Increased equitable access to medicines and other health technologies is one of the requirements for universal access to health and universal health coverage. The availability, accessibility, acceptability, and affordability of these medical products and their rational use should be pursued according to the national context and within the context of comprehensive integrated health services, with recognition of the right to the enjoyment of the highest attainable standard of health for all. The following measures should be considered:

a) Promote and update policies, norms, and strategies that improve timely access to and rational use of safe, affordable, quality-assured, clinically effective, and cost-effective health technologies, including medicines and vaccines, and that improve the sustainable capacity of health systems to prevent, diagnose, treat, eliminate, and palliate diseases and other medical conditions.

b) Advocate for the adoption of an explicit essential medicines list, essential in-vitro diagnostics lists, and a priority health technologies list—one based on health technologies assessment and other evidence-based approaches—that are evaluated, reviewed, and monitored periodically and are coherent with health benefit plans and coverage decisions.

c) Promote adequate financing and financial protection mechanisms to foster the progressive elimination of out-of-pocket expenditures and improve access to the essential medical products included in the national lists, according to national public health priorities and the context of each health system.

d) With a view to containing costs within health systems, adopt comprehensive strategies that improve affordability and foster competition, such as multisource and generic strategies; mechanisms to encourage the use of effective lower-cost medical products in lieu of more costly ones of little or no added value; and actions that promote, among other innovative mechanisms, when possible, the delinkage of the cost of research and development from the final price of medicines, in particular where existing market mechanisms fail to provide incentives for research and development.

e) Improve access to quality radiological, pharmaceutical, diagnostic, transplant, and blood services within a comprehensive and integrated network of health services.

f) Promote the development and strengthening of national and subregional regulatory systems that can ensure the quality, safety, and effectiveness of health technologies, including medicines and vaccines, throughout their entire life cycle.

g) Promote sustainable, efficient, and transparent public procurement mechanisms, as well as national, subregional, and regional pooled procurement mechanisms such as the PAHO revolving funds, which limit fragmentation, improve availability, and take advantage of economies of scale to improve equitable access to essential and strategic medical products.

h) Improve capacities to manage and oversee national medical product supply chains, including planning, forecasting, quality assurance, availability, and use, to ensure that the population has timely access to these products at the point of service.

i) Taking into account public health perspectives, strengthen the capacity to implement intellectual property policies and health policies that promote research and development of medicines, vaccines, and other health technologies for communicable and noncommunicable diseases that primarily affect developing countries; and promote increased access to affordable, safe, effective, and quality medicines and diagnostics and other technologies, reaffirming the World Trade Organization Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement), as amended, and also reaffirming the 2001 Doha Declaration on the TRIPS Agreement and Public Health, which recognizes that intellectual property rights should be interpreted and implemented in a manner supportive of the right of Member States to protect public health and, in particular, to promote access to medicines for all, and notes the need for appropriate incentives in the development of new health products.

j) Advance strategies and interventions to ensure appropriate use of antimicrobials to decrease the risk of intractable resistant infections, improving quality of care. k) Promote the use of existing regional platforms for sharing knowledge and experiences, taking into account developmental differences among Member States.

Note: For further details on the scope of this Outcome, please refer to the PAHO Strategic Plan 20-25 Document.