The existing acquisition cost for
essential drugs in the Cook Islands, Kiribati, Marshall Islands, Nauru, Niue, Tuvalu, is sufficiently high to compromise equitable access to quality
drug therapy. The difficulty of access is further compounded by problems of distance from
drug manufacturers and suppliers, associated with inadequate transport and communication links. In some of the Small Island States of the Pacific, internal distribution challenges further reduce access to drugs for those people who live on the outer islands. Two management processes to address these problems which have successfully been used in the past, are the establishment of an essential
drug list to guarantee consistent appropriate treatment, and the introduction of pooled or bulk purchasing in order to achieve economies of scale. The major
non-communicable diseases (NCDs) in the South Pacific include diabetes,
hypertension and
cardiovascular disease. These diseases, in association with life-style factors of
obesity and smoking result in significant morbidity and mortality. This paper demonstrates that collaboration in
drug purchasing of a defined list of
essential drugs for
hypertension would be beneficial in the South Pacific, and that the process is a model for achievement of rational
drug treatment for NCDs in isolated small economies.