World Health Organization and Health Action International, Measuring medicine prices, availability, affordability and price components, 2^nd Edition (Switzerland, 2008), available from http://www.who.int/medicines/areas/access/OMS_Medicine_prices.pdf
“Defined Daily Dose: Definition and general considerations” (WHO Collaborating Centre for Drug Statistics methodology, 07 February 2018), https://www.whocc.no/ddd/definition_and_general_considera/
“How to define a minimum wage?” (International Labour Organization, 2018),https://www.ilo.org/global/topics/wages/minimum-wages/definition/lang--en/index.htm
World Health Organization, The Global Burden of Disease: 2004 Update (Switzerland, 2008), available fromhttp://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/
“WHO Global Benchmarking Tool (GBT) for evaluation of national regulatory systems” (WHO Essential medicines and health products, 2018), available fromhttp://www.who.int/medicines/regulation/benchmarking_tool/en/.
“Disease burden and mortality estimates” (WHO Health statistics and information systems, 2018), available from http://www.who.int/healthinfo/global_burden_disease/estimates/en/index1.html.
Alkire, S. and Robles, G. (2016). “Measuring multidimensional poverty: Dashboards, Union identification, and the Multidimensional Poverty Index (MPI).” OPHI Research in Progress 46a, University of Oxford.
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Medicine	Category (Therapeutic group)	Justification
Salbutamol (100 mcg/dose inhaler)	NCD - Respiratory	Rationale: Salbutamol, a short acting beta-2 agonist, is recommended for prophylaxis and the first-line treatment of bronchospasm in asthma and COPD. It is recommended for all patients with acute severe asthma. Treatment References: WHO PEN 5.b, WHO Guidelines for primary health care in low-resource settings More information in WHO EML 2017 Section Reference: 25.1
Beclometasone (100 mcg/dose inhaler) or other corticosteroid inhaler Alternatives would include, but not be limited to, budesonide, fluticasone, ciclesonide. Refer to ATC group R03BA -	NCD - Respiratory	Rationale: Inhaled corticosteroids are indicated for maintenance treatment of asthma symptoms by reducing inflammation and reducing airways hyper-responsiveness. These do not provide symptomatic relief in acute asthma. Beclometasone is a representative antiasthmatic in the WHO EML. Treatment References: WHO PEN 5.b, WHO Guidelines for primary health care in low-resource settings More information in WHO EML 2017 Section Reference: 25.1
Gliclazide (80 mg cap/tab) or other sulfonylurea Alternatives would include but not be limited to glibenclamide, glimepiride. Refer to ATC group A10BB	NCD - Diabetes	Rationale: Second generation sulfonylureas (SFUs) increase the release of insulin from the pancreas to relieve the hyperglycaemia associated with diabetes. SFUs are useful in patients unable to tolerate metformin, or not adequately controlled on metformin. These are among the main therapies for most patients with type 2 diabetes, but contraindicated for patients with type 1 diabetes. However, it should be noted that glibenclamide has associated with higher levels of hypoglycaemia compared with gliclazide. Gliclazide is the representative sulfonylurea in the WHO EML. Treatment References: WHO PEN 5.b, WHO Guidelines for primary health care in low-resource settings More information in WHO EML 2017 Section Reference: 18.5
Metformin (500 mg cap/tab, 850 mg cap/tab or 1 g cap/tab)	NCD - Diabetes	Rationale: Metformin, an oral anti-diabetic medicine, can be used in patients with type 2 diabetes as a monotherapy or in combination with sulfonylureas. Treatment References: WHO PEN 5.b, WHO Guidelines for primary health care in low-resource settings More information in WHO EML 2017 Section Reference: 18.5
Insulin regular, soluble (100 IU/ml injection)	NCD - Diabetes	Rationale: Regular human insulin, a rapid acting insulin, is necessary for all patients with type 1 and more than 10% of patients with type 2 diabetes. It is currently more affordable to health systems than other long-acting or analogue insulins. Treatment References: WHO PEN 5.b More information in WHO EML 2017 Section Reference: 18.5
