Two billion men and women in developing countries cannot get essential medicines

November 21, 2011 – Two billion men and women in developing countries cannot get essential medicines
Once Every Seven Years World Experts Meet to Discuss Misuse of Medicines in Low- and Middle Income Countries. Eight Indonesian Researchers Attended this Prestigious Meeting.


High medicine costs push 150 million people below the poverty line each year.  In many low- and middle income countries, one month of life-saving insulin treatment for diabetes may cost half a month’s salary. In one Asian country, 42% of medicine costs is spent on bribing the doctors.  In Oman, misuse of antibiotic use has been reduced by half since 1995. Cell phone messages remind  East-African AIDS patients to take their medicines.
When Catherine Adwoa suddenly fainted and fell ill, her mother first thought she had AIDS. But when she was rushed to the district hospital, she was relieved to hear that that was not the case. The doctor told the 17-year old schoolgirl she had diabetes.  But her father knew immediately that his life would never be the same again. From now on, the daily injections of insulin for his daughter would cost him half his salary. Like in most other African countries medicines for AIDS are free, but treatment for diabetes is not. Hospitals rarely have the injections in stock, so he would have to go around private pharmacies to get the life-saving medicine for the rest of his life, which meant there would be no money left to pay for school fees.
Over 600 world experts on essential medicines met in Antalya, Turkey for the Third International Conference on Improving the Use of Medicines (ICIUM). They heard several similar stories from developing countries from all over the world – how life-saving treatments for malaria are not available in private pharmacies of East Africa; how unscrupulous local manufacturers continue to produce and promote malaria drugs that the World Health Organization has recommended be taken off the market because they lead to resistance; and how 42% of the price of medicines in one Asian country is spent on bribing the doctors.
Delegates from over 80 countries who attended ICIUM also learned that more people in developing countries die from chronic diseases such as hypertension, asthma and diabetes, than from infectious diseases such as AIDS and tuberculosis. Unfortunately very few governments do anything about it.
But there was also good news. The medicines for a year of treatment of such chronic diseases cost less than $6 dollars – provided they are bought as generic (off-patent) medicines and provided the local distributor, the pharmacist and the doctor do not add another 10 or 20 dollars to the price. The Sultanate of Oman has succeeded in drastically reducing the use of antibiotics (from 60% of prescriptions in 1995 to 15% of prescriptions in 2010), thus reducing the chance that resistance develops. Specially trained drug sellers in Tanzania, called ADDOs (Accredited Drug Dispensing Outlets), supply essential medicines of good quality to patients in rural areas.
ICIUM Conferences are only held every seven years. Earlier conferences were in 1997 and 2004, both in Thailand. This time ICIUM was held in Turkey to allow for more delegates from the Middle East to participate. The conference was originally planned to take place in Alexandria (Egypt) but had to be relocated in view of the political unrest in the region. However, over 250 Egyptian experts and students attended the conference through a live webcast. Special attention was given to the needs of the people in countries of the “Arab Spring” with examples of constitutional text from other countries reflecting access to essential medicines as part of human rights.
AIDS has become a chronic disease, for which life-long treatment in needed. There are now more cell-phones in Africa than in the USA and Canada together. A very promising development is the use of cell-phones and short text messages in several African countries to remind AIDS patients about their appointments to get their medicines.
Delegates also heard that in most countries, women did not have more difficulty than men in getting their medicines; but more such studies are needed in countries such as Yemen, Somalia, Pakistan and India. As Dr Anita Wagner of Harvard University, one of the organizers of the conference, put it: “In most developing countries, both men and women have equally bad access to essential medicines.”
Eight Indonesian researchers were invited to attend this prestigious meeting to present their works on various topics related to the use of medicines in the Indonesia context. The topics were Empathic Caring Consultation to Reduce Unnecessary Use of Analgesics (Prof. Johana E. P. Hadiyono/UGM), Compounding Polypharmacy Prescription and Impact of IT based Promotion of Rational Use of Medicine (dr. Purnamawati P. Sujud, SpAK /Concern & Caring Parent Foundation), Using CBIA-DM Strategy to Improve Diabetic Patients’ Adherence (Dra. Titien Siwi Hartayu, M.Kes., Apt./ Sanata Dharma University Yogyakarta), Using CBIA-Pregnancy to Improve Skills in Selecting OTC Medicines (Sri Hidayati, S.Ked/UGM), Using CEMA-Community to Improve Skill in Evaluating Medicine Advertisements (Dra. Chairun Wiedyaningsih, Apt /UGM), Antibiotic Surveillance in ICU (dr. Zunilda Djanun M.S., SpFK/FK-UI & RSCM), Generic Medicine Pricing Policies Evaluation (Yusi Anggraini, M.Kes/ Universitas Pancasila), and Self Medication with Antibiotics (Aris Widayati, M.Si., Apt/ Sanata Dharma University Yogyakarta). These presented studies were very well-received by participants of the conference.
The World Health Organization estimates that about one third of the world’s population – around 2 billion people – does not have regular access to essential medicines. Richard Laing, coordinator  for medicine policy at WHO’s Essential Medicines Programme, adds “These estimates have recently been confirmed by household surveys in countries such as Uganda. And every year, about 150 million people sink below the poverty line because of the high cost of the medicines they have to buy.”
For more information please contact:
ICIUM website: http://www.icium.org
dr. Rustamaji, M.Kes.,  Centre for Clinical Pharmacology and Drug Policy Studies, rustamaji.farklin@gmail.com
Anita Wagner, Harvard Medical School, tel: +65-9003-37

One Response to “Two billion men and women in developing countries cannot get essential medicines”

  1. Two billion men and women in developing countries cannot get essential medicines « Health and Medical News and Resources Says:

    […] Two billion men and women in developing countries cannot get essential medicines […]

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