Transcript Achievements made so far

Pharmaceutical System Strengthening :
Bangladesh Perspective
Aktari Mamtaz
Joint Secretary
Ministry of Health and Family welfare (MOHFW),
Bangladesh
Bangladesh: Country Profile
 Country Area
: 1.47.570 sq. km.
 Total Population
: 151.41 Million (BBS 2010)
 Population Density (per sq. km.)
: 993 persons (BBS 2009)
 Life Expectancy at Birth-
: 65.7 years (BBS 2009)
Male
Female : 68.3 years (BBS 2009)
 Maternal Mortality Rate (MMR)
( per 1000 live births )
: 1.94 (BMMS 2010)
 Infant Mortality Rate( per 1000 live births) : 52 (BDHS 2007) (<1 Yr)
 Neonatal Mortality Rate (<1 Month)
: 37 percent (BDHS 2007)
 Child Mortality Rate (<5 )
: 65 per 1000 live births
(BDHS 2007)
• Per Capita Income
:US$ 818
2
Achievements made so far
• Bangladesh has made considerable progress in high rates of
economic growth and reducing poverty rates by 8 per cent
between 2005 and 2010.
• In 2010, Bangladesh received the Millennium Development Goal
(MDG) award for remarkable achievement in reducing child
mortality (MDG 4).
• Bangladesh is also currently on track to meet MDG 5 (Maternal
Health)
• Bangladesh received Digital Health for Digital Development award
in 66th UN General Assembly for contributing Maternal and
Children Health through ICT.
Achievements made so far(cont.)
• Local pharmaceuticals contribute 90% of medicine production in
Bangladesh.
• Leading 20 local companies have achieved recognition from
International top regulatory authorities like,- UK, EU Australia,
GCC(Gulf Cooperation Council), and many other regulatory
authorities.
• Bangladesh pharmaceutical companies are now exporting
medicines in 84 countries, among them UK, USA, Turkey, Thailand,
Singapore etc.
• DGFP Supply Chain Information Portal (SCIP) has received two
awards in e-Health and e-Governance category in the National
Digital Innovation Award- 2011
Types of Pharmaceuticals in Bangladesh
System
Allopathic
No. of
Producti
on units
Public
1
Distribution No. of
No. Of
Production Pharmacy
units
(Distribution
Private
Outlets)
Govt. health
service centre
262
87577
Unani
268
273
Ayurvedic
202
262
Homeopathic
79
299
Herbal
19
Not known
Source: Directorate General of Drug Administration, Bangladesh
Government’s Tools for Managing Pharmaceutical
Sector & Improve Use of Medicines
• A dedicated department- Directorate Generals of Drug
Administration
• National Drug Policy Since 1982 , and updated in 2005
• Drugs (Control) Ordinance,1982, reviewed in 2005
• Drug rules and regulation, 1945 and 1946
• Drug Testing Laboratory at Dhaka and at Chittagong
Government’s Tools for Managing Pharmaceutical
Sector & Improve Use of Medicines(cont.)
• Essential drug lists for health professional (updated in 2008)
to ensure rational use of medicines.
• Bangladesh National Formulary (last updated in 2006) for
appropriate use of medicines.
• STGs (Standard Treatment Guidelines) for certain diseases –
TB, leprosy, Malaria etc.
Management steps of pharmaceutical products in
Bangladesh
• Registration: Any medicine either manufactured or
imported should be registered to Directorate General of
Drug Administration (DGDA)
• Selection: The Drug Control Committee of DGDA will select
a medicine either for manufacture or import. Quality , safety,
effficacy and usefulness is the criteria of selection.
• Production: After registration and Selection a
manufacturer could go for production. An importer could
import.
Management steps of pharmaceutical products in
Bangladesh(cont.)
• Quality Assurance: According to NDP DGDA will ensure good
quality medicines available at affordable price and WHO Good
Manufacturing Practice (GMP) guidelines should followed by
manufacturer’s.
• Procurement: According to requirement CMSD,DGHS and
LMU ,DGFP procure medicines and contraceptives for GOB service
delivery centre's.
• Distribution: Govt. Chanel and Private Chanel. Web-based
Logistics Management Information System (LMIS); Inventory
Management Software for DGFP at Sub district and Warehouse
level ensures good management of contraceptives distribution.
Medicines distribution channels in Health
Service Delivery System (public)
Specialized
Hospital
• National level
General
Hospital
• Tertiary Level
District
Hospital
• Secondary level
• Primary Level
•
Subdistrict
Hospital
Community
Clinic
Union
health
facilities
Stakeholders in Pharmaceutical Management
in Bangladesh
• Pharmaceutical companies, Public / Private
• Health Service delivery facilities, Public/Private/ NGO
• Health Service Providers, Public/Private/NGO
• Importers
• Manufacturers
• Distributors
• Medicine Sellers
• Users/ patients
Medicine Supply Chain (Private):
Manufacturers
Pharmacies
(Retail drug shop)
• local production of drug: 83,850 million in 2010
• Imported drug :10,710 million in 2010
Importers
Others
Source of medicines for patients seeking care
*92% of patients
get their medicines
from pharmacies
or retail outlets.
Pharmacies or retail outlets
NGO Health Centre
Govt Health Centre
Private Health Centre
Other shops
Other
Other services personnel
*Source: HIES 2005
Challenges/problems
• Lack of effective monitoring system
• Inadequate management capacity for effective
implementation of existing legislation and policies
and guidelines
• Quality assurance of the pharmaceuticals coupled
due to lack of independent lab for testing
products.
Challenges/problems
• Human Resources – inadequate trained staff.
• Lack of affordability – GOB’s resource
constraint to pay for medicine procurement
and also for Individuals to pay for medicines.
• Shortage of manpower in National Regulatory
Authority.
Challenges/problems(cont.)
• Gaps and weaknesses in existing rules and
regulations
• Inappropriate use of medicines – anybody can buy
any medicine from medicine shops without
prescription
• Lack of awareness & knowledge amongst users
and availability of information
Way Forward…
1. Strengthen norms, standards and policy options; promote
quality of medical products, vaccines and technologies.
2. Efficient procurement systems to combat counterfeit and substandard medical products, vaccines and technologies.
3. Promote good governance and transparency in procurement
and medicines pricing.
Way Forward…(cont.)
4. Strengthening capacity of drug administration authority.
5. Ensure equitable access, rational use and adherence to quality
medicine
6. Monitor quality and safety of products/vaccines/technologies.
7. Establish Active pharmaceutical Ingredients (API) park, which could
enable local pharmaceutical companies to produce raw materials.
.
Way Forward…(cont.)
• Comprehensive capacity building plan for all relevant personnel
involve in – supply chain management
• Effective expansion of Introduced telemedicine and e-health
services
• Automated patient registration and medicines management
system.
• Establish Procurement web portal under the Procurement and
Logistics Management Cell (PLMC) of Ministry of Health and
Family Welfare (MOHFW), which could help to track on line
medicine procurement and supply.
Thank you