Improving access to pharmaceuticals in Brazil and Argentina

Abstract

The population of many Latin American countries is having increasing difficulty in accessing needed medicines due to the rise in their unitary cost and the growing number of poor in most countries of the region. A number of countries have taken steps to increase access to pharmaceuticals and have had different levels of success. This article reports on two country-wide programmes: the AIDS programme in Brazil, which has been judged as being highly successful, and the Remediar programme that has been implemented recently in Argentina. Both programmes have significantly increased access to needed pharmaceuticals, and Argentina has done it in a record time. In the discussion, we suggest that pharmaceutical interventions are successful when there is a firm political commitment, they are comprehensive, include the participation of civil society, and use a combination of methods to control the rising cost of medicines, including centralized international competitive bidding processes for drug procurement and reliance on multi-source drugs.

Equity during an economic crisis: Financing of the Argentine health system

“…Remediar has been deemed to be successful in providing basic drugs to the most vulnerable. However, there has been concern regarding its longterm sustainability, since it is mostly financed with loans from the Inter-American Development Bank (Homedes and Ugalde, 2006).…”

Health sector reforms in Argentina and the performance of the health financing system

“…12 Therefore, there is no data regarding the sums these payments generate or how many people received free services [32,33]. However, the programme Remediar, which dispenses free basic drugs in the primary health care centers (CAPS), 13 bans CAPS from charging a fee for consultation, a practice that was common in some of them before Remediar [13,34].…”

“…The first reason is the successful implementation of the programme Remediar [34]. This programme was launched in October 2002 to provide 36 multi-source medicines at no cost to the estimated 15 million Argentines who are using public sector facilities and are unable to afford medicines.…”

“…The Remediar programme was successful in providing basic drugs to those more vulnerable while strengthening primary health care utilization [13,34]. However, there are some concerns about its sustainability.…”

“…Also, the programme has been criticized for buying from for-profit-oriented pharmaceutical firms instead of stimulating national production in public laboratories and for delivering kits that are adjusted neither by size nor by content. Thus, some of the drugs are not consumed and stockpile while others are delivered in insufficient quantities to satisfy the demand [34].…”