Cohen-Kohler J C
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
Clin Pharmacol Ther. 2007 Nov;82(5):610-4. doi: 10.1038/sj.clpt.6100359. Epub 2007 Sep 26.
Pharmaceuticals are one of the cornerstones of human development as their rational consumption can reduce morbidity and mortality rates and enhance the quality of life. Pharmaceuticals have curative and therapeutic qualities, so they cannot be considered as ordinary products. In line with this, ensuring public policy fosters access to medicines demands thoughtful and careful consideration, as it is often about whether a patient lives or dies. Despite the flow of international aid for pharmaceuticals, particularly used for the treatment of HIV/AIDS, tuberculosis, and malaria, there is a morally concerning drug gap globally; the World Health Organization (WHO) notes that one-third of the global population lacks regular access to essential medicines and that in some parts of Asia and Africa these figures are even more severe.(1) But what is troubling is that, despite the knowledge that we live in a world with inequitable access to medicines, we have not examined how we need to put in place policies that not only support drug access but also do not undermine it, which will be addressed later. What is promising, is that slowly, a paradigm shift is taking place. Access to essential medicines is increasingly viewed as a fundamental human right, with international human rights laws placing attendant obligations on states to ensure access.(2, 3) But governments also have to ensure that the policy environment is supportive of access to medicines. And this includes making sure that social policy is not undercut by economic interests.
药品是人类发展的基石之一,因为合理使用药品可以降低发病率和死亡率,提高生活质量。药品具有治疗功效,因此不能被视为普通产品。与此相符的是,确保公共政策促进药品可及性需要深思熟虑和谨慎考量,因为这往往关乎患者的生死。尽管有国际药品援助,特别是用于治疗艾滋病毒/艾滋病、结核病和疟疾的援助,但全球仍存在令人担忧的药品缺口;世界卫生组织(WHO)指出,全球三分之一的人口无法定期获得基本药物,在亚洲和非洲的一些地区,这些数字更为严峻。(1) 但令人不安的是,尽管我们知道生活在一个药品可及性不平等的世界里,但我们尚未审视如何制定不仅支持药品可及性而且不会破坏它的政策,这将在后面讨论。有希望的是,一种范式转变正在慢慢发生。获得基本药物越来越被视为一项基本人权,国际人权法规定各国负有确保可及性的相应义务。(2, 3) 但政府还必须确保政策环境有利于药品可及性。这包括确保社会政策不会被经济利益削弱。