Abstract
Security of supply of medicines is fundamental to ensure health for all. Furthermore, improving access to medicines is included in sustainable development goal 3. However, the concept of security of supply has mostly been applied to food, water and energy. Diversity of supply, vulnerability to disruption, expenditure, infrastructure, stability of exporting countries, ownership of production, price stability, access and equity, affordability, intellectual property, safety and reliability of supply, and countries’ capacity to adapt to market changes are all elements of security of supply. Based on these elements, we assessed security of supply for insulin, since access to insulin is a global problem. We found that three multinational companies, in Denmark, France and Germany, control 99% of the value of the global insulin market. Prices and affordability of insulin and access to it vary considerably between countries. Some countries are vulnerable to insulin shortage because they import insulin from only one source. Many countries spend large amounts of money on insulin and costs are increasing. Some countries lack an adequate infrastructure for procurement, supply chain management and distribution of insulin. Applying the security of supply concept to insulin showed that diversification of suppliers needs to be fostered. Global health actors should adopt a security of supply approach to identify medicines that are susceptible to supply issues and address this concern by strategic promotion of local production, strengthening regulatory harmonization, and adding local products to the World Health Organization’s programme on prequalification of medicines.
Highlights
Improving access to medicines is included in sustainable development goal (SDG) 3, which is to ensure healthy lives and promote well-being for all at all ages.[1]
We found that three multinational companies, in Denmark, France and Germany, control 99% of the value of the global insulin market
Availability and affordability of medicines in both the public and private sectors are important indicators of access to medicines. This relation has been recognized by the World Health Organization (WHO) in its Global action plan for the prevention and control of noncommunicable diseases 2013– 2020, which includes a specific target on access to medicines of “an 80% availability of the affordable basic technologies and essential medicines, including generics, required to treat major noncommunicable diseases in both public and private facilities.”[5]
Summary
Improving access to medicines is included in sustainable development goal (SDG) 3, which is to ensure healthy lives and promote well-being for all at all ages.[1]. For security of supply for medicines, the United Nations Children’s Fund (UNICEF) considers three essential components of supply: uninterrupted, sustainable and provides affordable, quality medicines.[13] A report of the Department for International Development of the United Kingdom of Great Britain and Northern Ireland on global health partnership impact on commodity pricing and security[14] presents the issue of security of supply for medicines and vaccines in terms of: (i) uninterrupted supply, meaning stock-outs do not occur because lead times and reserve stocks are sufficient; (ii) sustainable supply, meaning the market is attractive enough to maintain current production capacity and attract new producers to have a competitive market; and (iii) good quality supply, meaning medicines meet international quality standards Other elements, such as diversity of supply, vulnerability to disruption, amount spent on energy, infrastructure, stability of exporting countries, ownership of production, stability of prices, access and equity, affordability, intellectual property issues, safety and reliability of supply, and capacity of countries to adapt to changes in the market, can affect the security of supply of oil.[8] As such, the definition of security of supply goes beyond vulnerability of production to encompass supply systems and.
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