• Shanti Mendis, Keiko Fukino, Alexandra Cameron, Richard Laing, Anthonio Filipe, Oussama Khatib, Jerzy Leowski, and Margaret Ewen.
• Department of Chronic Diseases and Health Promotion, World Health Organization, Geneva, Switzerland. mendiss@who.int
• Bull. World Health Organ. 2007 Apr 1;85(4):279-88.

ObjectiveTo assess the availability and affordability of medicines used to treat cardiovascular disease, diabetes, chronic respiratory disease and glaucoma and to provide palliative cancer care in six low- and middle-income countries.MethodsA survey of the availability and price of 32 medicines was conducted in a representative sample of public and private medicine outlets in four geographically defined areas in Bangladesh, Brazil, Malawi, Nepal, Pakistan and Sri Lanka. We analysed the percentage of these medicines available, the median price versus the international reference price (expressed as the median price ratio) and affordability in terms of the number of days wages it would cost the lowest-paid government worker to purchase one month of treatment.FindingsIn all countriesConclusionContext-specific policies are required to improve access to essential medicines. Generic products should be promoted by educating professionals and consumers, by implementing appropriate policies and incentives, and by introducing market competition and/or price regulation. Improving governance and management efficiency, and assessing local supply options, may improve availability. Prices could be reduced by improving purchasing efficiency, eliminating taxes and regulating mark-ups.

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