# \[e-drug\] Increasing availability of essential medicines for noncommunicable diseases **URL:** \ **Category:** e-drug\ **Created:** [March 19, 2014, 3:38pm UTC](https://talk.edrugplus.org/t/e-drug-increasing-availability-of-essential-medicines-for-noncommunicable-diseases/40248 "2014-03-19T15:38:30Z")\ **Posts on this page:** 3\ **Page:** 1
**Author:** ![Douglas\_Ball3](https://avatars.discourse-cdn.com/v4/letter/d/edb3f5/32.png) [@Douglas\_Ball3](https://talk.edrugplus.org/u/Douglas_Ball3)\ **Post date:** [March 19, 2014, 3:38pm UTC](https://talk.edrugplus.org/t/e-drug-increasing-availability-of-essential-medicines-for-noncommunicable-diseases/40248/1 "2014-03-19T15:38:30Z")
E-DRUG: Increasing availability of essential medicines for noncommunicable diseases ---------------------------------------------------------------------------------------------------------- [PLEASE DO NOT CLICK REPLY. Please respond directly to Douglas Ball \ as requested in the message.] Dear E-Druggers    Noncommunicable diseases (NCDs) such as diabetes, cardiovascular    disease, chronic respiratory disease and cancer are now the leading    cause of death worldwide with about 80% of these deaths occurring in    low- and middle-income countries. NCDs threaten to undermine gains    made in the delivery of health services in these countries with a    substantial impact on future socio-economic development.    The 'Global Action Plan for the prevention and control of    noncommunicable diseases 2013-2020' and its monitoring framework   [http://www.who.int/nmh/events/ncd\_action\_plan/en/](http://www.who.int/nmh/events/ncd_action_plan/en/)) have established a set of targets for countries to meet in order to stem    the growing epidemic of NCDs. In terms of pharmaceuticals, one target    is of "at least 80% availability of the affordable basic technologies    and essential medicines, including generics, required to treat major    noncommunicable diseases" to be achieved by countries.    I am working with colleagues at the World Health Organization to look    at whether establishing a global or regional procurement facility for    noncommunicable disease (NCD) medicines and technologies could support    countries in achieving this target of 80% availability of essential    NCD medicines or if there are other mechanisms that separately or    together with this could do the same.    Examples of existing procurement mechanisms that it might be modeled    on include the PAHO Strategic Fund, the Global Drug Facilty (TB), the    Asthma Drug Facility, the Organisation of Eastern Caribbean States    pooled procurement or the Gulf Cooperation Council group purchasing    scheme.    I would welcome the views of E-Druggers on this concept of having a    global or regional procurement facility that would be available for    countries to purchase selected NCD essential medicines.    - Would it be effective in addressing availability of medicines in    facilities (public or private)?    - Would countries be willing to use such a facility ? Would they be    willing to pay in advance for the health products ?    - What other support would be needed to make it effective e.g.    forecasting, MIS ?    - What potential pitfalls or constraints would there be ?    - Which NCD medicines would be best suited to such a facility e.g.    limited-source vs. multi-source products ?    - What should WHO's role be in a procurement facility of this nature?    - What other mechanisms are there for supporting country procurement    units to address this issue ? e.g. procurement price transparency to    improve negotiating power    If you have any thoughts or advice about this, I would be pleased to    receive them to feed into the report that will examine the    desirability and feasibility of such a mechanism.    Please send me an e-mail to douglasball@yahoo.co.uk with your    comments, views, insights, experiences by 28 March 2014.    Regards   Douglas Ball Temporary advisor, World Health Organization Tel: +63-2-354.7891 (Philippines) Mobile: +63-921.500.6806 (Philippines) E-mail: douglasball@yahoo.co.uk References 1. [http://www.who.int/nmh/events/ncd\_action\_plan/en/](http://www.who.int/nmh/events/ncd_action_plan/en/) ---
