Controlled medicines for children's medical needs: a review of the scope, determinants, and consequences of inequitable access

Controlled medicines, defined here as any pharmaceutical product whose active principles are listed under the international drug Conventions, are essential for the medical care of children. Global disparities in controlled medicine access contribute to an immense burden of disease and serious health-related suffering for children across multiple health conditions, particularly in many low-income and middle-income settings. In this Review, we clarify the extent and nature of the problem of insufficient access to controlled medicines for children and explore its causal determinants. Children frequently experience additional barriers in accessing controlled medicines for several reasons, including their vulnerability to neglect in general policies and health services, inadequate availability of child-specific formulations, and gaps in knowledge and expertise. The poor visibility of children in global research on controlled medicines, as evidenced by this Review's rapid bibliographic analysis, underscores the need for targeted research and interventions focused specifically on improving children's access to controlled medicines.