E-DRUG: New PhD: The human rights basis of essential medicines policies and legislation
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Dear e-druggers,
On Sept 5, 2018 Ms. Katrina Perehudoff defended her PhD thesis, titled 'The right to health as the basis for universal access to essential medicines: A normative framework and practical examples for national law and policy', at the University of Groningen (Netherlands). Her research was supervised by myself and Prof. Brigit Toebes of the Global Health Law Groningen Research Centre.
Katrina's research studied how global human rights standards have been applied to essential medicines, how they correspond to targeted (national) policy measures, and how national governments have legalised, interpreted, enforced, and implemented those measures through national law and policy. She has developed a short check-list for pharmaceutical policies and medicine laws, and has collected practical examples of model text for national law and policy makers. Her findings are of value to the access to medicines community, who may wish to use them in their pharmaceutical policy analysis, advocacy, or research.
New knowledge and tools offered by this research
• An analysis of WHO’s policy tools for essential medicines (Model List of Essential Medicines, 2001 Guidelines for National Medicines Policies) in the light of right to health standards;
- A 12-point policy checklist that also serves as a wish list for (national) legal reform for access to medicines;
- Examples of legal texts from an analysis of 71 national medicines policies and case studies of legislation for universal health coverage in 16 countries. These examples may contribute to WHO's Medicines & Health Products Strategic Programme 2016-2030 goal 7 to develop model legislation for medicines reimbursement;
- A follow-up report of eight indicators for access to medicines in 195 countries, updating the initial 2008 report by the UN Special Rapporteur on the Right to Health.
Key recommendations
- WHO should develop guidelines for national law makers to embed universal access to medicines into domestic legal text, particularly in relation to universal health coverage. These guidelines can take the 12 principles for essential medicines and human rights in this thesis as a point of departure.
- WHO's policies for essential medicines should be revised to reflect the standards in international human rights law and WHO's own policies in related fields.
- WHO should develop a comprehensive online repository of domestic laws and policies that can be publicly consulted. The repository should encourage Member States to self-report on two indicators of access to medicines in domestic law, which serve as a snapshot of their legal commitments.
- WHO should establish an independent accountability mechanism based on these eight indicators of access to medicines, which could be complemented by the larger set of 24 indicators presented by the Lancet Commission on Essential Medicines Policies.
- WHO should sustain its efforts to systematically collect data on country-level access to medicines (i.e. National Health Accounts, essential medicines lists, Pharmaceutical Country Profiles) and support national surveys of medicines availability, price, and affordability.
- National Ministries of Health should undertake their own monitoring exercise of national law and policy using the 12-point policy checklist developed in this thesis, and address the gaps/areas of weakness.
- National courts should familiarise themselves with the right to health and facilitate its consistent application in domestic litigation.
- Patients, consumers, and public interest advocates should document and publish government performance on right to health indicators of access to medicines; they may also use the 12-point policy checklist to identify and advocate for areas of legal reform.
Thesis summary (3 pages): https://www.rug.nl/research/portal/files/64714038/Summary.pdf
Katrina's contact details: katrina.perehudoff@gmail.com
A pdf version of the full thesis is available on demand.
With best regards,
Hans V Hogerzeil, MD, PhD, FRCP Ed
Professor of Global Health and the Right to Health
University Medical Centre Groningen
The Netherlands
hans.hogerzeil@kpnmail.nl