A price and availability survey of essential medicines in Harare Province, Zimbabwe.
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Access to essential medicines is both a fundamental basic right and necessity for everyone, thus governments should make concerted efforts to ensure that all have access to safe, quality and comparative cost-effective medicines. Efforts aimed at identifying factors hindering full access are key in informing relevant policy makers. Thus in pursuant of making significant contributions to the above, a survey was carried-out in Harare metropolitan province of Zimbabwe to determine prices, price components, pricing policies, source and availability of essential medicines (their innovator and/or generic equivalents) in both private and public retail sectors. Comparisons with 36 other low to middle-income countries in the rest of Africa, Americas, Eastern Mediterranean, Europe, Southeast Asia and Western Pacific were also conducted. A standardized methodology developed by World Health Organization and Health Action International (WHO/HAI) was used to survey a selected basket of 40 medicines. The selection was based on the WHO/HAI core medicines list and the latest version of the essential drug list of Zimbabwe. The survey was conducted in 110 private pharmacies, of which 55 were from the central business district, 33 from the high density and 22 from the low density suburbs. In both private and public sectors, availability of the selected essential medicines (low priced generics) was quite high (>80%). Fewer innovator brands were found for the selected medicines. Median price ratios (MPR) of the lowest priced generics revealed that many people still might be having their accesses to essential medicines compromised by high prices, particularly in the private sector (4.52). The public sector showed significant progress towards procurement efficiency (MPR of 1.5). More than 70% of the surveyed medicines were from manufacturers outside Zimbabwe with more than 60% being produced by Indian generic manufacturers. Zimbabwe still needs to do more on pricing, particularly in the private sector as well as promoting local production among other efforts in its quest to ensure all its people have access to quality, safe and effective medicines.