Pharmaceutical Management: Our Impact

 {Photo: SIAPS South Africa}The biometric scanner recognizes a patient’s fingerprint at a Tshwane clinic.Photo: SIAPS South Africa

By Bright Phiri, Katelyn Payne, Sifiso Mahlaba, and Jean-Pierre Sallet Enhancing patient recordkeeping in Tshwane Metropolitan Municipality

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

An integrated approach to monitoring the safety of medicines that includes both active surveillance and spontaneous reporting is essential to a well-functioning pharmaceutical sector. Active surveillance is particularly important to support the introduction of new essential medicines in low- and middle-income countries (LMICs), where regulatory systems are often still developing and need support.

{Doctors visit patients in Rabia Balkhi hospital, Kabul Afghanistan. (Photo Credit: Afghan Eyes/Jawad Jalali)} Doctors visit patients in Rabia Balkhi hospital, Kabul Afghanistan. (Photo Credit: Afghan Eyes/Jawad Jalali)

Since 2003, with the support of international donors (namely the US Agency for International Development [USAID], World Bank, and European Union), Afghanistan’s Ministry of Public Health (MoPH) has worked with NGOs to implement two key health packages: the Basic Package of Health Services (BPHS), covering primary care services, and the Essential Package of Hospital Services (EPHS), covering secondary care needs. The implementing NGOs have produced internal pharmaceutical logistics reports for the commodities they deliver to their catchment provinces.

 {Photo credit: MSH}Dagnachew Hailemariam, Head Pharmacist at Bishoftu Hospital.Photo credit: MSH

Dagnachew Hailemariam has worked at Bishoftu General Hospital for six years. The hospital, located 45 km south of Addis Ababa in the town of Bishoftu, is state owned and provides services to between 400 and 500 patients per day. Likewise, the hospital pharmacy receives orders for around 400 to 500 prescriptions per day.

 {Photo credit: Beata Imans/PFSCM}Patients continue to receive their medicines at the counter of the temporary pharmacy.Photo credit: Beata Imans/PFSCM

On the night of December 17, 2014, a fire caused by a short circuit engulfed the pharmacy of the Divo regional hospital, one of the hospitals that provides medical services to more than one million inhabitants of the Loh-Djiboua region of Côte d'Ivoire. Despite the quick response and joint efforts of the neighboring community, $43,000 worth of general medicines and $54,000 worth of antiretrovirals (ARVs) were destroyed. Though the laboratory equipment was recovered, the laboratory was no longer functional as a result of fire damage.

 {Photo Credit: KZN PPSD}The KZN Provincial Pharmaceutical Supply Depot.Photo Credit: KZN PPSD

The KwaZulu-Natal (KZN) Provincial Pharmaceutical Supply Depot (PPSD) procures and supplies pharmaceuticals to approximately 550 health facilities in the South African province. In July 2013, it took the PPSD an average of 27 days to process and prepare for dispatch a health facility’s main order for medicine. The PPSD was therefore faced with a pressing question: How can we reduce the time to complete a facility’s main order?

 {Photo: SIAPS Namibia, September 2015}Martin Mandumbwa, PA, dispensing medicines to a patient at Robert Mugabe Clinic in Windhoek, Namibia.Photo: SIAPS Namibia, September 2015

Namibia faces a high burden of the human immunodeficiency virus (HIV) infection, with an estimated 13.1 percent of the adult population living with HIV. To help address this critical national health concern, the Namibian Ministry of Health and Social Services (MoHSS) has been receiving technical assistance from the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, with funding from the US President’s Emergency Fund for AIDS Relief (PEPFAR), through US Agency for International Development (USAID), and led by Management Sciences for Health (MSH).

{Photo credit: Loren Gomes/SIAPS}Photo credit: Loren Gomes/SIAPS

Curbing the spread of tuberculosis (TB) requires that patients have uninterrupted access to a full course of treatment—frequently a difficult task in developing country settings considering that each regimen includes multiple medicines taken over the span of several months. These may need to be customized based on the type of TB being treated and the patient’s reaction to the prescribed combination. The emergence of multidrug-resistant TB (MDRTB) and extensively drug-resistant TB (XDRTB) further complicates the management of TB medicines.

 {Photo credit: Anicia Filda/RHU Gulu}Reproductive Health Uganda's Gulu Branch Health Center, Uganda.Photo credit: Anicia Filda/RHU Gulu

Located in northern Uganda, Reproductive Health Uganda’s (RHU) Gulu Branch Health Center (Gulu) is one of the busiest clinics in the country—serving over 25,000 clients with sexual and reproductive health (SRH) services per month. When demand for SRH services outpaced Gulu’s supply of sexually transmitted infection (STI) drugs and other essential medicines, the clinic could not continue offering essential SRH services to many who needed them, threatening the equitable access to health care in the community.

 {Photo credit: Jamshid Noori/SPS Afghanistan}The GPHF-Minilab™ is fully adapted to resource-limited settings as a tool for pharmaceutical quality improvement.Photo credit: Jamshid Noori/SPS Afghanistan

Twenty-five staff from key pharmaceutical regulation stakeholders in Afghanistan completed a comprehensive training in March and April 2015 on the Global Pharma Health Fund’s GPHF-Minilab™ and its use. The GPHF-Minilab is a portable mobile mini-laboratory kit designed for rapid medicine-quality verification and counterfeit medicine detection in resource-limited environments.

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