Transcript WHO strategy for working with countries

WHO STRATEGY FOR WORKING
WITH COUNTRIES:REGIONAL
AND COUNTRY PERSPECTIVE
TECHNICAL BRIEFING SEMINAR,Geneva,19-23 September 2005
Dr. Jean-Marie TRAPSIDA
Essential Drugs and Medicines Policy (EDM)
WHO REGIONAL OFFICE FOR AFRICA
MISSION STATEMENT FOR
WORKING WITH COUNTRIES
Provide appropriate support to countries to
build sustainable environment, capacity and
develop relevant policies and programmes in
order to ensure that quality, safe and effective
essential medicines are available, affordable to
the population and are used appropriately.
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WORKING WITH COUNTRIES
The WHO Medicines Strategy represents a framework
for WHO support to countries in order to improve the
situation;
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Planning:
Country level
Regional Office level
HQ level
Implementation
Regular budget (RB)
Extra budgetary funds or voluntary funds
Monitoring and evaluation:
Semi annual monitoring (SAM)
Mid Term Review (MTR)
Biennium evaluation
ENHANCED EXPERTISE IN COUNTRY
OFFICES
 14 National Medicine Advisors in
C Congo,
AFRO: Cameroon, Chad,
DRC,Ethiopia,Ghana,Kenya,Mali,
Nigeria,Senegal,Rwanda,
Tanzania, Uganda and Zambia;
 Assist in planning, implementation
and monitoring of medicines
policies;
 Assist in coordination of partners
involved in pharmaceuticals
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NATIONAL MEDICINES POLICY
Implementation
and
medicines policies
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monitoring
of
Cape Verde, Burundi, Ghana, Nigeria and Tanzania were
supported in the review of NDP and implementation plans
Chad, Niger and Mali were also supported to assess
specific aspects of the NDP
Member States with
official NMP
Member States with official National Medicine Policies
(NMPs) in WHO African Region
35
30
25
20
15
10
5
0
30
30
26
21
16
11
0
1
1
1
3
5
1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005
Year
Member States with Official NMP
5
national
ACCESS
 Training in medicines supply management in The
Gambia, Ethiopia, Niger, Tanzania and Uganda
 Capacity building of NPO and their MOH counterparts in
TRIPS (Ghana, Ethiopia, Kenya, Nigeria & Uganda
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Direct support in pricing surveys to Cameroon, Ethiopia,
Ghana, Kenya, Mali, Nigeria, Tanzania & Uganda
Affordability of standard treatm ents for Asthm a and diabetes w ith innovator
brand m edicines in Algeria, Chad and Mali
Diabetes, Glibenclamide 5 mg
Algeria
Mali
Chad
Asthma, Salbutamol inhaler,
0.1mg/dose (200 doses)
0
2
4
6
8
10
No. days' wages needed to purchase medicines
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ACCESS Cont'd..
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National and local drug supply systems
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Enhanced drug supply management capacity
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Efficient drug supply management within health sector
reform
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Good pharmaceutical procurement practices
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Good drug donation practices
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Local production supported
QUALITY AND SAFETY
Implementation of instruments on effective drug
regulation and quality assurance systems:
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Sub regional harmonization(SADC,UEMOA,EAC,CEAC)
Assessment of National Drug Regulatory Authorities in
Ghana, Mali, Nigeria and Senegal.
Quality control of Anti-TB medicines undertaken in
Cameroon, Chad, Ethiopia, Ghana, Nigeria, Rwanda,
Senegal, Tanzania and Uganda revealed need for routine
monitoring.
Percentage of samples
Percentage of samples failing for dissolution
criteria
120
100
80
Rifampcin
60
Isoniazid
40
20
0
CAM CHA
ETH GHA
NIG RWA SEN TAN UGA
Countries
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Quality and safety
Onging assessment of ARV quality in 7 countries (joint
HQ/AFRO project)
 Drug registration in Cape Verde, Mali, Niger, Burkina
Faso, Cameroon, Kenya.
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 Training of Laboratory personnel from Cameroon, Mali,
Niger, Nigeria and Uganda in WHO Collaborating centres
in Algeria and South Africa
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RATIONAL USE OF MEDICINES
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Review of EML & STG completed in Ghana
Cameroon and Nigeria reviewed the STG for ART
Tanzania reviewed the STG
Support was provided to Ethiopia, Senegal and Uganda
for creation of Drugs and Therapeutics committee in
targeted hospitals.
TRADITIONAL MEDICINE
Institutionalization of TRM in Health Systems:
 Development of tools such as Policy framework, Strategic
Master Plan, Code of Ethics, Protocols for validating the
safety, efficacy and quality of TMs, Guidelines for
registration of TMs, etc…
 Assessment of local production of traditional medicines
identified products with marketing authorization in
Madagascar and Nigeria
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FUNDING FOR ACTIVITIES
 DFID: Improving access to medicines;
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EUROPEAN COMMISSION: Implementation of WMS
2004-2007;
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WORLD BANK: Support to the Pharmacy Direction of
CHAD;
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SIDA: Support to Medicines supply systems and
strengthening regulatory systems;
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CIDA: Traditional Medicine
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ADB: Implementation of Sierra Leone Pharmaceutical
Project.
ENABLING FACTORS
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Good collaboration between technical Units AFRO,
TCM/PSM/HQ and Member States;
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Better involvement of EDM/NPOs in EDM AoW;
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Good collaboration and availability of the WHO
Regional Expert Committee on TRM and consultants;
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Availability of extra budgetary funds from EC, DFID,
SIDA and CIDA.
CONSTRAINTS
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Role of WHO misunderstood in some countries;
Limited relevant human resource capacity at some
WCOs and countries to respond to increasing
demand.
Most activities dependent on limited funds in the
regular budget.
THANK YOU
WHO