Two of the following antihypertensive: Amlodipine (5 mg cap/tab) Enalapril (5 mg cap/tab) or other angiotensin converting enzyme inhibitor (ACEI). Refer to ATC group C09AA. Hydrochlorothiazide (25 mg cap/tab) or Chlorthalidone (25 mg cap/tab) Bisoprolol (5 mg cap/tab) or alternative betablocker (atenolol or carvedilol or metoprolol only)	NCD - Cardiovascular	Rationale: Calcium channel blockers (CBB) are among the first-line treatment options for patients with hypertension. Amlodipine is the representative CCB in the WHO EML. ACEIs are among first-line treatment options for patients with hypertension. ACEIs are also used in the management of heart failure. Enalapril is the representative ACEI in the WHO EML. Thiazide diuretics are among the first-line treatment options for patients with hypertension. Thiazides are also used as the management of heart failure. Hydrochlorothiazide is the representative thiazide diuretic in the WHO EML. Beta-blockers are among the recommended treatment options for patients with hypertension, angina, cardiac arrhythmias or heart failure. Bisoprolol is the representative beta-blocker in the WHO EML. Treatment References: WHO PEN 5.b, WHO Guidelines for primary health care in low-resource settings More information in WHO EML 2017 Section Reference: 12.3, 12.4
Simvastatin (20 mg cap/tab) or other statin. Refer to ATC group C10AA.	NCD - Cardiovascular	Rationale: Statins, lipid-lowering medicines, are used to reduce the risk of coronary heart disease, including fatal and non-fatal myocardial infarction and stroke. Simvastatin is the representative statin in the WHO EML. Treatment References: WHO PEN 5.b, WHO Guidelines for primary health care in low-resource settings More information in WHO EML 2017 Section Reference: 12.6
Acetylsalicylic acid (aspirin) (100 mg cap/tab)	NCD – Cardiovascular	Rationale: Aspirin, an anti-platelet medication, is recommended for preventing a first stroke, has an important role in preventing recurrent strokes, and can reduce the severity of an ischemic stroke. Low-dose aspirin has numerous therapeutic indications including anti-platelet therapy and can be used to reduce the risk of cardiovascular disease. Treatment References: WHO PEN 5.b More information in WHO EML 2017 Section Reference: 12.5
Furosemide 40 mg tablet	NCD - Cardiovascular	Rationale: Furosemide is a loop diuretic used in the treatment of oedema, congestive heart failure, and kidney disease. Treatment References: WHO PEN 5.b More information in WHO EML 2017 Section Reference: 12.4
Morphine (10mg tablet)	Palliative care	Rationale: Morphine, an opioid analgesic, is the first-choice opioid for treatment of strong pain, including cancer pain. It is also recommended as a preoperative medication and sedation for short-term procedures. Treatment References: WHO Model Prescribing Information: Drugs Used in Anaesthesia More information in WHO EML 2017 Section Reference: 2.2,1.3
Paracetamol (any strength)	Pain and Palliative Care	Rationale: Paracetamol, also referred to as acetaminophen or APAP, is an analgesic and antipyretic that is used widely as a first-line treatment for mild to moderate pain and fever. It is also often found in combinations with other medications to treat a cold or for severe pain. In particular, it is the preferred analgesic for pregnant women. Treatment References: WHO Model Prescribing Information: Drugs Used in Anaesthesia More information in WHO EML 2017 Section Reference: 2.1, 7.1
Fluoxetine (20 mg cap/tab) or other selective serotonin reuptake inhibitor (SSRI)	CNS	Rationale: SSRIs are among the most widely used drugs in the treatment of depressive disorders. Fluoxetine is recommended for use in depressive disorders and can be used to treat patients over 8 years old. SSRIs should be used as part of a comprehensive management plan. Treatment References: Evidence-based recommendations for management of depression in non-specialized health settings More information in WHO EML 2017 Section Reference: 24.2
