Abstract:
Patients with asthma need uninterrupted supplies of affordable, quality-assured essential
medicines. However, access in many low- and middle-income countries (LMICs) is limited. The World Health Organization (WHO) Non-Communicable Disease (NCD) Global Action Plan 2013–2020 sets an 80% target for essential NCD medicines’ availability. Poor access is partly due to medicines not
being included on the national Essential Medicines Lists (EML) and/or National Reimbursement
Lists (NRL) which guide the provision of free/subsidised medicines. We aimed to determine how
many countries have essential asthma medicines on their EML and NRL, which essential asthma
medicines, and whether surveys might monitor progress. A cross-sectional survey in 2013–2015 of
Global Asthma Network principal investigators generated 111/120 (93%) responses—41 high-income
countries and territories (HICs); 70 LMICs. Patients in HICs with NRL are best served (91% HICs
included ICS (inhaled corticosteroids) and salbutamol). Patients in the 24 (34%) LMICs with no
NRL and the 14 (30%) LMICs with an NRL, however no ICS are likely to have very poor access to
affordable, quality-assured ICS. Many LMICs do not have essential asthma medicines on their EML
or NRL. Technical guidance and advocacy for policy change is required. Improving access to these
medicines will improve the health system’s capacity to address NCDs.
