Markets and Policy Challenges in Access to Essential Medicines for Endemic Disease
Markets and Policy Challenges in Access to Essential Medicines for Endemic Disease
复制标题
DOI：
10.1093/jae/ejq017
复制
发表时间：
2010-01-01
影响因子：
1.6
通讯作者：
Mujinja, Phares G. M.
中科院分区：
文献类型：
--
作者：
Mackintosh, Maureen;Mujinja, Phares G. M.
获得基本药物是防治地方病所需的有效卫生系统的核心要素。成本效益高的准入反过来又取决于市场的有效运作和在国家和国际一级对市场作用采取适当政策。本文认为，目前促进获得基本药物的国际政策框架缺乏一致性，并显示拟议的市场干预措施的经验基础薄弱。对坦桑尼亚药品市场的一项研究对国际政策所依据的市场运作的一些假设提出了质疑，并显示了探索性实地研究如何能够缩小知识差距。药品政策的目标应是合理使用基本药品，并在使用点普遍免费提供治疗地方病和其他主要死因的基本药品。政府和非政府组织应采取行动，逐步限制基本药物零售市场不受管制的竞争。相反，应促进批发市场的竞争，而重建非洲制药业对于促进和维持获得机会至关重要。在每个市场层面，公共和非政府非营利贸易商和供应商可以发挥监管作用，同时提供更多的公民信息和公民行动。
Access to essential medicines is a core element of the effective health systems that are required to deal with endemic disease. Cost-effective access relies in turn on efficient market functioning and on appropriate polices towards the role of markets at national and international levels. This article argues that current international policy frameworks for promoting access to essential medicines lack coherence and display weak empirical foundations for proposed market interventions. A study of medicines markets in Tanzania questions some assumptions about market functioning underlying international policy, and shows how exploratory field studies can reduce the knowledge gap. Medicines policy should aim for rational use of essential medicines and for universal access free at the point of use to medicines essential to treat endemic diseases and other major causes of death. Unregulated retail market competition in essential medicines should be progressively constrained by government and NGO action. Wholesale market competition, in contrast, should be promoted, while the rebuilding of African pharmaceutical manufacturing is important for promoting and sustaining access. At each market level, public and non-governmental non-profit traders and providers can play a regulatory role alongside greater citizen information and civic activism.