Medicines
The first synthetic pharmaceutical, Aspirin, was introduced in 1897. Since then there have been incredible advances in drugs for a wide range of health concerns including disease, mental health and other conditions. Today there are thousands of drugs on the market able to prevent, treat and lessen the impact of ailments that would have been fatal just a few generations ago. At the same time, antimicrobial resistance is challenging the effectiveness of many commonly used medicines in one of the most concerning threats to global health today.
Access to appropriate medications is shown to have substantial impacts on community health and the related economic indicators. Quality-assured, safe and effective medicines, vaccines and medical devices are fundamental to a functioning health system. However, globalized trade can undermine regulation, and in resource-limited settings especially, incidence of substandard or falsified medicines is growing. Working to increase access to essential pharmaceuticals while limiting the spread of falsified products is at the heart of WHO’s global strategy on medicines.
Equal access and the reliable supply of medicines is an ongoing goal of WHO and global health delivery systems, the achievement of which is hampered by several factors. The first is regulatory issues, which can affect how medicines are bought to market, create lag times and cause the supply of medicines in some areas of the globe to be delayed long after they are available elsewhere. High prices, misuse of drugs and poor or unreliable drug quality contribute to this issue. Price has long been a barrier in poor countries, but because of sharp increases in recent years, this issue is spreading to some wealthy countries as well.
The price of medicine remains the largest impediment to access and the economic impact of pharmaceuticals is substantial. They are the largest public expenditure on health after personal costs in many low-income countries, and the expense is a major cause of household impoverishment and debt. Public expenditure ranges widely between nations, from under 20% of total healthcare costs in high-income countries to up to 66% in low-income countries.
Universal health coverage can only be achieved when there is affordable access to safe, effective and quality medicines and health products. WHO works with partners and Member States to strengthen regulation, including post-marketing surveillance, and to eliminate substandard and falsified medicines. It also develops international norms and standards so that countries worldwide can regulate health products and technologies consistently. In parallel, WHO facilitates access to quality-assured, safe and effective health products by assessing medicines, vaccines and medical devices for priority diseases, while working to fight the growing issue of antibacterial resistance.
Since 1977, WHO has maintained a list of essential medicines as a means to promote health equity around the world. This list began with 208 identified medicines and has grown to include 460 different pharmaceuticals. Although it was not designed as a global standard, the list now acts as a guide for the procurement and supply of medicines at the national and local level.
