Improving Access to Affordable Quality-Assured Inhaled Medicines in Low- and Middle-Income Countries
25 Pages Posted: 1 Jun 2022
Date Written: May 9, 2022
Abstract
Background: Access to affordable inhaled medicines for chronic respiratory diseases (CRDs) is severely limited in low- and middle-income countries (LMICs) causing avoidable morbidity and mortality. The International Union Against Tuberculosis and Lung Disease convened a stakeholder meeting on this topic in February 2022.
Methods: Focused group discussions were informed by literature and presentations summarising experiences of obtaining inhaled medicines in LMICs. The virtual meeting was moderated using a topic guide around barriers and solutions to improve access. The thematic framework approach was used for analysis.
Results: A total of 58 key stakeholders, including patients, healthcare practitioners, members of national and international organisations, industry, and the World Health Organization attended the meeting. 20 submitted pre-meeting materials. The main barriers identified were: (1) low awareness of CRDs; (2) limited data on CRD burden and treatments in LMICs; (3) ineffective procurement and distribution networks; (4) poor communication of the needs of people with CRDs. Solutions discussed were: (1) generation of data to inform policy and practice; (2) capacity building; (3) improved procurement mechanisms; (4) strengthening advocacy; and (5) a World Health Assembly Resolution.
Conclusion: There are opportunities to achieve improved access to affordable, quality-assured inhaled medicines in LMICs through coordinated, multi-stakeholder, collaborative efforts.
Note:
Funding Information: MS was funded by a Wellcome Trust Clinical PhD fellowship (Grant number 203919/Z/16/Z). The authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy, or views of the Wellcome Trust. SJ is funded by an NIHR Clinical Lectureship. BN was funded by the MRC DTP Programme at Liverpool School of Tropical Medicine.
Declaration of Interests: The authors report no conflicts of interest. KM reports advisory board fees from AstraZeneca. JRH has received personal payment and payment to his employer for educational and advisory work from pharmaceutical companies that make medicines to treat COPD. AY reports advisory board fees from AstraZeneca, Novartis, Abdi İbrahim, GSK, Bilim. DMGH has received personal payment for educational and advisory work from pharmaceutical companies that make medicines to treat COPD and is a member of the Board of Directors and Science Committee of the Global Initiative for Chronic Obstructive Lung Diseases (GOLD). MC has received personal payment for educational and advisory work from pharmaceutical companies that make medicines to treat Asthma and COPD. JC reports advisory board fees from AstraZeneca. EMK reports grants from the National Institute for Health Research Global Health Research Unit on Respiratory Health (RESPIRE) and Seqirus UK; personal fees from AstraZeneca and GlaxoSmithKline; and is board director of the International Primary Care Respiratory Group. TW reports advisory board/speaker fees from Amgen, AstraZeneca, GSK, Novartis, Sanofi/Regeneron. HKR reports research grants from AstraZeneca, GlaxoSmithKline and Novartis; honoraria for advisory boards for AstraZeneca, Chiesi, GlaxoSmithKline, Novartis and Sanofi-Genzyme; consulting from AstraZeneca and Novartis; and independent medical education presentations from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Sanofi-Genzyme and Teva. No other conflicts of interest were reported. RM has received grants and advisory board fees / speakers fees from Astrazeneca, GlaxoSmithKline (GSK) and Boehringer Ingelheim.
Keywords: asthma, COPD, non-communicable disease, chronic respiratory disease, inhalers, essential medicines
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