharmaceuticals production and consumption
MEDICINES AND PUBLIC HEALTH | 15(by value) increased in high-income countries,but fell in low-income countries — despitean increase in population. As a result, WHOestimates that 15% of the world’s populationconsumes 91% of the world’s production ofpharmaceuticals (by value).Compared to 1985, many more countries todayhave national medicines policies. However, inlow-income countries, all too often these policieslack implementation plans and supportingstrategies such as price control, generic promotionor the effective regulation of quality. Theserealities are a continuing challenge for WHO inpromoting the concept of essential medicines.Over the past 15 years, there have also beenchanges in the global context in which nationalmedicines policies are being implemented. Theglobal burden of disease has undergone a majorshift as both the scale and impact of HIV/AIDShave become fully apparent. In 1988, therewere an estimated 6.3 million HIV/AIDS casesworldwide. By the end of 2003 an estimated 40million people were living with HIV/AIDS. Ofthose, about 30% live in southern Africa — hometo just 2% of the world’s population — and anestimated 2.5 million are children under the ageof 15. During 2003, WHO estimates that about 5million people were newly infected with HIV andthere were about 3 million AIDS deaths.The global response to the HIV/AIDS pandemichas brought into focus a number of key issuesin medicines policy. One of these is the criticalimportance of innovation. The research anddevelopment of new, safe, and effective medicinesis critical to saving lives and reducing sufferingfrom a new disease on an epidemic scale.However, many of these new medicines havebeen at the centre of continuing controversiesabout prices and the legal limits to competitionthrough intellectual property rights in the form ofpatents. In a global trading situation, intellectualproperty rights occupy an important place andmedicines have held centre stage in discussionsin and around the World Trade Organization(WTO) about whether, and at what speed,implementation of a single set of internationaltrade rules should occur.
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REFERENCES
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REFERENCES | 1471Annual report 2000
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REFERENCES | 14912 th Model List of
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