**Author:** ![Donald\_Light](https://avatars.discourse-cdn.com/v4/letter/d/ecccb3/32.png) [@Donald\_Light](https://talk.edrugplus.org/u/Donald_Light)\ **Post date:** [March 22, 2014, 7:25am UTC](https://talk.edrugplus.org/t/e-drug-increasing-availability-of-essential-medicines-for-noncommunicable-diseases/40248/2 "2014-03-22T07:25:53Z")
E-DRUG: Increasing availability of essential medicines for noncommunicable diseases (2) --------------------------------------------------------------------------------------------------------- A major contribution to increased access and also to stopping incentives for companies to develop mainly new drugs with few or no advantages for patients would be value-pricing, that is paying more than the prices of existing drugs in proportion to how much better they are than existing drugs. That's how my mother (and yours?) shopped on a limited budget, and that's what rewards good research. The senior oncologist, Hagop Kantjarian, for example, has published several articles on the unaffordable prices of new cancer drugs that usually are little or no better for patients. Yet their high prices break the budget, cause patients to use up their lifetime savings, and have nothing to do with added value. In response, companies are devoting large portions of R&D to developing as many clinically minor new cancer drugs as they can. Income from the unwarranted high prices then pays leading oncologists to tell their colleagues how great they are. (See [http://www.medscape.com/viewarticle/805503](http://www.medscape.com/viewarticle/805503) and others at [https://www.google.it/?gfe\_rd=ctrl&ei=NDotU9HcHMfW8gfchYDQAg&gws\_rd=cr#q=hagop+Kantjarian](https://www.google.it/?gfe_rd=ctrl&ei=NDotU9HcHMfW8gfchYDQAg&gws_rd=cr#q=hagop+Kantjarian) ) Don Light ---
**Author:** ![Douglas\_Ball3](https://avatars.discourse-cdn.com/v4/letter/d/edb3f5/32.png) [@Douglas\_Ball3](https://talk.edrugplus.org/u/Douglas_Ball3)\ **Post date:** [April 3, 2014, 7:12am UTC](https://talk.edrugplus.org/t/e-drug-increasing-availability-of-essential-medicines-for-noncommunicable-diseases/40248/3 "2014-04-03T07:12:32Z")
E-DRUG: Availability of essential medicines and technologies for NCDs -------------------------------------------------------------------------------------- [PLEASE DO NOT CLICK REPLY. Respond directly to douglasball@yahoo.co.uk as requested in the message.] Dear colleagues Two weeks ago I asked for feedback on the concept of a 'drug procurement facility' for NCD essential medicines and health technologies to feed into a report examining this issue for WHO in order to support countries increase availability of NCDs in line with the Global Action Plan for NCDs. I am grateful to those who responded. I am now coming back with a follow-up question in the event that a procurement facility is not the highest priority. Q: What specific actions or interventions could and/or should be done to support countries in their own procurement of NCD essential medicines and health technologies or to spur demand or shape supply markets? Some of the earlier responses already spoke about the need for a systems approach and capacity building and avoiding more 'vertical' programs that do not need repeating. But you may have views about WHO could direct such activities or of other innovative ways to address this need at a regional or global level. Or perhaps you have more specific ideas or problems you have encountered that influence the availability of NCD essential medicines and health technologies that need to be considered e.g. EML to be updated to reflect latest/any corticosteroid asthma inhaler, reform of procurement laws to allow purchases from international agencies with domestic funds, scale-up capacity of cold-chain to support insulin procurement and distribution, etc. Or how should demand be driven, and what steps should this follow in concert with measures to strengthen the health system for NCDs? The focus is largely on diabetes, CVD, chronic respiratory disease and cancer, but this should not preclude thoughts related to other NCDs since these principles apply across the board. If you would like to contribute your ideas to this consultation, please e-mail me at douglasball@yahoo.co.uk. Thanks and regards Douglas Ball -- Temporary advisor, World Health Organization Tel: +63-2-354.7891 (Philippines) Mobile: +63-921.500.6806 (Philippines) E-mail: douglasball@yahoo.co.uk