Availability, prices and affordability of the World Health Organization’s essential medicines for children in Guatemala

An adaption of the standardized methodology developed by the World Health Organization and Health Action International (HAI) was used to conduct a cross sectional survey to collect data on availability and final patient prices of medicines in public and private sector medicine outlets during April and May of 2010.A subset of the public sector, Programa de Accesibilidad a los Medicamentos (PROAM), had the lowest average availability (25%) compared to the private sector (35%). In the private sector, highest and lowest priced medicines were 22.7 and 10.7 times more expensive than their international reference price comparison. Treatments were generally unaffordable, costing as much as 15 days wages for a course of ceftriaxone.Analysis of the procurement, supply and distribution of specific medicines is needed to determine reasons for lack of availability. Improvements to accessibility could be made by developing an essential medicines list for children and including these medicines in national purchasing lists.Children in poorer countries are more likely to die from treatable conditions than those in higher resource settings because they do not receive appropriate or timely medications [1]. This is also true in Guatemala, where poverty contributes to the country’s high mortality rate for children under the age of five [2]. Millennium Development Goal 4 (MDG4) states that a two-thirds reduction in mortality from 1990 to 2015 in children younger than five years is essential for global development [3]. Compared to the rate of mortality in 1990, Guatemala will need to increase the rate of decline in childhood deaths from 75.8 to 25.3 deaths per 1000 to achieve the MDG goal by 2015 [4]. To assist member countries with achieving MDG4, the WHO constructed the first Essential Medicines List for Children (EMLc) and launched the “Make Medicines Child Size” effort in December of 2007. This initiative aims to improve the accessibility of safe, effective and quality medicines for c