E-DRUG: Free essential medicines (3)
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I'd like to endorse Reinhard Huss's comments, and to ask why user
charges for medicines are supposed to be so necessary in poorer
countries when medicines are free to a very high proportion of users in
(for example) the UK national health service? This exemption from
payment covers about two-thirds of all prescriptions dispensed in retail
pharmacies in England - including everyone under 16 or over 60, pregnant
women, people on social security benefit and people with a specific
chronic disease (diabetes etc). Of course, it costs a lot of money to do
this - but who pays for it is largely a question of deciding national
priorities for investment in the health of the population (and thus in
the prosperity and security of the country) rather than a judgment about
whether or not individuals will or won't "appreciate" their treatment
when a payment is required at individual level. All too often, we seem
to impose much harsher rules on poor countries than we do in our own
richer ones. The issue of paying for medicines seems to be one of those
instances.
During the last few years, I have heard so many times from people who
are trying to get treatment in low-resource settings, about the fact
that large sectors of the population simply do not have money for the
"cost-sharing" user fees at clinics, as well as the costs of bus fares,
food, child care and lost employment income when accessing health
services. The arrival of antiretroviral treatment for HIV/AIDS has only
highlighted this even more - the problem was already there but now it is
even more urgent. Availability of drugs in a clinic or pharmacy is not
the same as a patient having access to those drugs. Not for nothing is
the AIDS epidemic called an emergency - and we have to think and act
differently to deal with it, and act fast. "Free-by-5" (not just "3 by
5")for HIV treatment is not an empty slogan, but a statement of pressing
need - not just for ARVs but for many other essential medicines as well.
Of course access to medicines is only one of many factors in the fight
to improve health but we have the means to resolve this, so that we can
then concentrate all the more on building capacity and quality in health
services, in building healthy communities and combating the stigma and
poverty that still prohibit people's attempts to achieve health for
themselves and their families.
Carolyn Green
Sen.Programme Officer, Care & Support
International HIV/AIDS Alliance
104-106 Queens Road
Brighton BN1 3XF
United Kingdom
direct phone: +44 1273 718747
main phone: +44 1273 718900
cellphone: +44 773311 2368
cgreen@aidsalliance.org
Supporting community action on HIV/AIDS in over 20 countries