What If a Quarter of a Loaf Is Not Much Better Than None? The Role of the Social Health Insurance Scheme in Promoting Access to Medicines in Ethiopia – An Overview

Abstract

Hundreds of millions of people worldwide do not have access to essential medicines,
particularly in Africa and many parts of Asia, and hence, millions of people
avoidably die every year. Moreover, as people in these countries pay for their own
medicines, the expenditure on medicines coupled with their high prices is pushing
people to poverty. This forces us to see enhancing access to medicines by all means
as not only a major component in realizing the right to health/life, but also as a tool
in contributing its share in the fight against poverty. One of the means through
which access to medicines may be enhanced and out-of-pocket spending may be
avoided is by introducing health insurance schemes with medicines forming part of
the benefit package. Proclamation No. 690/2010 establishes a Social Health
Insurance Scheme in Ethiopia, which contains medicines as one of the benefits of
the scheme. Although it suffers from certain shortcomings, the system is a
commendable step in enhancing access to medicines for its beneficiaries. This article
looks into some of the major shortcomings of the scheme, and tries to assess the role
of donors, pharmaceutical companies and NGOs in terms of enhancing the
formulary and accordingly improve access to medicines to the beneficiaries of the
scheme