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Health care

Scooter pharmacies

by Eva-Maria Verfürth

In brief

For free: Medical examination of a girl  in the slums of Phnom Penh, Cambodia

For free: Medical examination of a girl in the slums of Phnom Penh, Cambodia

Poor people tend to pay more than rich people do for the same medicine, but nonetheless often do not get ­access to the medication they need. A new publication shows how all this could change.

The demand that pharma companies provide medicine to the poor is nothing new, and the market opportu­nities look great. On the average, the poor spend more than five per cent of their income on health care, and a third of that on medicines. The untapped market should be worth more than 52 billion dollars in purchasing power parities.

Nonetheless, some 1.7 billion people lack access to vital medicines. In Africa and India, more than half of all people are affected. The pharmaceuticals they can buy, moreover, are often expensive, past their use-by-date or counterfeit.

These figures are surprising given that 95 % of essential medicines are no longer protected by patents. Accordingly, everyone should be able to afford generic versions. But low-price medication tends not to reach the poorest of the poor in the villages and slums of the developing world. Typically, medicines are even more expensive there because of transport problems, including bad road infrastructure. In addition, there are confusing rules and import duties. Physicians, moreover, are often not qualified and middlemen are likely to siphon off huge profits.

To overcome such obstacles, pharma companies have to take new approaches to sales and marketing. Published at the end of January, a manual entitled “Bringing medicines to low-income markets” gives advice on how to invest in poor markets. The authors recommend that firms apply “4As+1”:
Acceptance: Firms have to find out about the markets of the poor and tailor their products to their needs.
Awareness: They should support awareness raising on health issues to expand the medical knowledge of patients and health staff.
Availability: They must make their products available even in remote areas.
Affordability: Medicines must be affordable. To this end, firms can offer special funding or support micro-insurance schemes.
+Actors: For all four As, companies should cooperate with other agencies who are familiar with local situations and whom people trust.

The manual contains a number of examples, for instance for packaging: It helps the illiterate when instructions include drawings and colour schemes. Health camps are a good idea in places where people do not have internet access or standard education: in India, for instance, health educators visit villages, providing information, diagnoses and health tips. The African initiative Riders for Health lends vehicles – usually scooters – to medical staff so they can reach remote areas. And to ensure that patients do not forgo good pharmaceuticals for lack of money, one firm in the Philippines allows relatives abroad to pay for treatment. The firm even offers them discounts.

Eva-Maria Verfürth