Phenytoin (100mg Tablet) or Carbamazepine (200 mg cap/tab)	CNS	Rationale: Carbamazepine and phenytoin are anticonvulsant/antiepileptic medicines used in the management of generalized and partial seizures and neuropathic pain. Treatment References: Evidence-based recommendations for management of epilepsy and seizures in non-specialized health settings More information in WHO EML 2017 Section Reference: 5
Gentamicin (40 mg/mL in 2mL vial)	Anti-infective	Rationale: Gentamicin, an aminoglycoside antibiotic, is used for the systemic treatment of susceptible infections. It is classified as an ACCESS antibiotic in the WHO EML, signifying that it should widely available, affordable, and quality assured. It is the first-line treatment for community acquired pneumonia, complicated severe malnutrition, and neonatal sepsis, and second-line treatment for gonorrhoeae. Treatment References: WHO Model Prescribing Information: Drugs used in Bacterial Infections More information in WHO EML 2017 Section Reference: 6.2.2
Amoxicillin (500mg cap/tab)	Anti-infective	Rationale: Amoxicillin, a beta-lactam antibiotic, is used to treat a wide range of susceptible infections. It is classified as an ACCESS antibiotic in the WHO EML, signifying that it should widely available, affordable, and quality assured. It is the first-line treatment for specific infectious syndromes, including community acquired pneumonia, neonatal sepsis, lower urinary tract infections, and the second-line treatment for acute bacterial meningitis. Treatment References: WHO Model Prescribing Information: Drugs used in Bacterial Infections More information in WHO EML 2017 Section Reference: 6.2.1
Ceftriaxone (1g/vial Injection)	Anti-infective	Rationale: Ceftriaxone, a third generation cephalosporin, is used for the systemic treatment of susceptible infections. It is classified as a WATCH in the WHO EML, signifying it higher resistance potential and recommendation for only a specific, limited number of indications. It is the first-line treatment for specific infectious syndromes including severe community acquired pneumonia, acute bacterial meningitis, and gonorrhoeae. Treatment References: WHO Model Prescribing Information: Drugs used in Bacterial Infections More information in WHO EML 2017 Section Reference: 6.2.1
Procaine benzylpenicillin (1G = 1MU Injection) or Benzathine benzylpenicillin (900mg=1.2 MIU or 1.44g = 2.4MIU) injection	Anti-infective	Rationale: Procaine benzylpenicillin, a beta-lactam antibiotic, is used to treat syphilis in adults and children. It is classified as an ACCESS antibiotic in the WHO EML, signifying that it should widely available, affordable, and quality assured. Treatment References: WHO Model Prescribing Information: Drugs used in Bacterial Infections More information in WHO EML 2017 Section Reference: 6.2.1
One of the following contraceptives: Ethinylestradiol + levonorgestrel: tablet 30 mcg + 150 mcg (or alternative combined oral contraceptive) Levonorgestrel 30 microgram tablet. Medroxyprogesterone acetate injection IM 150 mg/mL or SC 104 mg/0.65mL Progesterone-releasing implant (etonogestrel 68 mg or levonorgestrel 150 mg) Levonorgestrel 750 mcg or 1.5 mg tablet	MCH	Rationale: Promotion of family planning – and ensuring access to preferred contraceptive methods for women and couples – is essential to securing the well-being and autonomy of women, while supporting the health and development of communities. Access to contraceptives can reduce infant and maternal mortality rates associated with closely spaced and ill-timed pregnancies. Additionally, contraceptives have be included on the WHO EML since its inception and are also listed as life-saving commodities by the UN Commission on Life-Saving Commodities for Women and Children. Treatment References: Medical eligibility criteria for contraceptive use More information in WHO EML 2017 Section Reference: 18.3
