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Open AccessArticle

Essential Medicines at the National Level: The Global Asthma Network’s Essential Asthma Medicines Survey 2014

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School of Population Health, University of Auckland, Auckland 1023, New Zealand
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Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland 1023, New Zealand
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Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
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Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
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South Western Sydney Clinical School, University of New South Wales, Sydney 2085, Australia
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The Epidemiological Laboratory (Epi-Lab), for Public Health and Research, Khartoum, Sudan
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Independent Consultant, 80220 Joensuu, Finland
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Farmalex, 75008 Paris, France
*
Author to whom correspondence should be addressed.
Membership of the Global Asthma Network Study Group is provided in the Acknowledgements.
Int. J. Environ. Res. Public Health 2019, 16(4), 605; https://doi.org/10.3390/ijerph16040605
Received: 28 December 2018 / Revised: 1 February 2019 / Accepted: 2 February 2019 / Published: 19 February 2019
Patients with asthma need uninterrupted supplies of affordable, quality-assured essential medicines. However, access in many low- and middle-income countries (LMICs) is limited. The World Health Organization (WHO) Non-Communicable Disease (NCD) Global Action Plan 2013–2020 sets an 80% target for essential NCD medicines’ availability. Poor access is partly due to medicines not being included on the national Essential Medicines Lists (EML) and/or National Reimbursement Lists (NRL) which guide the provision of free/subsidised medicines. We aimed to determine how many countries have essential asthma medicines on their EML and NRL, which essential asthma medicines, and whether surveys might monitor progress. A cross-sectional survey in 2013–2015 of Global Asthma Network principal investigators generated 111/120 (93%) responses—41 high-income countries and territories (HICs); 70 LMICs. Patients in HICs with NRL are best served (91% HICs included ICS (inhaled corticosteroids) and salbutamol). Patients in the 24 (34%) LMICs with no NRL and the 14 (30%) LMICs with an NRL, however no ICS are likely to have very poor access to affordable, quality-assured ICS. Many LMICs do not have essential asthma medicines on their EML or NRL. Technical guidance and advocacy for policy change is required. Improving access to these medicines will improve the health system’s capacity to address NCDs. View Full-Text
Keywords: essential medicines; access; noncommunicable diseases; asthma; inhaled corticosteroids; bronchodilators; national reimbursement list essential medicines; access; noncommunicable diseases; asthma; inhaled corticosteroids; bronchodilators; national reimbursement list
MDPI and ACS Style

Bissell, K.; Ellwood, P.; Ellwood, E.; Chiang, C.-Y.; Marks, G.B.; El Sony, A.; Asher, I.; Billo, N.; Perrin, C.; the Global Asthma Network Study Group. Essential Medicines at the National Level: The Global Asthma Network’s Essential Asthma Medicines Survey 2014. Int. J. Environ. Res. Public Health 2019, 16, 605.

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