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What do we know about access to chronic disease medicines ?

Dr Shanthi Mendis

Coordinator

Chronic Diseases Prevention and Management

Department of Chronic Diseases and Health Promotion

World Health Organization

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Noncommunicable DiseasesNoncommunicable Diseases

Cost effective interventions

• Cardiovascular diseaseCardiovascular disease• Chronic lung diseaseChronic lung disease• Diabetes Diabetes

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Global mortality

Cardiovascular diseases 30%

Cancer 13%

Other NCDs, Other NCDs, injuries injuries & mental health& mental health18% 18%

CommunicableCommunicable maternalmaternal infant 30% infant 30%

RespiratoryRespiratory7%7%

Diabetes 2%Diabetes 2%

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.

.

.

Essential Complimentary Strategies for Essential Complimentary Strategies for NCD prevention and controlNCD prevention and control

Population- wide

Primary prevention in high risk groups

Secondary prevention

5

30

40

81

48

0 20 40 60 80 100

Statins

BB

ACEI

Aspirin

Overall Percentage in 10 countries

Secondary Prevention of Heart Disease Secondary Prevention of Heart Disease

WHO PREMISE 2003Bulletin of the WHO 2005;83;820-828

Percentage

Drugs

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Affordability and Availability of 32 Affordability and Availability of 32 medicines for NCDs in 6 LMIC medicines for NCDs in 6 LMIC

••< 7.5% of the medicines available in public sector< 7.5% of the medicines available in public sector

•Cost of medicines in the private sector high •Cost of medicines in the private sector high

Affordability and Availability of 32 Affordability and Availability of 32 medicines for NCDs in 6 LMIC medicines for NCDs in 6 LMIC

••< 7.5% of the medicines available in public sector< 7.5% of the medicines available in public sector

•Cost of medicines in the private sector high •Cost of medicines in the private sector high

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1.5

6.1

17.4

5.4

0 10 20 30

Sri Lanka

Nepal

Pakistan

Malawi

AffordabilityAffordabilityNumber of days' wages for 1 month medicines after a heart attack Number of days' wages for 1 month medicines after a heart attack

WHO 2006Days

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Access to medicines for diabetes, asthma, CVDAccess to medicines for diabetes, asthma, CVD

Is it equitable ? Is it equitable ?

Do patients with Type I diabetes die because they are too Do patients with Type I diabetes die because they are too poor to get insulin?poor to get insulin?

Do asthma get hospitalized with acute attacks because Do asthma get hospitalized with acute attacks because they cannot afford asthma medicines?they cannot afford asthma medicines?

Can heart disease patients e who earn a daily wage afford Can heart disease patients e who earn a daily wage afford to buy medicines? to buy medicines?

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Thank YouThank YouThank YouThank You