Tomi Suryo Utomo(1*)

(*) Corresponding Author


Background: Access to affordable essential medicines is
critical for management of public health in Indonesia. This is
because the government budget for medications is limited.
Furthermore, Indonesian sale of generic drugs, which would
be an effective strategy of providing cheaper drugs to the
public, is only 10% of drug sales. This is lower than other
countries in Asia. Relating to HIV prevalence, there is a
significant increase number, particularly in some regions in
Indonesia. It is not impossible that it will increase at alarming
levels in the near future. Finally, the enforcement of
pharmaceuticals patent law in Indonesia has created a tension
between national needs and domestic developmental policy
and international patent standards. This tension has particularly
affected Indonesia, since the TRIPS Agreement was introduced
in 1994. The TRIPS Agreement’s protection of pharmaceutical
patent has had adverse consequences for the health needs
of Indonesia since many patients cannot afford expensive
patented drugs.
Objective: This paper will consider the options or alternatives
open to the Indonesian government to address the access to
essential medicine issues that confront Indonesia as a member
of the WTO. A number of questions will be considered. First,
what factors are major influences on access to essential
medicines, in Indonesia? Second, what strategies and policies
will be recommended to the Indonesian Government to manage
the problems of limited access to affordable essential medicines?
Result: Patent law is not the only factor reducing access to
essential medicines. Non-patent issues that affect access to
essential medicines include: rational selection and use of
medicines; sustainable adequate financing; affordable prices
and reliable health and supply systems are issues that must
be prioritized by the Indonesian Government. Several optional
strategies and policies also need to be considered such as
controlling drugs promotion, maximizing the use of generic
drugs, improving administrative competence, drug
procurement, distribution and storage. Finally, prescribing
practices by physicians, pharmacists and drug vendors should
be a priority. Meanwhile more complex long-term goals, such
as establishing an industry to produce raw materials for
pharmaceuticals, can be considered. This could reduce the
impact of international pharmaceutical patents on price and
availability of essential medicines.
Conclusion: This paper concludes that the Indonesian
government must assess a set of non-patent issues affecting
the use of available drugs, particularly generic drugs. The
recommended policies and strategies will require careful
consideration by a multi-disciplinary committee for selection
and use of essential medicines.
Keywords: patent law, distribution and availability of essential
medicines, access to essential medicines, public health


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