Oral rehydration (salts 1 litre)	MCH	Rationale: Oral rehydration salts (ORS), solutions containing sodium, potassium, citrate, and glucose, are used to replace fluid and electrolytes orally. ORS is used to treat acute diarrhoea in children to prevent or treat dehydration. Treatment References: Diarrhoea treatment guidelines including new recommendations for the use of ORS and zinc supplementation for clinic-based healthcare workers More information in WHO EML 2017 Section Reference: 26.1
Zinc sulphate (20mg dispersible tablet)	MCH	Rationale: Zinc supplements are recommended to reduce the severity and duration of acute diarrhoea. If given for 10 to 14 days, zinc also reduces the incidence of new episodes of diarrhoea in the 2 to 3 months following treatment. Treatment References: Diarrhoea treatment guidelines including new recommendations for the use of ORS and zinc supplementation for clinic-based healthcare workers More information in WHO EML 2017 Section Reference: 17.5.2
Oxytocin (5iu or 10iu injection)	MCH	Rationale: Oxytocin, a peptide hormone, is used for the prevention and treatment of postpartum and post-abortion haemorrhage in emergency situations. It is the recommended that all women giving birth should be offered uterotonic drugs, such as oxytocin, during the third stage of labour for the prevention of PPH. Treatment References: WHO Recommendations for the Prevention and Treatment of Postpartum Haemorrhage, UNFPA Medicines for Maternal Health More information in WHO EML 2017 Section Reference: 22.1
Magnesium sulphate 50% 10ml Injection	MCH	Rationale: Magnesium sulfate, an anticonvulsant, is used in the management and prevention of recurrent seizures in eclampsia and pre-eclampsia. Treatment References: WHO recommendation on magnesium sulfate for the prevention of eclampsia in women with severe pre-eclampsia, UNFPA Medicines for Maternal Health More information in WHO EML 2017 Section Reference: 5
Folic acid	MCH	Rationale: Single-agent folic acid is important for the prevention of neural tube defects and should be taken periconceptionally and in first trimester of pregnancy. Treatment References: WHO recommendation on periconceptional folic acid supplementation to prevent neural tube defects More information in WHO EML 2017 Section Reference: 10.1
Artemisinin-based combination therapy (ACT) for treatment of uncomplicated P. falciparum malaria. One of the following: Artemether+lumefantrine (20/120 mg cap/tab) Artesunate+amodiaquine (any strength) Artesunate+mefloquine (any strength) Dihydroartemisinin+piperaquine (any strength) Artesunate+sulfadoxine-pyrimethamine (50 mg+500mg/25mg)	Anti-malarial	Rationale: WHO Guidelines recommend treating adults and children with uncomplicated P. falciparum malaria with artemisinin-based combination therapy (strong recommendation, high-quality evidence). Treatment References: WHO Guidelines for the Treatment of Malaria More information in WHO EML 2017 Section Reference: 6.5.3.1
Artesunate (60 mg injection or 100 mg rectal dose form)	Anti-malarial	Rationale: IM or rectal artesunate is recommended pre-referral treatment of suspected cases of severe malaria pending transfer to a higher level facility. Treatment References: WHO Guidelines for the Treatment of Malaria More information in WHO EML 2017 Section Reference: 6.5.3.1
Combination anti-retroviral therapy for first line treatment of HIV One of the following combinations individually for concomitant use or in fixed-dose combination: 1. Efavirenz (400 mg or 600 mg) + Emtricitabine (200 mg) + Tenofovir disoproxil fumarate (300 mg) 2. Efavirenz (400 mg or 600 mg) + Lamivudine (300 mg) + Tenofovir disoproxil fumarate (300 mg)	Antiretroviral	Rationale: Efavirenz/Emtricitabine/Tenofovir is the preferred fixed-dose combination antiretroviral therapies for treatment of HIV in adults, pregnant or breastfeeding women, and adolescents. Treatment References: WHO Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection More information in WHO EML 2017 Section Reference: 6.4.2.4
Ibuprofen (200mg tablet)	Pain and Palliative Care	Rationale: Ibuprofen, a non-steroidal anti-inflammatory drug, is a first choice medicine in the treatment of mild pain. Treatment References: WHO Guidelines on the pharmacological treatment of persisting pain in children with medical illnesses More information in WHO EML 2017 Section Reference: 2.1
