|Public-private roles in the pharmaceutical sector: Implications for equitable access and rational drug use (WHO/DAP, 1997, 115 p.)|
|3. Essential state responsibilities|
What are the essential responsibilities of the state in the pharmaceutical sector?
Purely private markets for pharmaceuticals are unlikely to be either efficient or equitable. This is apparent from the preceding discussion. Thus, government needs to improve the operation of private markets by establishing a clear policy and regulatory framework. Regardless of how involved the private sector is in the financing and distribution of drugs, it is up to the state to ensure that a set of core functions are performed. These essential state responsibilities include policy-making, drug regulation, establishing professional standards, ensuring access to essential drugs and promoting rational drug use (Table 3). These functions constitute the minimum for which the state must take responsibility.
The state may choose not to implement all of these responsibilities itself; it may delegate some functions to other actors in the pharmaceutical sector. For example, professional bodies may be involved in setting educational standards and developing codes of conduct. The appropriateness of the state's delegating any of the tasks described below to others will depend on capacity in both public and private sectors and on the availability of suitably qualified and motivated agencies. Regardless of who performs these functions, the state must assume responsibility for ensuring that they are performed, and that they are performed effectively.