Managing Pharmaceuticals in International Health

1. Front Matter

   Pages i-xix

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2. Issues in the Management of Pharmaceuticals in International Health

   • Stuart Anderson, Reinhard Huss

   Pages 1-17

3. Access and Availability of Pharmaceuticals in International Health

   • Karin Wiedenmayer

   Pages 19-31

4. Assessing the Pharmaceutical Needs of Patients and Populations

   • Reinhard Huss

   Pages 33-51

5. The Role of Health Professionals

   • Karin Wiedenmayer

   Pages 53-69

6. The Role of the Pharmaceutical Industry

   • Stuart Anderson

   Pages 71-85

7. The Role of Governments

   • Rob Summers

   Pages 87-104

8. The Role of the European Union, National Assistance Agencies and NGOs

   • Reinhard Huss, Stuart Anderson

   Pages 105-124

9. The Role of International Organizations

   • Rob Summers

   Pages 125-140

10. Rational Use of Medicines

    • Karin Wiedenmayer

    Pages 141-152

11. Medicine Quality, Adverse Reactions and Antimicrobial Resistance

    • Karin Wiedenmayer

    Pages 153-173

12. Managing Medicines Information

    • Reinhard Huss

    Pages 175-189

13. Investigating the Use of Medicines

    • Reinhard Huss

    Pages 191-205

14. Trends and Developments

    • Stuart Anderson, Karin Wiedenmayer

    Pages 207-221

15. Policy Initiatives and their Implications

    • Stuart Anderson, Rob Summers

    Pages 223-236

16. Back Matter

    Pages 237-256

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"One third of the world's population lack effective access to quality assured essential medicines used rationally". When WHO first made this statement fifteen years ago, there was general concern that medical miracles such as antibiotics, antiparasitic medicines, vaccines and anal­ gesics would not be available to many people. Today, the proportion of those lack­ ing access is lower in Asia and Latin America and higher in Africa but there are probably about two billion people in this situation. This book describes the many problems involved, and then puts together possible solutions based on country expe­ riences in a comprehensive and coherent manner. Many people lack access to essential medicines because they and their countries are poor, and because of inefficiencies in their health systems. We know that in low and middle income countries between 25 and 40 per cent of health expenditure is on medicines, and that most of that expenditure is out of pocket. Often this amounts to less than US $ 2 per head per year! In contrast, high income countries spend only 8 to 15 per cent of health expenditure on medicines, and this is mostly paid for by health insurance or social security funds. High income country expen­ diture may be over US $ 400 per person per year! So managing the scanty resources available in low income countries becomes all the more important.

• Europe
• International Health
• Pharmaceutical Policy
• Public Health
• World Health Organization
• assessment

• Department of Public Health and Policy, London School of hygiene and Tropical Medicine, London, UK

  Stuart C. Anderson

• Department of Tropical Hygiene and Public Health, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany

  Reinhard Huss

• School of Pharmacy, Medical University of Southern Africa (MEDUNSA), Medunsa, Republic of South Africa

  Robert S. Summers

• Swiss Centre for International Health, Swiss Tropical Institute, Basel, Switzerland

  Karin A. Wiedenmayer

Policies and ethics