Chlorhexidine Solution or gel: 7.1% (digluconate) delivering 4% chlorhexidine	Neonatal care	Rationale: A recommended antiseptic that should be applied to the umbilical cord in cases of unclean delivery, and if the traditional practices in place increase the risk of cord infection Treatment References: Review of the available evidence on 4% chlorhexidine solution for umbilical cord care More information in WHO EML 2017 Section Reference: 29.1
Ready-to-use therapeutic food (RUTF), paste or spread (1 sachet = 92 g [500 Kcal]) or biscuit (28.4g, 500 kcal per 100g)	Nutrition	Rationale: Energy-dense, micronutrient enhanced pastes used in therapeutic feeding for the community-based management of children who are suffering from uncomplicated severe acute malnutrition and who retain an appetite. Is provided as the therapeutic food in the rehabilitation phase (following F-75 in the stabilization phase) Treatment References: WHO Guideline: Updates on the management of severe acute malnutrition in infants and children. 2013 More information in WHO EML 2017: Not currently included
Isoniazid + pyrazinamide + rifampicin (50 mg + 150 mg + 75 mg)	Antituberculosis	Rationale: Isoniazid + pyrazinamide + rifampicin is recommended as fixed-dose combination therapy for the intensive phase of treatment of drug-susceptible tuberculosis in children. Treatment References: Guidance for national tuberculosis programmes on the management of tuberculosis in children, 2014 More information in WHO EML 2017 Section Reference: 6.2.4
Erythropoiesis - stimulating agents. One of the following: Epoetin alfa (2,000 IU/mL) Darbepoetin alfa (100 mcg/mL)	Chronic kidney disease	Rationale: Erythropoiesis-stimulating agents are recommended for treatment of anaemia of chronic kidney disease in children, young people and adult patients with chronic renal disease requiring dialysis. Treatment References: WHO EML 2016-2017 - Application for erythropoietin-stimulating agents (erythropoietin type blood factors) More information in WHO EML 2017 Section Reference: 10.1
Suggested for monitoring (optional for countries) *
One of the following: Epinephrine injection 1 mg (as hydrochloride or hydrogen tartrate) in 1- mL ampoule Dexamethasone injection 4 mg/ mL in 1- mL ampoule (as disodium phosphate salt)	Antiallergics and medicine used in anaphylaxis	Rationale: Epinephrine (adrenaline) is the first line treatment for a severe allergic reaction. During anaphylactic shock, it must be administered through an intramuscular injection. Dexamethasone is a corticosteroid that prevents almost all symptoms of inflammation associated with allergy. It can also be used during emergency anaphylactic shock. Treatment References: WHO Antiallergics and Medicine Use in Anaphylaxis More information in WHO EML 2017 Section Reference: 3
Fluconazole (50 mg cap/tab) and Nystatin (tablet 500 000 IU)	Anti-fungal drugs	Rationale: Nystatin is an antifungal polyene antibiotic that is effective against infections caused by a wide range of yeasts and yeasts-like fungi. It is used for the treatment of oral, oesophageal and intestinal candidosis. Fluconazole is an orally active imidazole antifungal agent with activity against dermatophytes, yeasts, and other pathogenic fungi. It is widely used in the treatment of serious gastrointestinal and systemic mycoses as well as in the management of superficial infections. Fluconazole is also used to prevent fungal infections in immunocompromised patients. Treatment References: WHO Model Formulary 2008 WHO Model Prescribing Information Drugs used in sexually transmitted diseases More information in WHO EML 2017 Section Reference: 6.3
Levothyroxine (tablet 50 micrograms)	Thyroid hormones	Rationale: Levothyroxine is used for the management of hypothyroidism, diffuse non-toxic goitre, Hashimoto thyroiditis and thyroid cancer. Treatment References: WHO Model Formulary 2008 More information in WHO EML 2017 Section Reference: 18.8

