Improving Access to Affordable Quality-Assured Inhaled Medicines in Low- and Middle-Income Countries

Background: Access to affordable inhaled medicines for chronic respiratory diseases (CRDs) is severely limited in low- and middle-income countries (LMICs) causing avoidable morbidity and mortality. The International Union Against Tuberculosis and Lung Disease convened a stakeholder meeting on this topic in February 2022.Methods: Focused group discussions were informed by literature and presentations summarising experiences of obtaining inhaled medicines in LMICs. The virtual meeting was moderated using a topic guide around barriers and solutions to improve access. The thematic framework approach was used for analysis. Results: A total of 58 key stakeholders, including patients, healthcare practitioners, members of national and international organisations, industry, and the World Health Organization attended the meeting. 20 submitted pre-meeting materials. The main barriers identified were: (1) low awareness of CRDs; (2) limited data on CRD burden and treatments in LMICs; (3) ineffective procurement and distribution networks; (4) poor communication of the needs of people with CRDs. Solutions discussed were: (1) generation of data to inform policy and practice; (2) capacity building; (3) improved procurement mechanisms; (4) strengthening advocacy; and (5) a World Health Assembly Resolution.Conclusion: There are opportunities to achieve improved access to affordable, quality-assured inhaled medicines in LMICs through coordinated, multi-stakeholder, collaborative efforts