ArticlePloS one2020
Importance of medicine quality in achieving universal health coverage.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Access to Essential Medicines in Low- and Middle-Income Countries: A Systematic Review of Barriers and Facilitators.International journal of public health · 2026Pooled it
- Health, Economic, and Social Impacts of Substandard and Falsified Medicines in Low- and Middle-Income Countries: A Systematic Review of Methodological Approaches.The American journal of tropical medicine and hygiene · 2023Pooled it
- Medicines governance and systemic constraints: A qualitative study among healthcare professionals in South Africa.African journal of primary health care & family medicine · 2026Article
- Moving beyond a legacy paradigm: A vision for equitable access to quality medicines in Africa.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Strengthening pharmacovigilance and regulatory capacity in Southern Africa (SPaRCS): achievements, experiences and lessons learned from a participatory action learning project.Frontiers in drug safety and regulation · 2026Article
- Pharmaceutical quality and cost-effectiveness of branded versus generic medicines across 22 drug types and 8 therapeutic categories: a citizen-funded comparative study from regulated retail outlets in Kerala, India.Frontiers in pharmacology · 2026Article
- Supply chain management of health commodities and essential drug procurement systems at Sankhuwasabha and Kavrepalanchowk districts of federal Nepal.Journal of public health research · 2026Article
- The World Health Organization Coalition of Interested Parties Network: a unified and coordinated approach to regulatory system strengthening.Frontiers in medicine · 2026Article
- The economic and health impact of substandard uterotonic use for prevention of postpartum hemorrhage in three Sub-Saharan African countries: a comparative analysis.Health research policy and systems · 2025Article
- Modeling the economic and health impact of substandard uterotonics in Senegal.BMC pregnancy and childbirth · 2025Article
- Availability, pricing, and affordability of antithrombotic medicines in Addis Ababa, Ethiopia: implications for health policy.Journal of pharmaceutical health care and sciences · 2025Article
- Evaluation of the implementation and the associated operating costs of a medicine regulatory harmonisation model in Africa: the case of ZaZiBoNa, a SADC work-sharing initiative.Journal of pharmaceutical policy and practice · 2025Article
- Modelling the economic impact of substandard uterotonics on postpartum haemorrhage in Nigeria: safeguarding medicine quality can reduce costs and contribute towards universal health coverage.BMJ public health · 2025Article
- Drivers of vulnerability to medicine smuggling and combat strategies: a qualitative study based on online news media analysis in Iran.BMC health services research · 2024Article
- Nanomaterial-based Electrochemical Sensors for Multiplex Medicinal Applications.Current topics in medicinal chemistry · 2024Review
- Procurement process and shortages of essential medicines in public health facilities: A qualitative study from Nepal.PLOS global public health · 2024Article
- Modeling the economic burden of postpartum hemorrhage due to substandard uterotonics in Ghana.PLOS global public health · 2024Article
- Challenges of Antibiotic Formulations and Administration in the Treatment of Bloodstream Infections in Children Under Five Admitted to Kisantu Hospital, Democratic Republic of Congo.The American journal of tropical medicine and hygiene · 2023Article
- Article
- How and why pharmaceutical reforms contribute to universal health coverage through improving equitable access to medicines: a case of Ghana.Frontiers in public health · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the importance of ensuring medicine quality in order to achieve universal health coverage (UHC).
methodsWe developed a systems map connecting medicines quality assurance systems with UHC goals to illustrate the ensuing impact of quality-assured medicines in the implementation of UHC. The association between UHC and medicine quality was further examined in the context of essential medicines in low- and middle-income countries (LMICs) by analyzing data on reported prevalence of substandard and falsified essential medicines and established indicators for UHC. Finally, we examined the health and economic savings of improving antimalarial quality in four countries in sub-Saharan Africa: the Democratic Republic of the Congo (DRC), Nigeria, Uganda, and Zambia.
findingsA systems perspective demonstrates how quality assurance of medicines supports dimensions of UHC. Across 63 LMICs, the reported prevalence of substandard and falsified essential medicines was found to be negatively associated with both an indicator for coverage of essential services (p = 0.05) and with an indicator for government effectiveness (p = 0.04). We estimated that investing in improving the quality of antimalarials by 10% would result in annual savings of $8.3 million in Zambia, $14 million in Uganda, $79 million in two DRC regions, and $598 million in Nigeria, and was more impactful compared to other potential investments we examined. Costs of substandard and falsified antimalarials per malaria case ranged from $7 to $86, while costs per death due to poor-quality antimalarials ranged from $14,000 to $72,000.
conclusionMedicines quality assurance systems play a critical role in reaching UHC goals. By ensuring the quality of essential medicines, they help deliver effective treatments that lead to less illness and result in health care savings that can be reinvested towards UHC.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.