Child survival, cost - recovery and essential drugs : experience and issues

This report summarizes various countries" experiences with financing their pharmaceutical needs through revolving funds, reviews evidence on the relationship between expenditures on pharmaceuticals for child survival and total government pharmaceutical expenditures, and discusses alternative financing mechanisms. Efforts to involve the private pharmaceutical sector in child survival are also outlined. The major conclusions are: (1) the limited allocation of governments" financial resources to health is a major constraint on sustainability; (2) child survival efforts compete for scarce resources with other interests, including public demand for essential drugs; (3) A.I.D."s efforts to improve drug supply management have, in some countries, increased supply and controlled costs; (4) essential drugs are the one element in primary health care for which people are willing to pay, and thus can serve as an entry point into the primary health care system; (5) some local programs have met replacement costs with revenues from drug sales; (6) efforts to involve the private sector in child survival have been limited, for the most part, to oral rehydration therapy.