E-DRUG: Availability of essential children's medicines
-------------------------------------------------------------
Robertson J, Forte G, Trapsidac J-M, Hill Sl. What essential medicines
for children are on the shelf? Bull World Health Org 2009; 87 Published
online: 6 January 2009. DOI: 10.2471/BLT.08.053645
http://www.who.int/bulletin/volumes/87/08-053645.pdf
Jane Robertson,a Gilles Forte,b Jean-Marie Trapsida c & Suzanne Hill b
aUniversity of Newcastle, Callaghan, NSW, 2308, Australia. bWorld Health
Organization, Geneva, Switzerland. cWorld Health Organization, Regional
Office for Africa, Brazzaville, the Republic of the Congo.
Correspondence to Jane Robertson (e-mail: jane.robertson@newcastle.edu.au).
Abstract
Objective. To document the inclusion of key medicines for children in
nationalessential medicines lists (EMLs) and standard treatment
guidelines, and to assess the availability and cost of these medicines
in 14 countries in central Africa.
Methods. Surveys were conducted in 12 public and private sector medicine
outlets in each country’s capital city. Data were collected on medicine
availability on the surveyday and on the cost to the patient of the
lowest priced medicine in stock.
Findings. The proportion of survey medicines in national EMLs ranged
from 50 to 90%. In only three countries were more than 50% of such
medicines available from central medical stores (range: 15–75%).
Availability in nongovernmental organizationstores was not consistently
better (range: 10–65%) but tended to be higher inteaching hospitals,
although the range was similar (15–70%). District hospitals(range:
10–80%) had slightly better availability than teaching hospitals, while
primaryhealth care clinics generally had poorer availability (range:
28–48%). Retail or privatepharmacies tended to have more survey
medicines available (range: 38–63%).There was considerable variability
in prices, which tended to be higher in retailpharmacies.
Conclusion. The availability of key essential medicines for children was
poor. Better understanding of the supply systems in the countries
studied and of the pattern of demand for medicines is needed before
improvements can be made. Medicines must be available, affordable and
acceptable to patients. Substantial progress towards Millennium
Development Goals will not occur without a major effort toimprove access
to medicines for children.