Partners Coordination for National Medicines Policies in countries
What does this picture look like?
- The cooling system of a medium-size nuclear power plan.
- Servers and knots on the world-wide web.
- The family tree of a European Royal Family.
- The medicines supply chain of an African country.
The correct answer is D. Still wondering why roughly one in three people do not have access to essential medicines?
A little bit of background
Access to essential medicines is a crucial, yet complex pillar of a strong public health system. Ensuring that patients get the safe, affordable treatment they need requires an evidence-based national medicines policy, a well-managed medical supply process, sound infrastructure, efficient budgeting, and a well-trained staff for both proper drug management and sound procurement practices. Often, these different tasks are completed by a variety of entities representing both the public and private sectors. And all of these parts must be well coordinated for the entire system to function properly. But before a plan of action can be drafted to make sure all facets of the medicines supply chain work together smoothly, the scope of activities to be coordinate must be quantified.
For this reason, WHO has supported 12 African countries in mapping their medicines supply systems using a structured questionnaire aimed towards assessment of financing, procurement and distribution channels.
These surveys revealed crucial country-specific issues and improvement opportunities, while also giving WHO the opportunity to observe some of the larger systemic issues driving medicines delivery across Africa. Most of these issues stem from the supply-driven nature of pharmaceutical procurement. Donors determine what they will supply and countries do their best to absorb what is offered.
Spotlight on: United Republic of Tanzania
Like most other countries who completed the mapping process, the United Republic of Tanzania found that there is an impressive variety and volume of stakeholders participating in its medicines supply chain- each with its own set of interests. However, the coordination structures in place are weak. A number of reasons for this weakness were cited, including poor resource management, a general lack of collaboration among partners and at different levels of the system, insufficient data management competencies, weak leadership and the inability to accurately project and quantify supply needs throughout.
In response to this mapping exercise, the Ministry of Health of the United Republic of Tanzania organized a workshop to bring together primary stakeholders in the devising of a coordination framework to address identified shortcomings. The resulting strategy includes specific action items to improve information sharing and medicines supply proficiency, for instance with the creation of an information sharing portal among partners on the pharmaceutical regulatory authority's web site and the planning of specific capacity-building opportunities.
Results and next steps
While each country report elaborates on its own particular concerns, there were also several common challenges identified across all countries:
- A general lack of communication among actors regarding strategies, priorities and daily activities.
- Parallel procurement and recruitment practices creating fragmentation and competition between the ministries of health and vertical programs.
- Inability of national governments and health systems to sufficiently manage such a complex system with limited capacity for management and good governance practices.
- A crisis in human resources for health: pharmaceutical personnel are burdened by the needs of multiple supply systems and their morale is often lowered by poor working conditions.
- Unbalanced investment practices of international actors, such that too often the decision to invest in a country or on a disease does not reflect neither the needs (e.g. burden of disease), nor the country's priorities and plans.
- Download the report for Burundi
- Download the report for Congo
- Download the report for the Democratic Republic of Congo
- Download the report for Haiti
- Download the report for Mali
- Download the report for Nigeria
- Download the report for Senegal
Now that countries have begun to identify the key obstacles to an efficient and effective medicines supply system, we have shifted our focus to supporting their efforts to catalyze improvement. We do this generally through the following:
- Advocacy.
- Information generation, consolidation and dissemination.
- Assistance in the development of plans for coordinating actors within the system.
- Preparing strategies and recommendations for building a stronger pharmaceutical sector.
- Supporting health workforce development.
- Needs assessment, prioritization and planning.
Specifically, our next priority is to
develop and implement an innovative medicines systems strengthening and partners coordination methodology in selected African countries. All the while, we are expanding our analysis and advocacy role at the country, regional and global level, where we interact daily with leading actors in medicines policy and systems.