The economic burden of illness and limited access to pharmaceuticals has a significant negative impact on patient groups and their families [ 48 ]. To a great extent, pharmaceutical expenditure undermines national economic development, especially in countries with low gross domestic products GDPs and a dependent economy [ 49 ]. Even in countries where medicines are provided for free through the public sector, they can often be unavailable [ 34 ]. As such, patients are forced to pay out of their own pockets when they are ill, especially in developing countries [ 50 ].
Countries which rely heavily on out-of-pocket OOP payments are not likely to achieve universal health coverage [ 51 ]. In Bangalore, India, it was reported that According to Kumar et al. Additionally, the high prices of medicines and OOP is paving the way for health shocks in poor countries via the emergence of unpredictable illnesses that may weaken the health status of households [ 56 ]. Recommendations: how to better ensure access to medicines Access to affordable medicines is a basic human right and considered a fundamental goal of any welfare state [ 54 ].
Below are a series of recommendations necessary to achieve the goal of global access to medicines. Gaining full access to medicines widens treatment options and brings many advantages to patients and healthcare systems. If we hope to halt the development of acute to chronic diseases, and prevent diseases progressing with fatal consequences, more needs to be done to ensure all people across the globe have access to essential medicines.
All WHO Member States should intensify efforts to ensure that everyone within the scope of their responsibility promotes access to affordable medicine without delay. Policies that are directed at low-income individuals must be considered to address issues surrounding soaring medicine prices and inadequate access. Each Member State should eliminate or minimize duties and taxes on medicines to ensure adequate access. All issues preventing access to medicines for all need to be explored and addressed if we are to ensure that there is universal access to this human right. Competing interests : The authors declare that there is no conflict of interest in regards to the publication of this manuscript.
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Access To Medicines Resolution Adopted By UN Human Rights Council
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The Judicialized Right to Medicines
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Main issues for the chemicals and pharmaceuticals sector: Health and safety relating to the use of hazardous materials including short and long-term risks to health Other health and safety issues including dust, noise, unguarded machinery and ergonomic issues eg lifting Accidents at work with potentially severe consequences, eg: risk of explosion of volatile materials Insufficient information and training for workers on health and safety issues Information not provided in languages used by the workforce Protests against the use of animals in testing products may impact on the safety and security of workers.
Exposure to chemicals can be particularly hazardous for young workers. Main issues for the chemicals and pharmaceuticals sector: Children working long hours and missing out on educational opportunities Potentially hazardous conditions for young workers under 18 who should not be exposed to dangerous equipment, machinery or chemicals.
Main issues for the chemicals and pharmaceuticals sector: Testing conducted without the informed consent of those taking part. Taking into account: motivation for participating, particularly in poor or vulnerable communities the tone and content of company communications the provision of clear information about potential short and long-term side effects.
Testing conducted without due regard for the health and safety of participants Failure to apply internationally accepted standards when developing and testing potentially hazardous products in regions where laws or accepted standards may be lax or not applied Potential misuse of products for purposes not planned or condoned by their designers, manufacturers and distributors eg: medicines used for torture; inhalation of glues and solvents. Main issues for the chemicals and pharmaceuticals sector: Lack of appropriate and comprehensive product information, preventing consumers from making an informed choice Health risks of products inadequately explained in literature, labelling or advertisements Inadequate response to unforeseen product related crises eg: when a product already taken to market is found to have serious health implications Limited access to products due to cost, lack of availability or patent disputes may result in cheaper, less safe versions being developed and marketed.
These should comply with local and national law but also meet internationally accepted standards.
Companies should not seek to benefit from lax local regulation by not applying standards which are routinely required elsewhere Provision of detailed information about correct product use including any risks involved and documented assurance that reasonable steps are taken to ensure that products are not made available to those likely to misuse them Emergency response plan in the event of product recall on health and safety grounds. Main issues for the chemicals and pharmaceuticals sector: the safety and security of workers involved in extracting or producing the materials the provision of support directly or indirectly for illegal or oppressive armed conflict.
Transporting hazardous materials is risky Main issues for the chemicals and pharmaceuticals sector: Failure to ensure safety and security of transport and storage of hazardous materials at all stages in the production process. The rights and intellectual copyright of indigenous people should be respected Main issues for the chemicals and pharmaceuticals sector: Failure to obtain the free, prior and informed consent of indigenous peoples when using their knowledge and resources to develop commercial pharmaceutical products.
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Suppliers should be aware of potential hazards and have systems in place to protect workers and communities Clearly defined procedures around use of indigenous peoples' knowledge and resources, including payment, benefit-sharing or other consideration Transport and storage risk management plans for handling hazardous materials, including training of drivers and other workers and action to increase local community awareness of risks Site security plans which ensure that appropriate security measures are in place, specifying measures to be taken in the event of a major incident.
For example, providing an emergency water supply to local community if usual sources are contaminated. Local people may be exposed to risks Main issues for the chemicals and pharmaceuticals sector: Storage and transport of hazardous materials may pose risks for local communities if inadequate standards are applied, leading to damage to health or the local environment Natural resources may be contaminated by waste disposal and pollution. This may lead to damage to people's health through contamination of the food chain or water supplies.
40th anniversary of essential medicines: a loud call for improving its access - GaBI Journal
Local people may be disadvantaged by large scale use of resources Main issues for the chemicals and pharmaceuticals sector: Requirement for access to natural ingredients to produce pharmaceutical products may create tensions in the community and damage relationships with indigenous peoples Access to water, energy and land for product manufacture may impact adversely on the community. Moving populations away from their land for product or site development may lead to loss of livelihood, resources or assets Main issues for the chemicals and pharmaceuticals sector: This can result in tensions if there is not full consultation and compensation arrangements are inadequate, including the amount and mechanism for distribution.
Companies need to respond appropriately to major incidents Main issues for the chemicals and pharmaceuticals sector: Failure to respond adequately to an emergency situation eg: major explosion, leakage or other release of dangerous substances into the air, water or ground.
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