Improving access to affordable inhaled medicines – advocacy and the Global Asthma Report

Dr Karen Bissell, The University of Auckland, NZ

To explore the role of advocacy in improving access to essential asthma medicines, this presentation draws on lessons learned through the work of the International Union Against Tuberculosis and Lung Disease (The Union) and its partners in low- and middle-income countries and settings. One overarching lesson is that access does not improve simply by making medicines affordable and available. Demand for essential medicines must be created within countries, alongside demand for affordable, effective and acceptable asthma management. Advocacy is part of creating this demand and it is relevant at all levels (local, state/regional, national/federal, regional and global).

This presentation explores and adds to learnings from a) implementation of The Union’s signature programmatic approach to the standardised management of asthma and b) The Union’s Asthma Drug Facility (ADF) experience (2005-2013). The ADF aimed to provide affordable, quality-assured essential asthma medicines and to promote a quality improvement package for the diagnosis, treatment and management of asthma. Initially based on the experience of the Global Drug Facility (GDF) for tuberculosis, the ADF had to tackle distinct challenges, given the complexities of the asthma inhaler as a product for quality assessment, and the lack of political commitment and health system readiness for asthma management. With its WHO-compliant quality assurance system, pooled procurement and other procurement strategies, ADF provided quality-assured medicines at affordable prices. ADF clients shared learnings. Examples of how advocacy can help to initiate, consolidate and scale up asthma management with essential asthma medicines are discussed.