Transcript WHO Medicines Strategy for Country Support

Technical cooperation with countries
Technical Cooperation for essential drugs and traditional medicines
September 2005
Mission Statement for working with countries
………using the WHO Medicines Strategy as a framework
collaborate with countries to build a sustainable environment
where quality, safe and effective essential medicines,
including traditional medicines, are available, affordable and
used appropriately ………….
WHO Medicines Strategy 2004 – 2007:
4 objectives, 7 components, 44 expected outcomes
OBJECTIVES
• Policy
COMPONENTS
1. Implementation and monitoring of medicines policies
2. Traditional and complementary medicine
• Access
3. Fair financing and affordability
4. Medicines supply systems
• Quality and safety 5. Norms and standards
6. Regulations and quality assurance systems
• Rational use
7. Rational use by health professionals and consumers
Strategic direction of TCM Department
Key Areas
Values and Principles
Support
countries
topolicies:
develop,
National
medicine
Supportevaluate
countries to&develop,
implement,
implement,
integrate
NMP in
evaluate & integrate NMP in
health
systems plan
health systems plan
Collaboration/cooperation/
Building complementarities
Guide
pricing
Guide
pricingpolicies
policies
and
drug
supply
management
and drug supply management
Promote
appropriate
safe
use of
Promote
appropriateand
use of
essential
medicines
traditional
medicines
EML
andincluding
traditional
medicines
Strengthen
national
drug
Strengthen
nationalcapacity
capacity inin
drug
and herbal
medicines regulation
and herbal
medicines
regulation
to ensure quality, safety, efficacy
to ensure quality, safety, efficacy
Assist
in developing
sustainable
Assistcountries
countries
in developing
financing mechanisms
medicines financing mechanisms
countries
protect public
health
in
GuideAssist
countries
totoprotect
public
health
the negotiation and implementation of
negotiation
implementation
international,and
regional
and bilateral trade
of tradeagreement.
agreements
.localproduction
Guide Guide
policies
on local
and
promoting
production and
innovation
(R&D)
of
new
medicines
for
innovation (R&D) of new medicines for
public health needs
public
health needs
Provide
technical
and
Provide
technicalguidance
guidance and
support
TM
support
ononTM
Assist
in strengthening Pharmaceutical
HR
Assist
in strengthening
Pharmaceutical
Human Resources
OBJECTIVE
Demand/need
driven
Support countries to attain
sustainable, uninterruptible,
supply and appropriate use of affordable,
quality, safe, efficacious medicines
(including TM) for
public health problems
Ethical
practices
Consistent
message
from WHO: HQ,
RO's, CO's
Good governance/
accountability/
transparency
Linkages with Regions & Country Offices
AFRO
Other
WHO
Clusters
AMRO
NPO
NPO
EMRO
TCM
HTP
Country Offices
EURO
PSM
NPO
SEARO
Primary interaction
Secondary interaction
WPRO
NPO
Collaborative Activities Supporting WHO Medicine Strategy
Guidance, support and
collaborations
Strategic planning, implementation, monitoring
Headquarters (TCM):
Regional Offices:
Country Offices:
Ministries of Health:
•Support in planning
• Oversee countries
• Assess needs and
• Identify needs &
and management
and collaborations
policies and support
•Provide and coordinate
policy and technical
support
• Support in HR
development & training
• Assist in country
assessments &
monitoring
• Planning and
monitoring of
country support
• Technical, policy
and management
support to countries
• Human resources
development &
training
• Partnerships and
collaborations
at regional level
identify priorities for
technical support
• Plan & implement
priorities
• Plan, implement and
monitor action
WHO work
• Coordinate with other
•Provide technical
and policy support
to countries
• Assist in coordination
•Partnerships &
collaborations
in countries
•Feedback and report
Ministries and national
bilateral and
multilateral agencies
and CSO's.
