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

COMPONENTS OF THE STRATEGY | 57Figure 13:Financing medicines: the Uganda experienceUS$2.30 gap translates into – US$4.00 - US$5.00 in out-ofpockethousehold expenditures on drugs14%8%66%12%GAPPROJECTCENTRALED kits = US$0.08 per capitaDECENTRALIZEDAdequate and sustainable financing of medicinesremains a remote prospect for almost half of theworld’s population.Since 1995, private sources of finance forpharmaceuticals have become more importantin all countries, with attendant risks to publichealth objectives. Governments’ share inpharmaceutical spending has fallen faster thantheir share in total health spending. Whileexternal assistance has boosted pharmaceuticalspending in a small number of countries, mostcountries with high HIV/AIDS mortality arestill spending less than US$ 5 per capita onmedicines.Both published studies and WHO NationalHealth Accounts confirm that pharmaceuticalsexpenditure in developing countries accountsfor 25%-65% of total public and private healthexpenditure, and for 60%-90% of out-of-pockethousehold spending on health. 21In Uganda, it was estimated that annual percapita medicine needs in 2002-2003 were US$3.50. Figure 13 shows that the available fundsfrom local, central, and externally funded projectsources totalled only US$1.20 per capita, leavingUS$2.30 per capita — or two-thirds of thefinancial resources for medicines — to be metfrom household sources. From these figures it wasestimated that a typical household’s out-of-pocketspending on medicines would have to be betweenUS$4 and US$5 for needs to be met. Such aheavy financial burden will obviously hit poorerhouseholds hardest.A much greater role for public finance is needed,involving both developing country governmentsand international donors. In addition, increasedefficiency in public finance is needed in order toexpand access to essential medicines.In view of the heavy burden ofmedicines expenditure, especiallyin developing countries, and theunique aspects of managing thiscritical health resource, WHOprovides guidance on financingthe supply of medicines, in aneffort to increase the affordabilityof essential medicines in both thepublic and private sectors.