Dr Karen Bissell said that access to asthma medicines relies on policy, procedures and communications all working well in a country. Dr Bissell enlisted few factors that directly influence the access to medicines:
- Procurement: Who sets the agenda when medicines get procured
- Distribution: Public and private health services, other agencies
- Prescription by doctors or nurses (is the medication right?)
- Education: Healthcare workers such as doctors, nurses, pharmacists, patients, etc need to access training on how to educate patients, standard messaging, etc.
"Almost all countries have no national programme and no national information system for asthma. Many have no real national consensus, and or implemented asthma management guidelines, strategy or dedicated budget. Some countries follow guidelines that are more for high income countries. Essential medicines list (EML) often does not include inhaled cortico-steroids for asthma management, and if they do, then often these are not updated" said Dr Bissell.
Speaking about challenges in health services, Dr Bissell underlined that "few medical professionals understand the essential role of inhaled cortico-steroids in asthma management, rather they prescribe the reliever medication alone. Health services are often not organized for long term chronic care and health workers are not trained in asthma care."
"Procurement environment can effect access to medicines: market usually does not encourage rationale procurement. Nonessential medicines are often pushed by pharmaceutical companies and specialist physicians" said Dr Bissell.
A report brought out by The Union and Global Asthma Network, states that asthma medicines were part of essential medicines list (EML) in only 10 countries surveyed and these were available in 41% of private pharmacies surveyed and 17% of public hospitals surveyed.
Asthma Drug Facility was created by The Union and made commendable contribution during 2005-2013 by providing affordable access to quality-assured essential asthma medicines for low and middle income countries. Although critically needed in today's context too, yet it is on hold since 2013 due to lack of funds and demand from countries.
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