Enhanced expertise in countries
WHO Medicines advisers in about
30 countries to assist in:
Cameroon
Chad
Ethiopia
Ghana
Kenya
Mali
Nigeria
Senegal
Rwanda
Tanzania
Uganda
DRC
Congo
Zambia
• assessing needs and priorities
• planning, implementation and
monitoring of medicines policies
• coordination of stakeholders involved
in pharmaceuticals
• feedback and reporting
Activities Driven by Country Needs & Priorities
Initiation of most activities are in response to requests by Member States.
Other activities are based on WHA Resolutions, country specific needs.
Type A:
Situation analysis &
Monitoring
Type B:
Specific technical
support
Type C:
Comprehensive
programme support
Type IC:
Inter-country
• Assessment of
•
• Time frame may
• Ad hoc or regular
cover one or more
biennia
• Usually involves a
full-time national
programme officer
• Covers most or all
of the following
areas: policy;
access, quality,
safety & efficacy,
and rational use
support involving
two or more
countries often in
the same region
• Usually focused on
a subset of the
following areas:
policy; access;
quality, safety &
efficacy;
and rational use
pharmaceutical
situation, identify
priority needs –
recommendations
for interventions
Ad hoc or regular
support usually
focused on a
subset of the
following areas:
policy; access:
quality, safety &
efficacy; and
rational use
Evidence based planning and interventions
Level I, Level II core indicators, household survey + other
tools assess & monitor structures, processes, outcomes
and specific pharmaceutical components
Regional/country plans &
strategies implemented
in coordination with
partners: bilateral and
multilateral agencies,
NGOs, and other
stakeholders
1. Assess and Monitor
3. Implement
2. Plan
Data & evidence used,
objectives and targets
set, implementation
plan developed,
resources identified
Indicators for monitoring and evaluation of
pharmaceutical sector
Level I
Core indicators
On structures &
processes
Level II
Core indicators on outcomes/impact &
household survey
Level III
Indicator tools for specific components of the
pharmaceutical sector
• Pricing
• Traditional medicine
• HIV/AIDS
• Etc, etc.
• TRIPS
Monitoring and assessment to measure
progress over time
Comparing 1995-2002 Level II indicators shows progress in some areas
but that enhanced efforts needed in others
Bulgaria
Philippines
100%
80%
60%
40%
20%
0%
Availability of key %of presc. drug in
drugs
EDL
%presc. with
injection
Availability of key %of presc. drug in
drugs
EDL
1995
2002
%presc. with
antibiotics
%patient with
adequate
knowledge
%presc. with
injection
Rationale for seeking evidence
• Raise awareness on realities and actual situation
(qualitative observation with evidence)
• Provide “numbers for advocacy” to convince
policy-makers, donors
• Identify problem areas and set priorities among
possible areas for intervention
• Assess country medicines situation and trends
over time
• Measures impact of interventions
Links with other partners
HQ
WHO
Regional Offices
WHO operational
partners
UNAIDS, bilateral
and multilateral
agencies, public
interest NGOs in
health, UNDP,
UNFPA, UNCTAD
UNICEF, EU
Country Offices
Countries
Ministries of Health
Partners in Country Support
WHO scientific
WHO strategic
partners
partners
WHO Collaborating
Centres in
pharmaceuticals,
universities, research
centres, international
health professional
associations
World Bank and
development banks,
Donor Agencies,
pharmaceutical
industry, WTO,
WIPO
WHO-HAI Africa Regional collaboration for action on
essential medicines in Africa
1.
Increased access to quality essential medicines through improved
policies and advocacy – collaboration on affordability of medicines
2.
Increased capacity and participation of NGOs and consumers in the
development and implementation of medicines policy
3.
Expanded participation in and strengthened coordination of the HAI
Africa Network
4.
Project countries: Uganda, Kenya and Ghana
Rationale for WHO-CSO collaboration in countries
• Synergy of expertise & know how
• Complementary mandates and approaches
• Enhance CSO participation in policy development &
implementation
• Empower CSO and build capacity in the medicines field
• Increase impact on decision & policy makers
• Forge dialogue & links-changed NGO-MOH dynamics helped close the “NGO credibility gap”
• Improve co-ordination and efficient use of resources