- Essential medicines save lives and access to them is a part of the realization of everyone’s right to health.
- Essential medicines are those that satisfy the priority healthcare needs of the population, and are selected with due regard to public-health relevance, evidence of efficacy and safety and comparative cost-effectiveness.
- Governments must ensure that essential medicines are available at all times at all levels of health care, in adequate amounts, in the appropriate dosage forms, with assured quality and adequate information, and at a price the individual and the community can afford.
- Access to essential medicines is a part of the UN Millennium Development Goals (MDGs). MDG 8 seeks to improve access to essential medicines in developing countries in cooperation with pharmaceutical companies.
- Access to medicines supports the attainment and sustainability of other MDGs, such as the reduction of infant and maternal mortality and ensuring universal access to treatment for HIV/AIDS, TB, malaria and other major diseases.
- The market for pharmaceuticals in Viet Nam was valued at US$1.827 in 2010 and is expected to reach US$3.304 billion by 2015. Per capita expenditure continued to increase over the years, reaching US$22.5 in 2010.
- Despite a robust pharmaceutical industry, access to essential medicines remains a public-health concern. Availability is low while prices are high. The availability of the lowest priced generics (IB) is only 10.5 % in the public sector and 23.8% in the public sector. The availability of innovator brands, on the other hand, is 24.8% in the public and 31.4% in the private sector.
- Medicines prices are high. The prices of LPG are 1.09 to 3.40 times and 1.70 – 5.14 times the International Reference Price (IRP) in the public and private sector respectively, while the innovator brands are 10.53 to 38.62 times and 12.8 to 41.54 times the IRP in the public and private sector respectively.
- Medicines are also highly unaffordable. For instance the cost of a one-month of treatment for peptic ulcer using Omeprazole IB would need the equivalent of 27 days’ wages (Figure 1 below).
Figure 1. Affordability of treatment for acute respiratory infection and a one month course of treatment using certain types of medicines, across private and public sectors
- In 2009, the WHO Country Office strengthened its support for access to essential medicines and pharmaceuticals in Viet Nam. An Aide Memoire on Strategic Collaboration in Pharmaceuticals was signed by WHO and the Ministry of Health.
- The Aide Memoire includes the following key strategies:
- Progressively work towards universal financing that covers essential medicines, giving special attention to full coverage of the poor;
- Develop and promulgate a National Generic Policy to ensure affordability of safe and quality medicines;
- Establish a Medicines Price Policy Board;
- Ensure availability of essential medicines at all levels of health care, giving particular attention to district and commune levels and remote areas;
- Strengthen the capacity for local production of essential medicines that meet public-health needs;
- Work towards good governance and accountability in medicine registration, selection, procurement and supply. A robust mechanism for monitoring pharmaceutical trends and situations will serve as the key step towards accountability and good governance;
- Implement a national program for rational use of medicines and medication safety;
- Ensure quality and safety of essential medicines along the supply chain;
- Establish a National Medicines Council that can serve as a body for collective and participatory decision and policy making.
- In addition, WHO Viet Nam has supported the Government and collaborated with partners in the development of policies and the establishment of systems to improve access to essential medicines. These include:
- WHO-UNIDO-MOH collaboration on fostering the local production of quality-assured and affordable generic medicines;
- Assessment of the national pharmaceutical situation, including impact assessments of the National Medicines Policy and the Pharmaceutical Law to provide evidence for policy and decision making;
- Strengthening the national regulatory authority;
- Strengthening of the drug-quality control network;
- Establishment of a national network for the safety of medicines;
- WHO works with the Viet Nam Social Security (VSS) in the development of policies for cost containment and for improving efficiency in medicines use;
- Launched the “Be Safe to Medicines” programme to ensure patient safety and prevent medication errors.
- WHO provides technical support in the development of policies and regulations for medicine prices, supply and distribution and procurement of medicines;