Balanced drug policy needed to ensure access, affordability and safety: Experts

A balanced drug policy is needed to ensure medicines are geographically accessible, affordable and safe and effective for people across Bangladesh, experts said at a national policy dialogue in Dhaka today (25 August).

They said simply updating the national essential medicines list would not be enough to achieve universal health coverage unless medicines are available across the country, priced within people's purchasing capacity and supplied safely and effectively.

The World Health Organization's (WHO) essential medicines list contains 532 medicines for adults, while Bangladesh's national essential medicines list has only 117. Although regulations require the list to be updated every two years, Bangladesh has not done so regularly.

The experts made the remarks at the national policy dialogue titled "Patient Access to Medicines, Producer Sustainability: In Search of a Balanced Drug Policy 2026", organised by research organisation Public Integrity Network for Evidence and Transparency (PINET) at the CIRDAP auditorium in Dhaka.

Dr Mamunur Rahman Malik, WHO representative and head of the mission in Bangladesh, said the WHO updated the 34th edition of its Essential Medicines List in 2025, which includes 532 essential medicines for adults and around 342 for children.

He said ensuring access to essential medicines under Sustainable Development Goal (SDG) indicator 3.8.1 is a national commitment for Bangladesh.

However, access depends on three factors — whether medicines are available across the country, whether people can afford them, and whether they can take them safely in practice.

"Many times, even when medicines are available in the market, weaknesses in stock management, counterfeit and substandard medicines or problems in the supply system deprive patients of healthcare," he said.

Lack of pharmaceutical sector assessment

According to Dr Malik, Bangladesh does not regularly conduct Pharmaceutical Sector Assessment Surveys, which the WHO encourages in other countries.

He said such surveys assess four areas — patients' access to essential medicines, medicine pricing structures, affordability in the national context, and medicine safety and compliance with regulatory requirements.

"Such data is rarely available from Bangladesh. Yet this information is extremely important for policymaking on pricing and affordability," he said.

The WHO representative said the country's drug regulatory authority needs to be strengthened to ensure medicine safety and regulatory standards.

"We often talk about strengthening various institutions, but the drug regulatory authority also needs to be developed into an effective and independent institution," he said.

He also stressed the need to strengthen pharmacovigilance, or medicine safety surveillance, in Bangladesh.

A stronger system would help identify counterfeit and substandard medicines and regularly monitor adverse events following the use of medicines, he said.

Dr Malik said the concept of "rational use of drugs" had been discussed in Bangladesh for many years, but its practical implementation remains weak.

He warned that antimicrobial resistance (AMR) could become one of the biggest global health threats of the coming century.

"Antimicrobial resistance could rise to become the second or third among the world's top 10 health threats. Therefore, this is not just a matter for discussion; it is time for effective implementation," he said.