Improving access to safe and quality essential medicines and medical devices. The role of pharmacy

The right to health is a fundamental human right of every individual to enjoy the highest attainable standard of physical and mental health, regardless of any socioeconomic, demographic and health identifiers. Universal health coverage is an imperative goal that hinges on the realisation of equitable and affordable access to safe, effective, and quality medicines and medical devices for all.

Access to essential medicines and medical devices is vital for managing health conditions, preventing diseases, and improving well-being. These medicines and devices are considered essential for addressing public health priorities as timely access can be life-saving, and without them, health disparities worsen. While essential medicines lists do not encompass all medications, they serve as a foundation for promoting equitable access to healthcare and addressing the most pressing health needs within a population.

During the COVID-19 pandemic, challenges around equitable access increased, exacerbated by disruptions in the supply and competition for resources, disproportionately affecting vulnerable populations. These challenges include political and regulatory variations, marketing decisions, and supply chain disruptions that contribute to disparities in healthcare outcomes globally, necessitating international collaboration and regulatory harmonisation to improve access.

In this context, the International Pharmaceutical Federation (FIP) aligned its development goals with the Sustainable Development Goals (SDGs) of the United Nations (UN), which assert health as a fundamental human right. FIP Development Goal (DG) 18 (Access to Medicines, Devices and Services) sets out clear strategies to widen access to
medicines, devices, and services. This reference document aims to strengthen collaboration among healthcare professionals, patients, policy makers, and other health stakeholders to improve access and address issues in access such as medicine affordability, availability, quality and safety.

Specifically, it aims to provide a comprehensive overview of the important contributions that pharmacists, pharmaceutical scientists and educators can make in ensuring availability, affordability, and appropriate use of safe and quality essential medicines and medical devices. Pharmacists, as the most accessible healthcare professionals, can
help to ensure global access to essential medicines. For instance, pharmacists play an integral role in improving the affordability and availability of medicines. They ensure uninterrupted medicine supply and collaborate with healthcare providers for optimal usage. They can monitor shortages, advice on suitable alternatives and ultimately alert authorities to shortages, price changes, or supply chain issues and advocate for patients by assisting them in navigating healthcare systems, understanding their rights, and accessing support programmes for affordable medication. Pharmacists are also critical in ensuring access to safe and quality medicines by detecting medication interactions and allergies, educating patients on proper medication usage, and managing waste disposal to mitigate environmental risks and enhance the efficacy of medicines.

In addition, pharmacists implement strategies for safe and optimal medicine use, actively monitoring patients, engaging in proactive discussions, contributing to antimicrobial stewardship and deprescribing, improving transitions of care, conducting medication reconciliation, participating in education campaigns, and ensuring evidence-based information dissemination for patient-centred care and positive health outcomes. For example, in antimicrobial resistance pharmacists can ensure the use of correct protocols and guidelines, sequencing of agents and sparing agents for alternative lines of therapy and therefore ensure safe access to medicines at each stage of the disease as needed.

However, there is a significant disparity in pharmacy workforce between low- and high-income countries, underscoring the need for targeted initiatives to bridge this gap.1 FIP DG 18 which aims to create a competent, agile, and welldistributed workforce aligns with the imperative to address these imbalances and maximise the impact of pharmacists
in enhancing healthcare accessibility globally. Various barriers, including under-resourced healthcare systems, regulatory challenges, and the conflict between intellectual property rights and the right to health, hinder progress towards equitable access to medicines. Also, in light of the latest technological developments, it is important that
pharmacists can use appropriate digital tools and participate in initiatives that improve access in geographically or otherwise isolated

Pharmacy organisations play a crucial role in advocating for improved policies, with pharmacists leveraging their expertise to contribute to enhancing access globally, striving towards equitable healthcare for all. Moreover, they support policy implementation. Through active engagement with stakeholders and collaboration across sectors,
pharmacists make substantial contributions towards addressing disparities in access and advancing the objective of universal health coverage.

This document outlines the importance of access to essential medicines and medical devices, the role of pharmacists, as well as the role of FIP in improving access and addressing the challenges and issues that exist around it.