Lack of access to medicines is a multi-dimensional challenge that stands in the way of better health everywhere. In particular, limited access to essential medicines is one of the key barriers to health in most LMICs: an estimated two billion people have no access to essential medicines.

According to the World Health Organization (WHO) definition, essential medicines are those that satisfy the priority health care needs of the population and are intended to be available at all times in adequate amounts, in the appropriate dosage forms, with assured quality, and at a price the individual and the community can afford.

Affordability is the cornerstone of access but by itself it is not enough. There are other barriers such as diagnosis, health system readiness and government commitment. The WHO Model List of Essential Medicines (WHO EML) provides an internationally recognisable set of selected medicines to help Member States to choose how to treat their priority health needs. However, in a review of 137 National EMLs performed in 2019, there were identified more than 200 substantial differences between national lists of essential medicines and the WHO EML.

Unless we solve affordability but also these other challenges, most of patented essential medicines including those for treating diabetes, cardiovascular diseases, and cancer, will continue to remain beyond the reach of most people in need, stalling progress towards achieving the Universal Health Coverage (UHC) goals.

How can we make essential medicines available and affordable in LMICs? What could be the right approach to develop a more holistic strategy to address access? What lessons can we learn from COVID-19 that could be used to make access easier and quicker in NCDs? The answers will depend on specific circumstances but, nevertheless, must be judged against the standards of transparency, sustainability, and impact.