The WHO estimates that around a third of the world’s population does not have access to medicines. Given the complexity of the topic, an order of magnitude estimate is more appropriate than a point estimate. In 2017, the WHO said that 1.5 million deaths could be prevented annually if vaccination coverage improved, providing a lower bound to our estimate of 1.5 million.
The WHO estimates that around a third of the world’s population does not have access to medicines.1 There are no comprehensive statistics on how many people die as a result of a lack of access to medicines, so the best that can be done is to look at estimates and assertions in particular fields. It is important to remember that a death may be preventable through some means that is not related to drugs, and that drugs may be inaccessible for some reason other than high pricing enabled by monopoly patent rights. Given the complexity of the topic, an order of magnitude estimate is more appropriate than a point estimate.
A useful yardstick for estimating the number of deaths from lack of access is the number of deaths in total each year. According to the Global Burden of Disease Study, in 2015 11.3 million people in total died from communicable diseases; 39.8 million died from noncommunicable diseases; and 4.7 million died of injury.2 That is a total of 55.8 million deaths in 2015.
A number of sources give assertions on how many deaths are preventable (through health interventions and healthcare as well as through drugs access). Africa Renewal Online states:
‘Approximately 1.6 million Africans died of malaria, tuberculosis and HIV-related illnesses in 2015. These diseases can be prevented or treated with timely access to appropriate and affordable medicines, vaccines and other health services.’3
In a similar way, the WHO assert:
‘5.9 million children under the age of 5 years died in 2015. More than half of these early child deaths are due to conditions that could be prevented or treated with access to simple, affordable interventions.’4
Such claims are only somewhat helpful. Not only are they not backed up with evidence; the numbers also include deaths preventable from ‘other health services’ and ‘interventions’. This means that the number of deaths caused by lack of access to drugs will be smaller than the numbers given here.
The most helpful statistic on deaths preventable by access to drugs is the WHO estimate that in 2008, 8.8m children died from vaccine-preventable illnesses.5 In 2017, the WHO said that 1.5 million deaths could be prevented annually if vaccination coverage improved.6 Although these statistics are also not backed up with evidence, there is an obvious sense in which vaccine-preventable illnesses are preventable directly through access to medicines. These figures thus give us a lower bound to our estimate of 1.5 million.
The number of people who die through lack of access to medicines must then number in the millions: vaccine coverage alone would prevent more than a million deaths annually. It also seems probable that the number of people who die through lack of access will be less than tens of millions. The overall annual global mortality is 55.8 million, and it seems unlikely that more than a fifth of deaths are preventable through access to drugs. ‘Millions’ rather than ‘tens of millions’ is the most plausible order of magnitude.
“WHO | Immunization Coverage.” WHO. Accessed September 11, 2017. http://www.who.int/mediacentre/factsheets/fs378/en/.
“WHO | Measles.” WHO. Accessed September 11, 2017. http://www.who.int/mediacentre/factsheets/fs286/en/.
“WHO World Health Organization: Immunization, Vaccines And Biologicals. Vaccine Preventable Diseases Vaccines Monitoring System 2017 Global Summary Reference Time Series: DIPHTHERIA.” Accessed September 11, 2017. http://apps.who.int/immunization_monitoring/globalsummary/timeseries/tsincidencediphtheria.html.
“Dying from Lack of Medicines | Africa Renewal Online.” Accessed September 11, 2017. http://www.un.org/africarenewal/magazine/december-2016-march-2017/dying-lack-medicines.
“Global, Regional, and National Life Expectancy, All-Cause Mortality, and Cause-Specific Mortality for 249 Causes of Death, 1980–2015: A Systematic Analysis for the Global Burden of Disease Study 2015.” The Lancet 388 (2016): 1459–1544.
“GBD Compare | IHME Viz Hub.” Accessed September 11, 2017. http://vizhub.healthdata.org/gbd-compare.
“WHO | Children: Reducing Mortality.” WHO. Accessed September 11, 2017. http://www.who.int/mediacentre/factsheets/fs178/en/.
“WHO | Estimates of Disease Burden and Cost-Effectiveness.” WHO. Accessed September 11, 2017. http://www.who.int/immunization/monitoring_surveillance/burden/estimates/en/.
“Delivering on the Global Partnership for Achieving the Millennium Development Goals.” United Nations, MDG Gap Task Force, 2008. http://www.who.int/medicines/mdg/MDG08ChapterEMedsEn.pdf.
Frost, Laura J., Michael R. Reich, and others. Access: How Do Good Health Technologies Get to Poor People in Poor Countries? Harvard Center for Population and Development Studies, 2008. https://www.cabdirect.org/cabdirect/abstract/20103004633.
