National availability, prices and affordability of essential medicines: a comprehensive analysis using WHO/HAI methodology in Chad.

Introduction: in Chad, the pharmaceutical sector faces many challenges, including essential medicine availability, affordability, and pricing. The country has a weak health system with limited access to medical care for the population. This study aims to assess the availability, affordability, and pricing of essential medicines in Chad from 1 Methods: we conducted a descriptive and cross-sectional study including public, private, and contractual sectors. Availability of essential medicines was measured as a percentage (%) of the surveyed outlets, and pricing was computed using the median price ratio (MPR). Results: our results showed that the average medicine availability ranged between 39.59% to 67.37%. In the public sector, average availability ranges from roughly 46% at the health center level to 61.4% at the provincial pharmacy level, with a 52.6% average across all health institutions. In the private sector, it is around 38% for private wholesalers, 48% for pharmacies, 58.4% for pharmaceutical depots, and 48% contractual sector. Provinces with the lowest availability rates were Batha, Kanem, Lac, and Hadjer Lamis, with percentages ranging between 39 and 43%. In terms of cost, the lowest priced generics (LGPs) are 9 times less than originator pharmaceuticals in the contracted sector, 4 times less in the public sector, and 2 times less in the private sector. Conclusion: this study's findings highlight the critical need to provide access to essential medicines and reduce their costs in Chad. Efforts should be undertaken to implement World Health Organization (WHO) guidelines for universal access to essential medicines in Chad.