Annex 1: Basket of core set of relevant essential medicines for primary health care and related disease category

Table 1. Basket of core set of relevant essential medicines for primary health care

* These additional medicines were suggested for monitoring during the consultations with WHO regional advisers and WHO Member States, however they do not represent major burden of disease in countries and cannot be weighted according to the same procedure as the mandatory list.

Table 2. Diseases treated with the medicines in the core list

Medicine name	Affiliated disease (code of the diseases according to the ICD-11 classification)
Salbutamol	→ Asthma (1190) → Chronic obstructive pulmonary disease (1180)
Beclometasone or other corticosteroid inhaler	→ Asthma (1190)
Gliclazide or other sulfonylurea	→ Diabetes mellitus (800)
Metformin
Insulin regular, soluble
Amlodipine	→ Hypertensive heart disease (1120)
Enalapril or other angiotensin converting enzyme inhibitor	→ Hypertensive heart disease (1120) → Cardiomyopathy, myocarditis, endocarditis (1150)
Hydrochlorothiazide or Chlorthalidone
Bisoprolol or alternative betablocker (atenolol or carvedilol or metoprolol only)	→ Hypertensive heart disease (1120) → Ischaemic heart disease (1130) → Other circulatory diseases (1160) → Cardiomyopathy, myocarditis, endocarditis (1150)
Furosemide	→ Cardiomyopathy, myocarditis, endocarditis (1150)
Simvastatin or other statin	→ Ischaemic heart disease (1130) → Stroke (1140)
Acetylsalicylic acid (aspirin)	→ Ischaemic heart disease (1130)
Morphine	→ Malignant neoplasms (610)
Paracetamol	→ weight = 1/T
Ibuprofen	→ weight = 1/T
Fluoxetine or other selective serotonin reuptake inhibitor	→ Depressive disorders (830)
Phenytoin or Carbamazepine	→ Epilepsy (970)
Gentamicin	→ Lower respiratory infections (390) → Infectious and parasitic diseases (20)
Amoxicillin	→ Infectious and parasitic diseases (20)
Ceftriaxone
Procaine benzylpenicillin or Benzathine benzylpenicillin
Ethinylestradiol + levonorgestrel (or alternative combined oral contraceptive)	→ Maternal conditions (420)
Medroxyprogesterone acetate injection
Progesterone-releasing implant (etonogestrel or levonorgestrel)
Levonorgestrel
Oral rehydration	→ Diarrhoeal diseases (110)
Zinc sulphate	→ Diarrhoeal diseases (110)
Oxytocin	→ Maternal conditions (420)
Magnesium sulphate	→ Epilepsy (970)
Folic acid	→ Iron-deficiency anaemia (580)
Artemether+lumefantrine	→ Malaria (220)
Artesunate+amodiaquine
Artesunate+mefloquine
Dihydroartemisinin+piperaquine
Artesunate+sulfadoxine-pyrimethamine
Artesunate
Efavirenz + Emtricitabine + Tenofovir disoproxil fumarate	→ HIV/AIDS (100)
Efavirenz + Lamivudine + Tenofovir disoproxil fumarate	→ HIV/AIDS (100)
Chlorhexidine	→ Neonatal sepsis and infections (520)
Ready-to-use therapeutic food (RUTF)	→ Nutritional deficiencies (540)
Isoniazid + pyrazinamide + rifampicin	→ Tuberculosis (30)
Erythropoiesis - stimulating agents	→ Other chronic kidney disease (1273)
Suggested for monitoring (optional)
Epinephrine or Dexamethasone	→ weight = *0.5(**1/T)
Fluconazole
Nystatin
Levothyroxine

Annex 2. Calculation of weights

Weights are region-specific, and the sum of the weights assigned to medicines in the basket is always equal to “1” in a given region. Since some of the medicines are weighted not according to the DALYs but according to the formula in points iii. and iv. above, the weights have to be normalized so that their sum is equal to “1”.

WHO regional data on disease burden is computed and published for 5-year intervals (e.g. 2000, 2005, 2010 and 2015 for now). As a result, for data points falling between the reference years for which DALY estimates are available the closest reference year is used to calculate medicines’ weights (either previous or following) (Figure 1).

Figure 2.1. Selection of data year for computing medicine weights

Two versions of weights are computed: one capturing 32 medicines (excluding optional medicines) and the other capturing 36 medicines (including optional medicines). For countries where the distribution of specific medicines is calculated only in specialized facilities (for example injectable medicines are provided only in hospitals), WHO suggests computing two versions of weights (1 – for pharmacies and other non-tertiary health care facilities based on a shorter list of medicines that exclude the mentioned medicines and 2 – for hospitals that includes the full list of medicines).

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Annex 3: Basket of core set of relevant essential medicines for primary health care: number of units and duration per treatment

