Pharmaceutical Management: Our Impact

HIV, tuberculosis, malaria, diarrheal disease, respiratory tract infections—these major killers in the developing world are becoming resistant to the medicines used to treat them. According to the Center for Global Development, the emergence and spread of drug resistance are draining resources and threatening the ability to treat infectious diseases in developing countries. Through international forums and publications, Management Sciences for Health (MSH) continues to spread the word about ways to contain resistance to antimicrobials.In September, Dr. Mohan P.

A National Medical Store in Uganda. Photo Credit: MSH Staff.The US Agency for International Development recently awarded MSH a five-year, $39-million cooperative agreement to implement the Securing Ugandans’ Right to Essential Medicines (SURE) Program. SURE’s mandate is to make certain that Uganda’s people have access to good-quality essential medicines and health supplies by strengthening the national pharmaceutical supply system.

With increased access to essential medicines in developing countries comes an increased need to monitor and promote the safety and effectiveness of these medicines. The USAID-funded Strengthening Pharmaceutical Systems (SPS) Program recently published “Supporting Pharmacovigilance in Developing Countries: The Systems Perspective”(PDF), in the Journal of Acquired Immune Deficiency Syndromes (JAIDS), a paper describing the SPS conceptual framework and operational approach to strengthening pharmacovigilance and medicine safety systems in resource-limited settings.

Many people in rural Tanzania seek health care and medicines from retail drug shops, called duka la dawa baridi, for reasons such as convenience. Historically, the Tanzania Food and Drugs Authority (TFDA) authorized duka la dawa baridi to provide nonprescription medicines; however, a 2001 assessment showed that many shops sold prescription drugs illegally and that the drug sellers were generally unqualified and untrained.

MSH: What is your role at MSH?JN: I am the Country Program Manager for Namibia for the Strengthening Pharmaceutical Systems (SPS) Program. MSH: What is MSH doing in Namibia?JN: MSH is working in Namibia under the centrally funded SPS Program. SPS implements the support of the US Agency for International Development (USAID) to the Ministry of Health and Social Services (MoHSS) to strengthen pharmaceutical systems for the delivery of antiretroviral therapy programs.

MSH: Tell us a little bit about yourself, your background, and how you decided to become a doctor. I went to school here in Nigeria, at the University of Jos. After the basic medical degree, I did a residency in the Faculty of Community Health. I worked briefly teaching medical students Dr. Zipporah Kpamorand then began development work with the Centre for Development and Population Activities (CEDPA), starting with expanding access to reproductive health services in the north.

As the Rational Pharmaceutical Management (RPM) Plus Program draws to a close, the Program Director, Dr. Douglas Keene of MSH, reviewed the successes of almost a decade of contributions to improved pharmaceutical management. He spoke at the annual conference of the Global Health Council in Washington, DC, on May 28, 2008. Getting Help to People in Need

Access to condoms to prevent HIV transmission, test kits to detect HIV infection, and medicines to treat HIV-positive individuals is often severely limited in countries with weak pharmaceutical management systems. To address such limitations, countries need to implement plans to assure proper purchase, storage, distribution, and use of medicines and health commodities, while establishing sound information management systems.In Haiti, the country with the highest HIV/AIDS rate in the western hemisphere, thousands of HIV-infected individuals are without treatment.

Could people become immune?A paper by Dr. Malcolm Bryant of Management Sciences for Health was presented at the American Public Health Association Conference in San Francisco last November. The topic of this provocative presentation was whether widespread resistance to antiretroviral agents is inevitable in Africa.Antiretroviral treatments provide hope to people infected with HIV/AIDS in Africa and around the world. However, this treatment requires an absolutely accurate prescription coupled with an adherence by the patient to a prescribed regimen.

During 2002 alone, 3.1 million people died of AIDS and another 5 million were newly infected. Young people ages 15-24 account for 42 percent of new HIV infections and represent almost one-third of people living with HIV/AIDS worldwide.

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