Building from the HIV Response toward Universal Health Coverage.

Jonathan Jay and colleagues draw lessons from the the global HIV response that could help guide the universal health coverage movement.

Quality use of medicines within universal health coverage: challenges and opportunities.

BACKGROUND: Medicines are a major driver of quality, safety, equity, and cost of care in low and middle-income country health systems. Universal health coverage implementers must explicitly address appropriate use of medicines to realize the health benefits of medicines, avoid wasting scarce resources, and sustain the financial viability of universal health coverage schemes. DISCUSSION: Medicines are major contributors to the health and well-being of individuals and populations when used appropriately, and they waste resources and endanger health when used unnecessarily or incorrectly. Stakeholders need to balance inherently competing objectives in the pharmaceutical sector. Emerging and expanding UHC schemes provide potential levers to balance competing system objectives.To use these levers, sustainable universal coverage programs will require a) information systems that can track medicines utilization, expenditures, and quality of medicines use; b) routine monitoring of indicators of medicines availability, access, affordability, and use; c) policies and programs that facilitate appropriate medicines use by prescribers, dispensers, and patients; d) transparency in setting priorities for medicines coverage under resource constraints; and e) a system perspective to engage diverse actors.As they operationalize paths toward universal health coverage and include targeted medicines coverage policies and programs, systems can build on, and innovate, pharmaceutical policy frameworks and management tools from different countries' settings. SUMMARY: Ensuring that medicines which achieve important health outcomes are available, accessible to all, used appropriately, and sustainably affordable is essential for realizing universal health coverage. Stakeholder cooperation and use of information and financing system levers provide opportunities to work toward this goal.

Social media for public health: Reaping the benefits, mitigating the harms.

With more than 4.26 billion social media users worldwide, social media has become a primary source of health information, exchange, and influence. As its use has rapidly expanded, social media has proven to be a "doubled-edged sword," with considerable benefits as well as notable harms. It can be used to encourage preventive behaviors, foster social connectivity for better mental health, enable health officials to deliver timely information, and connect individuals to reliable information. But social media also has contributed to public health crises by exacerbating a decline in public trust, deteriorating mental health (especially in young people), and spreading dangerous misinformation. These realities have profound implications for health professionals, social media companies, governments, and users. We discuss promising guidelines, digital safety practices, and regulations on which to build a comprehensive approach to healthy use of social media. Concerted efforts from social media companies, governments, users, public interest groups, and academia are essential to mitigate the harms and unlock the benefits of this powerful new technology.

A quiet revolution in global public health: The World Health Organization's Prequalification of Medicines Programme.

Problems with the quality of medicines abound in countries where regulatory and legal oversight are weak, where medicines are unaffordable to most, and where the official supply often fails to reach patients. Quality is important to ensure effective treatment, to maintain patient and health-care worker confidence in treatment, and to prevent the development of resistance. In 2001, the WHO established the Prequalification of Medicines Programme in response to the need to select good-quality medicines for UN procurement. Member States of the WHO had requested its assistance in assessing the quality of low-cost generic medicines that were becoming increasingly available especially in treatments for HIV/AIDS. From a public health perspective, WHO PQP's greatest achievement is improved quality of life-saving medicines used today by millions of people in developing countries. Prequalification has made it possible to believe that everyone in the world will have access to safe, effective, and affordable medicines. Yet despite its track record and recognized importance to health, funding for the programme remains uncertain.