pharmaceutical management

{Photo credit: Brooke Huskey/MSH}Photo credit: Brooke Huskey/MSH

Many child deaths in developing countries are preventable: Children die from treatable conditions, such as pneumonia, diarrhea, and malaria, because families in rural, hard-to-reach, or conflict-ridden areas can’t access or afford the treatments. The Sustainable Development Goals (SDGs), launched in September 2015, set ambitious targets of ending preventable child deaths by 2030 and reducing mortality among children under age five to at least 25 per 1,000 live births.

Integrated community case management (iCCM) has been recognized as a key strategy for increasing access to essential treatments and meeting the objectives for children under five laid out in the SDGs. Integrated community case management entails training volunteer community health workers to serve as the first point of contact for medical treatment in remote areas, enabling them to recognize and treat common childhood illnesses. To be effective, community health workers must operate within a broader pharmaceutical system in which the needs for quality medicines and other health commodities are assured.

 {Photo credit: Alan Levine via Flickr / CC BY}Vials of insulin. Diabetes medicines and health technologies, including lifesaving insulin, are available in only one in three of the world’s poorest countries.Photo credit: Alan Levine via Flickr / CC BY

Cross-posted with permission from Devex.com.

The World Health Organization’s first global report on diabetes released this month highlights the disease’s “alarming surge” with rates that have quadrupled in fewer than three decades. The report reminds us that essential diabetes medicines and health technologies, including lifesaving insulin, are available in only one in three of the world’s poorest countries.

Availability of medicines is certainly an important piece of the complex challenge of ensuring that health systems seamlessly integrate prevention, screening, referral, treatment, and adherence. However, choosing the best way to spend limited public health budgets amid competing priorities is equally important.

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

"Medicines are a key component of treatments to save lives"

~ Kwesi Eghan, trained Ghanian pharmacist and MSH portfolio manager for the US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program in South Sudan and Afghanistan

A child in Tanzania has a fever for three days. A pregnant woman in Namibia is taking antiretroviral therapy (ART) to treat HIV and prevent transmission of HIV to her baby. A man in Swaziland suffers from drug-resistant TB and struggles to adhere to treatment.

Who helps ensure they take the right drug, at the right time, and for the right reason?

A pharmacist.

In many developing countries, pharmacists are primarily responsible for medicines selection, procurement, distribution, and explaining rational use of these medicines to their patients. But, many low- and middle-income countries suffer shortages of trained pharmacists. MSH and partners are helping countries and communities ensure that pharmacists and related health workers are equipped with the skills, systems, and support to provide quality services every day.

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

Tuberculosis (TB) claims a life every 15 seconds; it is the single largest infectious killer and is universally recognized as a global epidemic. Nearly 200 children die every day of TB.

The challenges of tackling TB are well known, particularly in settings with limited resources, crowded urban environments, and among high risk groups including people living with HIV, prisoners, and children. The emergence of multidrug resistant strains of the disease (MDR-TB), the result of incomplete or poor managed TB treatment, present further obstacles and add exponential costs to already burdened health systems. Furthermore, challenges with access to, affordability, and proper use of pharmaceuticals and laboratory materials can have devastating consequences on diagnosis and treatment.

The key to ending TB is to work together to strengthen health systems in high TB-burden countries to be able to effectively implement both proven and innovative strategies. Four approaches will help save lives by uniting stakeholders to collaborate, innovate, and end TB:

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

Medicines are a critical component of quality health care. In fact, most of the leading causes of death and disability in low- and middle-income countries could be prevented or treated with the appropriate use of affordable, effective medicines.

Yet, about two billion people—one third of the world’s population—lack consistent access to essential medicines. Fake and substandard medicines exacerbate the problem. When these people fall ill and seek treatment, too often they end up with small quantities, high prices, poor quality, and the wrong drug. This leads to prolonged suffering, and even death.

Management Sciences for Health (MSH) is a global leader on pharmaceutical management and universal health coverage (UHC). 

{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.

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

This week, at the 46th Union World Conference on Lung Health (hashtag ), the US Agency for International Development (USAID)-funded and Management Sciences for Health (MSH)-led, Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program is launching a new tool to improve how the safety and effectiveness of medicines is monitored in low- and middle-income countries.

All medicines undergo rigorous clinical testing prior to being made publicly available. Continuing to monitor the safety and effectiveness of medicines in real world settings, also referred to as pharmacovigilance, is critically important to ensure that medicines can be used over a prolonged period of time, in conjunction with other medicines, among new patient populations, and in patients with multiple illnesses. 

Low- and middle-income countries, however, often lack the resources, capacity, and systems required to effectively implement pharmacovigilance activities. They often rely heavily on passive reporting methods which can underestimate potential medicines use issues.

 {Photo credit: Todd Shapera}Antibiotics on the shelves of a pharmacy in Rwanda.Photo credit: Todd Shapera

Picture a scenario where infections become totally untreatable because none of the available antimicrobial agents work. This is not imaginary, but is likely to happen very soon if we don’t act urgently, intensely, and consistently to tackle the rising tide of antimicrobial resistance (AMR).

This week, the global health and development community is commemorating the first World Antibiotic Awareness Week. Spearheaded by the World Health Organization (WHO) to raise global awareness on the magnitude, reach, and severity of antibiotic resistance; the event comes at a time when resistance to many antimicrobials, not just antibiotics, has now escalated to pandemic proportions and is a serious global health risk that requires urgent attention. In fact, the WHO has labeled AMR one of the biggest global public health threats.

 {Photo credit: Rui Pires}This Accredited Drug Shop (ADS) in Kibaale district, Uganda, is one of nearly 1,500 small private vendors supported by MSH that provide rural access to family planning commodities, counseling, and referrals.Photo credit: Rui Pires

This week, conference organizers announced that the anticipated 2015 International Conference on Family Planning (ICFP) in Nusa Dua, Indonesia would be postponed due to a volcanic ash cloud limiting air travel and presenting health concerns. We stand in solidarity with all those in the region. Although the conference is postponed, the family planning conversation must go on.

Earlier this fall, the 193 member states at the 70th United Nations General Assembly ratified and launched the Sustainable Development Goals (SDG). Now, stakeholders are determining together how to achieve the 17 goals and 169 targets.  Management Sciences for Health (MSH) works primarily toward Goal 3: to ensure healthy lives and promote well-being for all at all ages and related targets by 2030.

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