Abstract
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.
Highlights
Asthma, one of the major chronic diseases, has become a cause for global concern due to its increasing prevalence, morbidity, and economic impact
The questionnaire and cover letter were emailed by the Global Asthma Network (GAN) Global Centre (Auckland) to the principal investigator of each of 276 GAN centres in 120 countries and territories, including 41 high-income countries and territories (HICs) and 79 low- and middle-income countries (LMICs)
Three French overseas territories were included as HICs since they have always been presented as distinct centres for asthma prevalence surveys that have been undertaken by the International Study on Asthma and Allergies in Childhood (ISAAC) [22] and GAN
Summary
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
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