Pharmaceutical Management: Our Impact

Twenty MSH experts on tuberculosis (TB) from 15 countries showcased the latest global experience and methodologies at the 40th Union Conference on Lung Health, held December 3-7 2009, in Cancun, Mexico.

The MSH East African Drug Seller Initiative and the Tanzania Food and Drugs Authority (TFDA) finalized the rollout model for Tanzania’s accredited drug dispensing outlet (ADDO) program at a workshop in Morogoro, Tanzania, in September. MSH Senior Program Associate Edmund Rutta presented elements of the revised model at the Corporate Council on Africa’s 2009 US–Africa Business Summit, in a panel supported by the Rockefeller Foundation.

The Initiative on Adherence to Antiretrovirals of the International Network for the Rational Use of Drugs (INRUD-IAA) has published a new bibliography of 460 articles that will interest to those working in the field of adherence to antiretroviral therapy (ART) in Africa.

Coptic Waiting in Tent. Photo Credit: MSH StaffOn November 4–6, 2009, in Gisenyi, Rwanda, the Initiative on Adherence to Antiretrovirals of the International Network for the Rational Use of Drugs (INRUD-IAA) hosted its third annual meeting on antiretroviral therapy (ART) adherence. Results of an INRUD-IAA research study showed that the adherence indicators chosen for study are clinically meaningful—that is, they correlate to increases in patients’ CD4 counts and weight gain.

Andualem Mohammed, SCMS advisor. Photo Credit: Margaret Hartley.MSH: Please tell me about your background and how you became interested in public health. I am from Ethiopia, and I joined Management Sciences for Health (MSH) as an employee seconded to a Missionaries of Charity orphanage for HIV-positive children, where I became the head of the pharmacy. But I wanted an opportunity to help millions of people instead of hundreds, so I joined the Supply Chain Management System (SCMS) Project as Quantification and Supply Planning Advisor.MSH: What is your role at MSH?

In a recently published article in the Journal of Acquired Immune Deficiency Syndromes, MSH and Columbia University staff assert that funding for the scale up of AIDS-related drug and commodity procurement, distribution, and pharmacy management systems can strengthen the entire health system in countries with limited resources. In the abstract, "How AIDS Funding Strengthens Health Systems: Progress in Pharmaceutical Management," Martha Embrey,* David Hoos,†and Jonathan Quick* describe some of these positive effects.

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.

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