Ensuring Equitable and Affordable Access to Essential Cardiovascular Medicines in the Eastern Mediterranean Region
This statement was submitted in written form under Agenda Item 5(e) – Progress Report on the Regional Strategy to Improve Access to Medicines and Vaccines in the Eastern Mediterranean Region 2020-2030 – at the Seventy-Third session of the WHO Regional Committee for the Eastern Mediterranean.
Honourable Chair,
Distinguished Delegates,
The World Heart Federation commends WHO and Member States for the strides made in the implementation of the regional strategy to improve access to medicines and vaccines in the Eastern Mediterranean Region.
Equitable access to essential health products is fundamental to the prevention, diagnosis, and management of cardiovascular disease as well as to achieving Sustainable Development Goal 3.8. Yet, the availability, accessibility, and affordability of quality-assured cardiovascular medicines across the continuum of care – from prevention to diagnosis, treatment, rehabilitation, and palliative care – remain out of reach for millions of individuals in the region, especially among vulnerable and underserved populations.
We note with concern that access to medicines and health technologies remains a global challenge, driven in part by high costs, which can place a significant burden on individuals and families, especially when medicines are paid for out-of-pocket. In the region, pharmaceutical spending accounts for up to 54% of out-of-pocket expenditure in some countries, with fragmented supply chains, limited pooled procurement mechanisms, and insufficient promotion of generic medicine further restricting access to essential health products.
The WHO Model List of Essential Medicines and WHO Model List of Essential Medicines for Children provide an evidence-based foundation for national essential medicines lists, procurement, reimbursement, and health benefit package-related decisions. We urge Member States to align national essential medicines lists with WHO recommendations and to ensure that essential medicines for the prevention and management of cardiovascular disease and its risk factors are fully integrated into universal health coverage benefit packages.
Nonetheless, inclusion into national essential medicines lists and benefit packages must translate into effective access for patients. Essential cardiovascular medicines should be available and affordable at all levels of care, especially primary health care, and supported through adequate public financing arrangements, including reimbursement mechanisms, to ensure initiation and continuation of life-saving interventions, while safeguarding individuals and families from financial hardship and catastrophic health expenditure.
For instance, reliable access to benzathine penicillin G is critical to reducing the burden of rheumatic heart disease. BPG remains the first-line treatment for the prevention of recurrent rheumatic fever and rheumatic heart disease. However, persistent shortages and supply disruptions continue to place people living with rheumatic heart disease at avoidable risk of disease progression, disability, and premature death. WHF urges Member States to ensure sustainable procurement and uninterrupted availability of quality-assured BPG, in line with resolution WHA71.14 and the Framework for Action on Rheumatic Fever and Rheumatic Heart Disease in the WHO Eastern Mediterranean Region.
Equitable access must remain at the centre of regional action on access to medicines. We call on Member States to strengthen procurement, supply chain, and logistics systems for essential medicines and health technologies, including through sustainable financing and effective regulatory oversight, to lower costs, minimize waste, and improve the availability, accessibility, and affordability of quality-assured essential medicines. Thank you.