Published on: September 7, 2024

Access to Medicines: A Cornerstone of the Right to Health – Part 2

This article series by Dr Preeti Chauhan draws upon the foundational knowledge presented during Day 1 of the five-day training on “Access to Medicines, TRIPS, and Patents in the Developing World,” organized by the Third World Network and Inter-University Centre for IPR Studies (IUCIPRS), CUSAT. The content is adapted from the core concepts introduced by Dr. Gargeya Telakapalli from Third World Network and Dr. Arathi PM, Mahatma Gandhi University, whose expertise was instrumental in shaping the understanding of the complex interplay between health rights, intellectual property, and access to medicines in developing countries.

Read the previous article: The Role of TRIPS and Patents

Introduction

India’s health system, characterized by its fragmentation and the dominance of the private sector, presents significant challenges to ensuring equitable access to medicines. This article delves into the key factors influencing access to medicines in India, including health system fragmentation, health financing, and the role of out-of-pocket expenditures (OOPs).

Health Systems and Fragmentation

A health system is a complex network of organizations, people, and actions aimed at promoting, restoring, or maintaining health. In India, the health system is highly fragmented, with multiple actors operating in both the public and private sectors. This fragmentation creates challenges in coordination, standardization, and ensuring equitable access to services, including medicines.

Health Financing

India’s health financing is characterized by low public investment in the health sector, with government spending on health at 1.35% of GDP among the lowest in the world. This low public investment has led to a heavy reliance on OOPs, which can lead to catastrophic health expenditures and impoverishment.

Out-of-Pocket Expenditures

OOPs are a significant barrier to access to medicines in India. Many households incur catastrophic health expenditures due to the high cost of medicines, especially for chronic diseases. This can lead to financial hardship and impoverishment, particularly for vulnerable populations.

Key Challenges to Access to Medicines
  • High OOPs: The high cost of medicines, particularly in the private sector, is a major barrier to access.
  • Inadequate public health infrastructure: Public health facilities often lack the necessary infrastructure and resources to provide affordable and accessible medicines.
  • Limited availability of essential medicines: Shortages of essential medicines in public health facilities force patients to seek care in the private sector, where costs are higher.
  • Lack of financial protection: Many people in India lack adequate health insurance coverage, leaving them vulnerable to catastrophic health expenditures.

Improving Access to Medicines

To improve access to medicines in India, several strategies are necessary:

  • Increased public investment in health: A significant increase in government spending on health is essential to reduce reliance on OOPs and improve the availability of affordable medicines.
  • Strengthening public health infrastructure: Investment in public health facilities is necessary to ensure that they have the capacity to provide quality care, including access to essential medicines.
  • Implementing price controls: Regulation of pharmaceutical prices can help to make medicines more affordable for patients.
  • Expanding health insurance coverage: Expanding access to health insurance can help to protect people from catastrophic health expenditures.
  • Promoting generic medicines: Encouraging the use of generic medicines can help to reduce costs for patients.

Conclusion

Ensuring equitable access to medicines in India requires an overhaul as per demand approach that addresses the challenges of fragmentation, inadequate health financing, and high OOPs. By increasing public investment in health, strengthening public health infrastructure, and implementing price controls, India can make significant progress towards improving access to medicines for all its citizens.

Read the next article in the series: Navigating the Pharmaceutical Landscape 

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