02329nas a2200253   4500000000100000008004100001260001200042653003000054653001800084653002900102653002000131653001700151653003900168653003000207653001300237653001200250653002400262100001200286700001500298700001200313245015900325520157700484022001402061       2020                            d  c03/202010aUniversal health coverage10aGlobal health10aGlobal Health Governance10aschistosomiasis10aPraziquantel10aNeglected tropical diseases (NTDs)10aNon-communicable diseases10aDiabetes10aInsulin10aAccess to medicines1 aWells N1 aChappuis F1 aBeran D00aSpotlight on experiences of medicine unavailability: Access to medicines challenges for NCDs and NTDs - The contrasting cases of Insulin and Praziquantel.3 a<p>: Effective medicines exist to address leading global health challenges including Neglected Tropical Diseases (NTD) and Noncommunicable Diseases (NCD) however these are often unavailable and unaffordable. To date little literature exists comparing medicine unavailability across broad disease areas.: Using insulin and praziquantel as useful tracer medicines this review aims to demonstrate that separating global health governance agendas for NCDs and NTDs ultimately impacts the effectiveness of coalitions for access for the poorest populations. Electronic literature searches were performed (March-May 2017 and updated in September - December 2019) using key words from Shiffman's framework of four challenges global health face (problem, coalition, priority, governance) for NCD and NTD and for each medicine through Science Direct, PubMed and Google Scholar. Best practice from each area was analyzed.: Many actors responded to the London Declaration which reinforced praziquantel's central role in control and elimination of schistosomiasis whereas access to affordable insulin emerged secondary to framing around prevention and management of diabetes. For insulin key stakeholders are not aligned around access and the position taken by pharmaceutical companies as donors versus commercial actors was critical to sustainable affordable access to these medicines. Integrated access models for low resource populations need shared pathways given the increasing need for available and affordable essential medicines in the context of Universal Health Coverage.</p>  a1751-2441