Exploring access to essential medicines in the South Pacific: insights from a multi-country cross-sectional study.

BACKGROUND

Access to essential medicines is imperative for delivering effective healthcare, yet a significant proportion of the global population continues to face barriers in obtaining them. The South Pacific Region (SPR) faces unique medicine access challenges due to geographic remoteness, economic limitations, and, strained healthcare infrastructure. To gain further insight, this study aimed to assess the availability, pricing, and, affordability of essential medicines stratified by World Bank income group.

METHODS

The WHO and Health Action International standardised methodology was employed in the public and private sectors of New Caledonia, French Polynesia, Wallis and Futuna, Fiji, Vanuatu, and, the Solomon Islands between February 1st 2023 and October 1st 2023. We measured availability, median price ratio (MPR), and affordability. Data were analysed by World Bank income group.

FINDINGS

Data were collected from 19 public-sector hospitals and 24 private-sector pharmacies. Lower-middle income countries (LMICs) had the lowest mean availability for both public and private sectors, while upper-middle and high-income countries (HICs) demonstrated moderate to high availability. The mean availability of lowest-priced generics (LPG) in LMICs was 59.1% in the public sector and 57.4% in the private sector, compared to 87.2% and 72.5% respectively in HICs. MPRs indicated high medicine prices across all categories. Affordability analysis revealed that medicines were unaffordable in LMICs yet affordable in UMICs and HICs.

INTERPRETATION

LMICs within the South Pacific display low availability and poor affordability of essential medicines. Urgent targeted policy reform and strategic initiatives are required to ensure effective and equitable healthcare within this region.

FUNDING

This research was supported by l'Agence Française de Développement, Le Fonds Pacifique [CZZ3165ORC].