Availability, Price and Affordability of Medicines for Treating NCDs in the Ugandan Private Sector

Thesis (Master's)--University of Washington, 2019Globally, access to medicines is a major public health challenge (Wirtz et al., 2017). Countries have committed to improving access to medicines through universal health coverage and the Sustainable Development Goals (SDGs) (UN General Assembly, 2015). For example, in the context of the growing burden of Non-Communicable Diseases (NCDs), the WHO Global NCD Action Plan 2013–2020 has a target on access to medicines for NCDs: “80% availability of the affordable basic technologies and essential medicines, including generics, required to treat major NCDs in both public and private facilities” (WHO, 2013). In Uganda, household out of pocket expenditure (OOP) accounts for 37% of the health expenditures, yet households spend 95% of the OOP on curative health care visits. This study was secondary analysis of data collected in a cross sectional survey of private for profit retail pharmacies and set out to assess the availability, price and affordability of medicines for diabetes, hypertension, and seizures in private medicines retail outlets in Uganda. Results and Conclusion: Our study found that whereas a large proportion of medicines to treat NCDs were reasonably available, in line with the WHO target of ensuring at least 80% availability, they are not affordable to a lot of Ugandans. Availability of Insulin though is still below the required target. A lot of effort should be put in ensuring people do not have to choose between filling their life-saving medicine prescriptions and feeding their families. Recent efforts by the government that are geared towards establishing a national health insurance scheme as well as promoting local manufacture of medicines will go a long way towards reducing the cost to families and hence improving access