**10. Patients**

Last but not the least most important stakeholders of pharmaceutical policy development are the patients since they are at the centre of attention of all other stakeholders mentioned above. They are the end-users of medicines manufactured by pharmaceutical companies, licensed, approved and regulated by governments, marketed, supplied and sold by pharmaceutical traders, prescribed by doctors and dispensed by the pharmacists, thereby making them the fulcrum that bears all the load of efforts and activities of others in the chain. Success or failure of any policy

framework rests upon the relief or hazard that it brings to the patients and provides some succor to them in alleviating their sufferings from the disease. Health indicators, patient satisfaction and overall health of a society can be the outcome measures to judge the success and effectiveness of any newly developed policy framework. Therefore, during the course of pharmaceutical policy formulation needs, demands and aspirations of patients need to be given due consideration in order to make the policy patient-driven and outcome-oriented one. Focus of the policy making has to shift ostensibly from products to patients, from patent protection to patient protection, from industry orientation to public health orientation, from club good to public good, from corporate-driven to consumer-driven framework. That alone can help in making quick progress towards achieving universal health coverage and securing the health and well-being of patients through social solidarity, social security and social justice, for any society that claims to be civilized, just and humane must be able to provide basic health access to its citizens irrespective of their paying capacity.

As we know now, health is not just about diagnosing ailments, hospitals and social services; it is an issue of social justice. Getting good health care is not a privilege; it is considered a fundamental right. Access to essential medicines has been viewed as an integral component of the right to health, which is a basic human right. Ensuring equitable access to quality pharmaceuticals is thus a key development challenge and an essential component of health system strengthening and primary health care reform programmes throughout the world. WHO in its Preamble [24] states, "The enjoyment of the highest attainable standard of health is one of the fundamental Rights of every human being without distinction of race, religion, political belief, economic or social condition [24]."

Article 12 of the 1966 International Covenant on Economic Social and Cultural Rights (OHCHR) [25] recognizes the right of everyone to "the enjoyment of the highest attainable standard of physical and mental health" including through a health-care system that is "economically accessible to all" and details the steps that states should take to achieve this. In consonance with this recognition, providing access to affordable essential medicines in developing countries has been listed as one of the Millennium Development Goals (UNMDG) [26] outlined by United Nations Organization i.e. MDG 8E (MDG, 2008), Target 17, Indict.46. The Millennium Development Goals whose deadline expired in 2015 were followed by the Sustainable Development Goals (UNSDG) [27] with an extended deadline of 2030 that also contain a commitment to "provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health". The new 2030 agenda, summarized in the Sustainable Development Goals (SDGs), sets a clear path for future action by placing equity and universal health coverage on centre stage. The health goal, SDG 3 - 'Ensure healthy lives and promote well-being for all at all ages' – underscores the importance of access to medical products and that of the Universal Health Coverage (UHC). UHC is the aspiration that all people obtain the health services they need without suffering financial hardships paying for them.

Coulter [28] has suggested that the twenty-first century health service user is at once 'a decision-maker, a care manager, a co-producer of health, an evaluator, a potential change agent, a taxpayer and an active citizen whose voice must be heard by decision-makers'. In view of all these facts due recognition needs to be accorded to the right to health and the right to equitable access to medicines of patients in any pharmaceutical policy development process and adequate policy provisions need to be incorporated to ensure these rights. Policy-makers need to address both the social determinants of
