access to medicines

Alime, a patient featured in MSH's Medicine Movers

by Devex's Noa Gutterman and Management Sciences for Health

This summer, Devex partnered with Management Sciences for Health (MSH) to host Access to Medicines (), a conversation that has analyzed and amplified the discussion on global access to medicines.

Over the last three weeks,  has examined major questions including: 

 Cynthia (left) cares for her grandson, Alime, orphaned to AIDS and living with HIV, in East London, South Africa.

This post is an excerpt from "Medicine Movers," written by Daphne Northrop, and videos by Emily Judem

EAST LONDON, South Africa -- Nine-month-old Alime and his grandmother Cynthia sit at a table piled with pill bottles, cardboard cartons, and syringes. There are 19 items in all. 

The squiggly Alime, who traveled that morning on his grandmother’s back to the hospital, happily munches on a cookie while the pharmacist counsels his grandmother on when he should take each of his medicines and how much to give him. It’s hard to believe such a tiny boy needs so many pills to survive.

Alime has been HIV-positive since birth. His treatment seems to be working. His weight has doubled, and as he smiles and gurgles quietly in Cynthia’s arms, he looks like a healthy toddler. He rarely takes his eyes off his grandmother, and he reaches out to touch her face as she talks.

Medicine Movers: South Africa from Management Sciences for Health on Vimeo.

{Photo credit: Michael Paydos/MSH}Photo credit: Michael Paydos/MSH

This week, Devex and Management Sciences for Health (MSH) are discussing innovations for access to medicines in low- and middle-income countries. Public-private partnerships are key to ensuring innovations help medicines affordably reach the people who need them most.

From communities to global policy: Innovations to access to medicines underway

Devex reporter Andrew Green writes:

In Tanzania in 2002, MSH realized the medicines needed for basic treatment are in the government system, but not available to patients -- either because health facilities ran out of stock or were too far away.

Instead, patients turn to private dispensaries in high numbers. MSH reports that 82 percent of people in sub-Saharan Africa seek health care and medicines from retail drug shops -- even though the people staffing them often have little knowledge or training.

In Tanzania, MSH decided to try to change that, conceptualizing a program in 2002 to set government standards for the accredited drug dispensing outlets, or ADDOs, and upping the knowledge of the people running them. ...

Saving lives and improving health continues long after diagnosing disease or delivering medicines.

(Watch Faith tell her story)

Faith had been ill for months. She was 31 and had two daughters. She didn’t know what was wrong. A friend urged her to get an HIV test; it came back positive.

Faith started on antiretroviral treatment.

But, in 2013, one of her antiretroviral medicines started to work against her, causing misshapen fat deposits to develop on her body.

When she finally mustered the courage to speak up one year later, her doctor knew just what to do and shifted her to a different medicine.

(Medicine Movers: Kenya from Management Sciences for Health on Vimeo)

Faith didn’t know it, but her report to the doctor became part of a nationwide database that tracks adverse drug reactions, and poor quality or expired medicines.

MSH Vice President, Pharmaceuticals & Health Technologies Group, Dr. Douglas Keene, tells Devex how strong governance enables access to medicines.MSH Vice President, Pharmaceuticals & Health Technologies Group, Dr. Douglas Keene, tells Devex how strong governance enables access to medicines.

This week, Management Sciences for Health (MSH) and Devex are talking about how to maximize the impact of access to medicines in low- and middle-income countries. Below are excerpts, descriptions, videos, and links to the conversation. See the full conversation on Access to Medicines.

By strengthening governance and promoting transparency, developing countries can be better equipped to regulate the flow of medicines and support their efficient and effective use. Countries could make much progress by assuring the quality of medicines, but what is really being achieved in practice?

Recent global crises such as Ebola and Zika have revealed the dangers of weak health systems. As countries work to strengthen these systems, Dr. Douglas Keene, vice president of the pharmaceuticals & health technologies group at MSH, advises policymakers to first start by addressing existing regulations and governance.

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

In 2012, the United Nations unanimously passed a resolution endorsing the concept of universal health coverage (UHC), urging governments everywhere to “provide all people with access to affordable, quality health care services”. Management Sciences for Health (MSH) and the US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program are among global champions for UHC and joined global leaders celebrating UHC’s notable inclusion in the Sustainable Development Goals (SDGs) last Fall. Now, we continue to help countries face the obstacles of making UHC a reality.

Access to medicines has not always been at the forefront of the global discourse on UHC, which instead has tended to focus on financing. UHC programs must include adequate health financing and coverage of essential medicines if they are to deliver meaningful health outcomes. Policymakers attempting to establish and maintain UHC programs therefore need to have a sound understanding of the pharmaceutical sector and those pharmaceutical system components that must be considered to ensure ready access to the pharmaceuticals needed to support any UHC program.

An Accredited Medicines Stores (AMS) seller receives an infrared thermometer to use in Ebola and other outbreak surveillance.

by Arthur Loryoun

Editor's note: This post originally appeared on the Bill & Melinda Gates Foundation's blog, Impatient Optimists. Funded by the Gates Foundation and led by Management Sciences for Health (MSH), the Sustainable Drug Sellers Initiative (SDSI) project worked to ensure the sustainability of public-private drug seller initiatives in Tanzania and Uganda, and to roll-out the initiative in Liberia.

MSH's Douglas Keene, PharmD, MHS, Vice President, Pharmaceuticals & Health Technologies Group, was among the speakers at a recent event in Basel, Switzerland, hosted by Novartis, with representatives from NGOs, academia, and government discussing how to expand access to health in developing countries, including through the newly-launched program, Novartis Access.

MSH is partnering on Novartis Access to help empower governments of low- and lower-middle-income countries to provide access to health for chronic diseases patients who need it most. Ensuring affordable and equitable access to medicines is critical to achieving health for all -- and central to MSH's mission and health-systems strengthening approach.

{Photo Credit: Warren Zelman}Photo Credit: Warren Zelman

The universal health coverage (UHC) movement has reached a turning point. With an unprecedented coalition of global partners rallying behind the UHC movement, the inclusion of UHC as a key aim of the newly launched sustainable development goals, and growing recognition of health as a human right, the real work of achieving UHC has begun – many countries are now grappling with the challenge of making UHC a reality.

As a key partner in bringing the UHC agenda to the forefront of the global community MSH is on the leading edge of translating this global momentum into tangible gains for women, children, and families at the country level. This UHC Day, MSH is working to advance by recognizing that UHC means that people should have access to not only the health services they need, but also to the essential medicines and heath commodities that help to treat many of the most serious global health threats.

Ensuring equitable and affordable access to medicines is a key component of achieving UHC, but one that is often left out of the conversation. As many low- and middle-income countries start implementing a range of UHC policies, programs, and initiatives, MSH is taking steps to ensure that access to medicines remains on the agenda.

 {Photo credit: MSH staff}A woman and child visit an accredited dispenser in Tanzania.Photo credit: MSH staff

There are ways to make informal outlets fit for quality care in poor areas, say Jafary Hassan Liana and Martha Embrey.

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