14 April 2000
BETTER QUALITY AT LOWER PRICES
"Some countries routinely pay 150% to 250% of world market prices for the essential drugs, while other countries complain of unreliable suppliers and poor quality drugs", stated Dr Hans Hogerzeil, of WHO’s Essential Drugs and Medicine Policy Department, at today’s launch of the guide Operational Principles for Good Pharmaceutical Procurement.
Improper procurement practices lead not only to high prices and poor quality, but can also result in shortages of life-saving drugs. "When lax drug procurement systems lead to national shortages of one or two drugs in a four-drug tuberculosis treatment regimen, treatment failures increase and resistance can quickly develop to those drugs still in stock", commented Dr Hogerzeil.
Produced by the Interagency Pharmaceutical Coordination (IPC) Group, the Operational Principles aim to assist national governments, donor agencies and other organizations involved in drug procurement to obtain lower prices, better quality, and more reliable delivery of essential drugs. Consisting of the pharmaceutical advisers of UNICEF, UNFPA, the World Bank and WHO, the IPC is especially well placed to advise on how drugs of assured quality can be purchased more effectively and more cheaply.
The need is great – one-third of the world’s population lacks regular access to good quality essential drugs. In poor populations adults and children die needlessly of treatable diseases such as malaria, acute respiratory illness and diarrhoeal diseases. Poor pharmaceutical procurement practices are partly to blame.
Good procurement – getting quality medicines to people when and where needed
Procurement is the sum total of processes involved in the purchase and delivery of drugs. Ideally, the most cost-effective drugs are bought in the most appropriate quantities from reputable suppliers, delivered where and when required, at the lowest possible total cost.
Experience shows, however, that the process can go badly awry. The number of different agencies involved in procuring drugs – including ministries of health, manufacturers and donor agencies – can render the process highly complex and vulnerable to inefficiency and waste. Other problems such as corruption and lack of transparency, lead to lack of competition with fewer choices, higher prices and poorer quality. At the same time, irregular and limited funding can greatly hinder efforts to secure timely delivery of drugs. External funding from international agencies or bilateral donors sometimes helps. Outdated local regulations and supply procedures not suitable for the special requirements of buying pharmaceuticals can further complicate the problem.
The Operational Principles tackle these problems by providing a solid basis to help ministries of health, donor agencies and others to harmonize their drug procurement practices. Grouped into four categories, the 12 principles cover: (i) transparent management, (ii) selection and quantification, (iii) financing and competition, and (iv) supplier selection and quality assurance.
Even without appropriate policies and procedures, lack of properly trained personnel can doom a procurement system to failure. So, as well as advising on best procurement practices, the Operational Principles are intended for use in training staff responsible for drug procurement.
"The complex process involved in efficient and effective drug purchases is clearly presented in the document", comments Dr Ramesh Govindaraj, Pharmaceutical Advisor for the World Bank. "If the principles are observed, the ultimate result will be more essential drugs for less money, better quality and fewer deaths from malaria, tuberculosis, childhood illness and other treatable causes".
For further information, journalists can contact Ms Jacqueline Sawyer, Department of Essential Drugs and Medicines Policy, WHO, Geneva. Telephone (+41 22) 791 3921. Fax (+41 22) 791 4167. Email: firstname.lastname@example.org
.All WHO Press Releases, Fact Sheets and Features as well as other information on this subject can be obtained on Internet on the WHO home page http://www.who.int