Access to essential drugs in poor countries - A lost battle?

Drugs offer a simple, cost-effective solution to many health problems, prov ided they are available, affordable, and properly used. However, effective treatment is lacking in poor countries for many diseases, including African trypanosomiasis, Shigella dysentery, leishmaniasis, tuberculosis, and bact erial meningitis, Treatment may be precluded because no effective drug exis ts, it is too expensive, or it has been withdrawn from the market. Moreover , research and development in tropical diseases have come to a near standst ill. This article focuses on the problems of access to quality drugs for th e treatment of diseases that predominantly affect the developing world: (1) poor-quality and counterfeit drugs; (2) lack of availability of essential drugs due to fluctuating production or prohibitive cost; (3) need to develo p field-based drug research to determine optimum utilization and remotivate research and development for new drugs for the developing world; and (4) p otential consequences of recent World Trade Organization agreements on the availability of old and new drugs, These problems are not independent and u nrelated but are a result of the fundamental nature of the pharmaceutical m arket and the way it is regulated.