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Clin Pharmacol Ther. 2007 Nov;82(5):610-4. Epub 2007 Sep 26.

The morally uncomfortable global drug gap.

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Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.


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.

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