The 130th Annual Meeting of APHA

Abstract #38674

Nuria Homedes, MD, DrPH, School of Public Health, University of Texas Houston, Health Science Center, 1100 North Stanton, Suite # 110, El Paso, TX 79902, 915-747 8508, nhomedes@utep.edu and Antonio Ugalde, PhD, Department of Sociology, University of Texas-Austin, 1802 Westridge, Austin, TX 78704.

The study is based on analysis of published and unpublished documents from Latin American NGOs and international agencies, and fieldwork interviews with Latin American pharmaceutical policy makers.

Our findings suggest that the three main health sector reform strategies (decentralization, privatization and changes in financing of health services) have some negative consequences for the access and adequate use of pharmaceuticals. They also limit governments’ capabilities to regulate the market, control expenditures, and implement policies to foster rational use. The downsizing of the health sector and the increasing provision of services through the private sector predispose health providers to prescribe more expensive brand-name drugs that are promoted by the industry. The industry spends large amounts of resources influencing physicians and marketing their products.

Fieldwork indicates that decentralization facilitates the availability of pharmaceuticals. However, without being able to benefit from economies of scale, decentralized units spend more resources on pharmaceuticals. The additional expenditures are recovered by the units through fees that tend to restrict access to services among the poor.

The current harmonization of regional markets attempts to harmonize technical requirements for registration of pharmaceuticals causing a further weakening of the regulatory capacity of national governments. Our study suggests that harmonization of regional markets favors the interests of the industry. If implemented differently, it could benefit consumers. The study also found contrasting positions held by the WTO and WHO, the former favoring the industry and the latter the consumers, and advances solutions to resolve the identified conflicts.

Learning Objectives: From the presentation participants learn

• To design interventions to improve the appropriate use of medicines;
• To select pharmaceutical policies that increase the access to medicines of the most vulnerable population groups.
• To identify and read critically documents issued by WHO and other international agencies to improve pharmaceutical policies.

Keywords: Health Reform, Access

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.