Measurement and monitoring of access to essential medicines are of high priority for the global development agenda given access is an integral part of the Universal Health Coverage movement and an indispensable element of the delivery of quality health care. Access to medicines is a composite multidimensional concept that is composed of the availability of medicines and the affordability of their prices. Information on these two dimensions has been collected and analysed since the 54th World Health Assembly in 2001, when Member States adopted the WHO Medicines Strategy (resolution WHA54.11). This resolution led to the launch of the joint project on Medicine Prices and Availability by WHO and the international non-governmental organization Health Action International (HAI/WHO), as well as a proposed HAI/WHO methodology for collecting data and measuring components of access to medicines.

Proportion of health facilities that have a core set of relevant essential medicines available and affordable on a sustainable basis. The indicator is a multidimensional index reported as a proportion (%) of health facilities that have a defined core set of quality-assured medicines that are available and affordable relative to the total number of surveyed health facilities at national level.

The proposed indicator will allow for the following disaggregation: 1) public/private/mission sectors facilities (managing authority) 2) geography – rural/urban areas 3) therapeutic group 4) facility type (pharmacy/hospital) 5) medicine.

The index is computed as a ratio of the health facilities with available and affordable medicines for primary health care over the total number of the surveyed health facilities: 𝑆𝐷𝐺3.𝑏.3 = 𝐹𝑎𝑐𝑖𝑙𝑖𝑡𝑖𝑒𝑠 𝑤𝑖𝑡ℎ 𝑎𝑣𝑎𝑖𝑙𝑎𝑏𝑙𝑒 𝑎𝑛𝑑 𝑎𝑓𝑓𝑜𝑟𝑑𝑎𝑏𝑙𝑒 𝑏𝑎𝑠𝑘𝑒𝑡 𝑜𝑓 𝑚𝑒𝑑𝑖𝑐𝑖𝑛𝑒𝑠 (𝑛) 𝑆𝑢𝑟𝑣𝑒𝑦𝑒𝑑 𝐹𝑎𝑐𝑖𝑙𝑖𝑡𝑖𝑒𝑠 (𝑛) For this indicator, the following variables are considered for a multidimensional understanding of the components of access to medicines: • A core set of relevant essential medicines for primary healthcare • Regional burden of disease • Availability of a medicine • Price of a medicine • Treatment courses for each medicine (number of units per treatment & duration of treatment) • National poverty line and lowest-paid unskilled government worker (LPGW) wage • Proxy for quality of the core set of relevant essential medicines.

Regional and global aggregates can be computed using national population size of a country as a proxy for the country weights in the region or globally. This is justified because medicines must be available and affordable for every individual in the population. To compute the regional indicator, the weighted average of the country indicators (using either the actual national indicator when available for the specific year of calculation, or the imputed value that corresponds to the year closest to the year of calculation) is used.

Not Applicable

Based on historical data points, the first release of the SDG indicator 3.b.3 results is planned for the summer of 2019. Subsequently, updated values will be calculated and published on an annual basis.

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