Transcript WHO-Technical Briefing Seminar | 03

WHO Technical Briefing Seminar
Geneva 01- 05 November 2010.
WHO Collaboration with Countries on
Pharmaceutical Policies
Dr Gilles Forte
Essential Medicines and
Pharmaceutical Policies
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WHO-Technical Briefing Seminar | 03 November 2010
Gilles Forte
WHO: 193 Member States
6 Regional Offices
Regional Office AFRO
Regional Office EMRO
Regional Office EURO
Regional Office WPRO
Regional Office SEARO
Regional Office AMRO
WHO HQ Geneva
(Source: http://www.who.int/about/regions/en/index.html)
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Coordination mechanisms
for a sustainable collaboration with countries
AFRO
WHO
HSS
EMP
AMRO
EMRO
EURO
SEARO
WPRO
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WHO-Technical Briefing Seminar | 03 November 2010
Gilles Forte
WHO Country Medicines Advisers and
Collaborating Centres
Medicines Adviser
Collaborating Centre
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WHO-Technical Briefing Seminar | 03 November 2010
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The WHO Country Medicines Advisers Network
for Africa
Medicines Advisers in 15 countries in
Africa for:
UEMOA
Burundi
Cameroon
Central African Rep.
Chad
Congo
Democratic Rep. of the Congo
Ethiopia
Ghana
Kenya
Mali
Nigeria
Rwanda
Senegal
Uganda
United Rep. of Tanzania
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CEMAC
EAC
SADC
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• Assessing national medicines needs &
priorities;
• Planning, implementing, monitoring
WHO interventions;
• Facilitating coordination of partners;
• Contributing to WHO Regional work
on medicines and health systems;
Key principles for collaboration with
countries
 Country ownership - planning & implementation is country led - based on country needs and
priorities;
 Technical collaboration with countries:
-for building evidence base and quality information;
-for sound policies, good practices and advocacy;
-for strengthening pharmaceutical systems & capacity;
 Sustainability and continuity;
 Promoting regional and subregional collaboration and integration;
 Promoting efficient coordination of partners, synergies and aid effectiveness.
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Collaboration framework

Millennium Development Goals 2000-2015 – Goal 4, 5, 6 & 8;

Resolutions of the World Health Assembly – Endorsed by WHA;

WHO Medium Term Strategic Plan 2008 - 2013 - Endorsed by WHA;

Regional Declarations endorsed by Member States e.g. Abuja, Ougadougou, Talinn etc.

Priorities set by the Director General

WHO Medicines Strategy 2008 -13 :
–
–
–

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Information and Policy
Access
Quality and Safety
Rational Use
Multi Country Programmes e.g. EC/ACP/WHO; MeTA; etc.
WHO-Technical Briefing Seminar | 03 November 2010
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Partnership with ACP countries
on Pharmaceutical Policies
Number of countries supported by result areas
60
50
40
n. of countries
supported
30
20
10
0
Policies
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Patents
Prices
Supply
WHO-Technical Briefing Seminar | 03 November 2010
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Quality
Regulation
Rational use Rational use
by
by
prescribers
consumers
National Medicines Policy
NMP and implementation plan
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
2003
2007
Countries with NMP Countries with NMP
Countries with
updated within 5 implementation plan
years
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Medicines regulation and quality
assurance
System in place
to report ADR
60%
50%
50%
45%
40%
40%
35%
30%
2003
25%
30%
2007
20%
15%
20%
10%
5%
10%
0%
Web-site of MRA
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Computerized registration system
0%
2003
2007
Monitoring availability and pricing of
medicines (Uganda)
100%
Median availability basket of key medicines, public & private sectors 2004-8
75%
50%
25%
Private median
Public median
Linear (Private median)
Linear (Public median)
0%
Apr-04
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Oct-04
Apr-05
Oct-05
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Apr-06
Oct-06
Apr-07
Oct-07
Apr-08
Oct-08
Selection and rational use of medicines
100%
90%
80%
70%
60%
2003
50%
2007
40%
30%
20%
10%
0%
EML updated with 5 years
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National STGs
The EC/ACP/WHO Partnership:
collaboration with Sudan

The National Medicines Policy was updated in 2005.

An assessment of the Pharmaceutical Sector was carried out in 2007 and a Pharmaceutical Country Profile was developed in
2010.

A survey on medicines prices was carried out and, as a result, advocacy work was conducted to reduce taxes on medicines and
increase public funding. The effectiveness of the drug revolving fund as a mechanism for financing medicines was assessed.