Medicine	Dose	Duration	Units
Salbutamol	100 mcg/dose inhaler	30	30
Beclometasone	100 mcg/dose inhaler	30	60
Gliclazide	80 mg cap/tab	30	30
Metformin	500 mg cap/tab OR 850 mg cap/tab OR 1 g cap/tab	30	90
Insulin regular, soluble	100 IU/ml injection	30	90
Amlodipine	5 mg cap/tab	30	30
Enalapril	5 mg cap/tab	30	30
Hydrochlorothiazide	25 mg cap/tab	30	30
Chlorthalidone	25 mg cap/tab	30	15
Bisoprolol	5 mg cap/tab	30	30
Simvastatin	20 mg cap/tab	30	30
Acetylsalicylic acid (aspirin)	100 mg cap/tab	30	30
Morphine	10mg cap/tab	30	180
Paracetamol	500 mg tab/cap	30	180
Fluoxetine	20 mg cap/tab	30	30
Phenytoin	100mg cap/tab	30	90
Carbamazepine	200 mg cap/tab	30	150
Gentamicin	40 mg/mL in 2mL vial	3	15
Amoxicillin for adults	500mg cap/tab	7	21
Ceftriaxone	1g/vial Injection	1	1
Procaine benzylpenicillin	1G = 1MU Injection	10	10
Benzathine benzylpenicillin	900mg=1.2 MIU OR 1.44g = 2.4MIU injection	1	1 or 2
Ethinylestradiol + levonorgestrel	30 mcg cap/tab + 150 mcg cap/tab	28	21
Levonorgestrel	30 mcg cap/tab	28	28
Medroxyprogesterone acetate injection	IM 150 mg/mL OR SC 104 mg/0.65mL	84	1
Progesterone-releasing implant: Etonogestrel OR Levonorgestrel	Etonogestrel 68 mg OR Levonorgestrel 150 mg	3 or 5 years	1
Levonorgestrel	750 mcg OR 1.5 mg tablet	1	2 or 1
Oral rehydration salts	1 litre	1	3
Zinc sulphate	20mg dispersible tablet	14	14
Oxytocin	5iu or 10iu injection	1	1
Magnesium sulphate	50% 10ml Injection	1	2
Folic acid	400 mcg tablet	30	30
Artemether+lumefantrine	20/120 mg cap/tab	3	24
Artesunate+amodiaquine	100 mg + 270 mg	3	6
Artesunate+mefloquine	100 mg + 220 mg	3	6
Dihydroartemisinin+piperaquine	40 mg + 320 mg	3	9
Artesunate+sulfadoxine-pyrimethamine	200 mg + 1500mg + 75mg	3	3 + 1
Artesunate	60 mg injection OR 100 mg rectal dose form	1	1
Efavirenz + Emtricitabine + Tenofovir disoproxil fumarate	400 mg OR 600 mg + 200 mg + 300 mg	30	30
Efavirenz + Lamivudine + Tenofovir disoproxil fumarate	400 mg or 600 mg + 300 mg + 300 mg	30	30
Ibuprofen for adults	200mg cap/tab	30	60
Furosemide	40 mg cap/tab	30	30
Epinephrine	1 mg injection	1	0.5
Dexamethasone	injection 4 mg/ mL in 1- mL ampoule (as disodium phosphate salt)	1	1
Fluconazole	50 mg cap/tab (depending on indication)
Nystatin	tablet 500 000 IU	2	8
Levothyroxine	tablet 50 micrograms	30	60
Chlorhexidine	Solution or gel: 7.1% (digluconate) delivering 4% chlorhexidine	7	1
Ready-to-use therapeutic food (RUTF)	paste or spread (1 sachet = 92 g [500 Kcal]) OR biscuit (28.4g, 500 kcal per 100g)	30	150 - 220 kcal/kg per day
Isoniazid + pyrazinamide + rifampicin	50 mg + 150 mg + 75 mg	30	30 (60, 90 or 120)
Epoetin alfa	2,000 IU/mL	12	50 units/kg

Annex 4 – Combination of availability and affordability

As an example, consider a simplified case of access to a basket of three medicines (Figure 2). In the matrix:

“1” indicates that a medicine is available or is affordable.
“0” indicates that a medicine is not available or not affordable. In other words, “0” in the matrix indicates that the dimension is deprived.
“.” indicates cases when medicine is not available and consequently affordability of medicine is not measured. In other words, information on prices cannot be collected when a medicine is not found by the interviewer in the facility.

Figure 4.1. Achievement matrix on access to medicine (two dimensions)

In this basket the 1^st medicine is fully accessible (i.e. it is both available and affordable), the 2^nd medicine is partially accessible (i.e. it is available but not affordable), while the 3^rd medicine is inaccessible (i.e. it is not available and thus it is not possible to collect information on prices).

In this example, the first medicine is accessible and the third medicine is not. However, the second medicine is partially deprived indicating that specific policies applied in the country may be effective for availability of the medicine but not for its affordability. Applying the union identification approach by S. Alkire and G. Robles that treats elements (medicines) in the matrix with partial deprivation as fully deprived, the second medicine is considered not accessible as well (Figure 3).

Figure 4.2. Achievement matrix of access to medicine (two dimensions & deprivation of dimensions)

At the end of this step, the variable “access” to medicines is generated, combining the 2 dimensions of availability and affordability. This variable remains binary in nature with 1 – medicine is accessible (both available and affordable) and 0 – medicine is not accessible (not available or available but not affordable).

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