Many people in developing countries lack access to health technologies, even basic ones. Why do these problems in access persist? What can be done to improve access to good health technologies, especially for poor people in poor
countries? This book answers those questions by developing a comprehensive analytical framework for access and examining six case studies. Access to health
technologies in poor countries is shaped by social, economic, political, and cultural
processes. To understand those processes, the authors develop an analytic framework based on four A’s: Architecture, Availability, Affordability, and Adoption.

The book applies this approach to explain why some health technologies
achieved more access than others. The technologies include praziquantel (for the
treatment of schistosomiasis), hepatitis B vaccine, malaria rapid diagnostic tests,
vaccine vial monitors for temperature exposure, the Norplant implant contraceptive, and female condoms. The book is based on research studies commissioned by the Bill & Melinda Gates Foundation.