Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program

 {Photo credit: © 2011 Arturo Sanabria, Courtesy of Photoshare}A health care provider dispenses TB drugs for Directly Observed Treatment (DOTS) at Tete's Urban Health Center, Mozambique.Photo credit: © 2011 Arturo Sanabria, Courtesy of Photoshare

Successfully combating the tuberculosis (TB) epidemic requires that national TB programs (NTPs) prevent new infections and ensure that current patients are cured. Although the treatment for drug-sensitive TB is very effective, curing the disease requires that patients adhere to a strict daily regimen of multiple pills for six to nine months. Adding to the challenge is the fact that treatment for drug-resistant TB is longer, more toxic, and less effective.

All medicines carry some risk of adverse events, and anti-TB medicines are no exception. In addition to threatening the health of patients, adverse events, if not well managed, may also result in individuals stopping their treatment early. Patients who prematurely discontinue treatment may remain sick, develop resistance to the medicines, and spread TB to others in their community.

To support NTPs and health professionals efforts to meet treatment goals and improve the safety of anti-TB medicines, the US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program developed the first guide of its kind on minimizing risks associated with anti-TB medicines.

 {Photo credit: Durmuş Şahin}(left to right) Dr. Raed Arafat, Chair of the Conference, Secretary of State, Ministry of Health of Romania; Dr. Martin van den Boom, TB Program Focal Officer, WHO Regional Office for Europe; Francis (Kofi) Aboagye-Nyame, Director, SIAPS Program; and Dr. Joel Keravec, Head of Operations, Global Drug Facility, Stop TB Partnership, at the First Conference on Pharmaceutical Management for TB and M/XDR-TB for the WHO European Region.Photo credit: Durmuş Şahin

The highest rate of multi-drug resistant (M) and extensively drug-resistant (XDR) cases of tuberculosis (TB) is found in the World Health Organization (WHO) European Region. The Consolidated Action Plan to Prevent and Combat M/XDR-TB in the WHO European Region specifies that, by the end of 2013, all member states assure provision of an interrupted supply of quality first- and second-line medicines for treatment of all TB and M/XDR-TB patients.

Safe and rational use of these medicines is also a challenge. To deal with these demanding challenges means an increased need to strengthen pharmaceutical management, especially in the areas of second-line TB medicines management, new TB medicines, and novel treatment regimens.

Mildred shares her story of surviving XDR-TB at an event honoring "TB Champions" in DC; Ambassador Goosby listens. {Photo: E. Delmotte/MSH.}Photo: E. Delmotte/MSH.

Mildred Fernando lives and works in the Philippines for the USAID-funded, MSH-led, Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. Mildred spoke at several World TB Day events in Washington, DC, including at a senate briefing and an event honoring TB survivors and advocates (watch video). The interview below first appeared on the SIAPS blog.

It all began in November 2001 for Mildred Fernando when she was diagnosed with tuberculosis (TB), a preventable and curable disease which caused the death of 1.4 million people in 2011. She was only 19 years old, working on completing her last semester in college when she contracted TB from her father who sadly succumbed to it two years later.

Patients wait in a well-ventilated area outside the TB clinic in Homa Bay, Kenya. {Photo credit: A. Kwiecien and A. Salakaia / MSH.}Photo credit: A. Kwiecien and A. Salakaia / MSH.

The state of tuberculosis (TB) is in a tug-of-war as current challenges threaten to undo past successes. One of the primary hurdles currently facing TB prevention and cure is the emergence of strains that are resistant to at least two of the most effective medicines (rifampicin and isoniazid).

So-called drug-resistant (DR)-TB arises when patients are unable to complete a full-course of appropriate, high quality anti-TB medicines. As compared with the 6 month treatment regimen for drug-sensitive (DS)-TB, DR-TB requires 18-24 months of treatment with medicines that are less effective, can cause sometimes severe side effects, and can cost up to 300 times more.

Jane Briggs of the USAID-funded SIAPS program at MSH gives examples from Rwanda and Kenya during the Improving Access to Essential Maternal Health Medicines session on the first day of the conference. {Photo credit: C. Lander / MSH.}Photo credit: C. Lander / MSH.

Cross-posted from the SIAPS website.

“Respectful maternal care was said to be more than just a means to an end, and can be framed as several issues: human rights, quality of care, equity and public health,” Jocalyn Clark, senior editor of PLoS Medicine, noted about the final day of the 2013 Global Maternal Health Conference (GMHC).

The conference brought together scientists, researchers, practitioners, and policymakers to share knowledge, ideas, innovations, research, programs and policies on maternal health quality and access, among several other topics. Participants also worked on building progress towards reducing and eliminating preventable maternal mortality and morbidity.

Quality of maternal care was a consistent theme throughout the conference.

Lisa Peterson, Deputy Chief of Mission, US Embassy, Yaoundé, Cameroon. {Photo courtesy of US Embassy Yaoundé.}Photo courtesy of US Embassy Yaoundé.

Formally launched in 2012 in Cameroon, the USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, led by Management Sciences for Health, has been working on strengthening the overall pharmaceutical management system, specifically to ensure the people of Cameroon have access to safe and affordable medicines at the central and peripheral levels.

In a new podcast, US Deputy Chief of Mission in Cameroon Lisa Peterson discussed SIAPS’ important work in the country and how it will impact the local population.

"The program will help, I believe, bring people to clinics. It will help definitely ensure that when people get to a clinic, they are able to access medicines and medical supplies that they need," Ms. Peterson said.

Senegal {Photo credit: Galdos/MSH.}Photo credit: Galdos/MSH.

Crossposted on Maternal Health Taskforce's mhtfblog as part of the Maternal Health Commodities Blog Series.

Despite a decade of significant progress reducing maternal mortality rates, very few countries are on target to meet Millennium Development Goal of reducing the maternal mortality ratio by three-quarters by 2015.

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