# An analysis of the registration of essential medicines in Namibia: a proxy measure of the availability of essential medicines

## TL;DR

This study assesses the availability of essential medicines in Namibia by analyzing their registration status, revealing gaps in product diversity despite high registration rates.

## Contribution

The paper introduces the registration status of essential medicines as a proxy measure for their availability in Namibia.

## Key findings

- 80.2% of essential medicines on the NEMList are registered in Namibia.
- Only 45.5% of registered essential medicines have at least three registered products.
- Reserve group antibiotics have the lowest diversity with only 25% having three registered products.

## Abstract

Many African countries, including Namibia, face challenges with the availability of essential medicines, impacting health outcomes. This study aimed to evaluate the availability of essential medicines in Namibia by examining the registration of medicines on the Namibia Essential Medicines List (NEMList) as a proxy.

An in-depth analysis of the registration of essential medicines was carried out by comparing medicines in the NEMList against registered medicines on the Namibian Human Medicines Register as of February 2024. Microsoft Excel was used to capture details about the generic names of medicines, strengths, and dosage forms in which the medicines were available. A sub-analysis of antibiotics, which classified them using the Access, Watch and Reserve (AWaRe) classification, was also conducted.

A high proportion of essential medicines listed in the NEMList, 80.2% (386/481) are registered in the country. However, essential medicines only accounted for 23.7% (1,288/5,444) of all medicines on the Namibian Human Medicines Register. Among the essential medicines registered in Namibia, only 45.5% (176/386) had at least three registered products. Of the 55 antibiotics on the NEMList, 94.5% (52/55) had registered products, with 96.2% (25/26), 92.0% (23/25) and 100% (4/4) of Access, Watch and Reserve group antibiotics having registered products, respectively. Despite the high proportions of registered essential antibiotics, only 65.4% of Access group antibiotics, 68.0% of Watch group antibiotics and 25.0% of Reserve antibiotics had at least three registered products.

Registration of essential medicines is crucial to ensure access and availability. Further studies are needed to understand the bottlenecks encountered by the Namibia Medicines Regulatory Council (NMRC) in registering essential medicines. Concerted programmes and policies to strengthen regional harmonisation of medicines registration should be developed, and essential medicines should be prioritised.