The supply system was evaluated and strengthened through the establishment of a national forecasting and surveillance unit, the
purchase of IT material and training of personnel.

The situation of human resources for the pharmaceutical sector has been assessed.

The Adverse Drug Reaction Centre has been supported. Software Vigiflow has been purchased.

The National Quality Control Laboratory (NDQCL) was assessed and personnel was trained on use of equipment.

The Medicines Regulatory System was assessed in 2008. Software SIAMED for registration installed. Guidelines for quality
assurance developed in July 2006 and personnel trained. Guidelines and SOPs for key regulatory activities developed.
Equipment and training provided to inspectors.

A number of training sessions and workshops held to promote rational use of medicines.
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The EC/ACP/WHO Partnership:
collaboration with the Caribbean

Support provided to carry out pharmaceutical sector surveys (Level 1 2007,Facility and Household surveys in
Barbados, Jamaica, Saint Lucia and Suriname), regional meta analysis (report published in 2009) and
development of regional medicines policy (June 2010 draft available);

Support provided to the Caribbean Regional Network of Pharmaceutical Procurement and Supply
Management Authorities (CARIPROSUM). The network includes the Organization of Eastern Caribbean
Countries Pool Procurement Service (OECS/ PPS) which received support through training sessions,
participation to workshops and assessment of its procurement system.

Support was provided for the assessment of Medicines Regulatory Authorities and establishment of
regulators network as part of PANDRH;

Information on counterfeit medicines was collected and a position paper with options for actions was
developed. A campaign was conducted in 2008-9 to sensitize the public;

The Caribbean Regional Drug Testing Laboratory (Jamaica) was supported and used to conduct training
courses. The laboratory is currently working to achieve WHO pre-qualification status.

A regional network for Pharmacovigilance (VIGICARIB) was established in 2008 for monitoring of adverse
drug reactions.
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Synergies for increased efficiency and aid
effectiveness in countries
Opportunities for synergies in countries:
– With programmes aimed at supporting countries to deliver on MDGs
4, 5 and 6 e.g. GFATM etc.
– With other initiatives for improving access to medicines (e.g.
Medicines Transparency Alliance (MeTA), Southern Africa Regional
Programme on Access to Medicines (SARPAM) etc.;
– With other activities aimed at strengthening health systems and
improve coordination of development partners e.g. EC/WHO on
HRH; NHPSP; IHP+;
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DFID/WHO/HAI-A Regional Collaboration
MoH Pharm Dept
Ghana, Kenya, Uganda
Collaboration
to improve policies
and practices for access
to medicines
WHO
Country Medicines
Adviser
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HAI Africa
MeTA multi stakeholders approach
Pharmaceutical companies
(generic and patent)
•Access to more information
on medicines needs
•Active role in national policy
agenda
•Visibility & concerned by
public health issues
•Address quality matters
Wholesales, distributors,
retailers
•Access to more information
Opportunity for building
capacity & improve business
practices
•Active role in policy agenda
Civil
society
Private
sector
Int.
institutions
•Promote transparency & good
governance agenda
•Improve health systems
efficiency & access to medicines
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Ministries
& Gov.
agencies
WHO-Technical Briefing Seminar | 03 November 2010
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•Improve health systems efficiency
& access to medicines
•Commitment to good governance
& transparency agenda
•Promote multi stakeholders
inclusive approach
DPs
•
Active role in
national policy
agenda
•Supportive environment for
advocacy
•Financial and other support
•Improved dialogue with
public and private sectors
Good governance agenda
Tackle corruption
Increase access to medicines
Support responsible business
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Some readings
 WHO Medicines Programme Coordination (MPC) web page
http://www.who.int/medicines/areas/coordination/en/index.html
 Evaluation of WHO/DFID/HAI Regional collaboration for Action on Essential Medicines in Africa
http://apps.who.int/medicinedocs/documents/s16564e/s16564e.pdf
 Evaluation of the Government, civil society and WHO Partnership
http://apps.who.int/medicinedocs/documents/s16564e/s16564e.pdf
 Medicines Transparency Alliance (MeTA) web pages
http://www.who.int/medicines/areas/coordination/meta/en/index.html
 MeTA assessment report (summary):
http://www.medicinestransparency.org/fileadmin/uploads/Documents/Evaluation/MeTA_Evaluation_Summary_Report.pdf
 EC-ACP-WHO Partnership web pages
http://www.who.int/medicines/areas/coordination/ecacpwho_partnership/en/index.html
 Web page on Medicines Adviser in the African Region (key products available):
http://www.who.int/medicines/areas/coordination/medicinesadvisers/en/index.html
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