On Friday, December 12, 2014, over 500 partners from the global health community will come together to commemorate the first Universal Health Coverage (UHC) Day. Although marking the day is new, support for the concept has been building for several years–-and momentum for it continues to grow. Dr. Margaret Chan, Director of the World Health Organization (WHO), framed it as “the single most powerful concept public health has to offer.”
Eight years ago Busisiwe Beko was undergoing treatment for multidrug-resistant tuberculosis (MDR-TB) when, after months of waiting to see a pediatric specialist, her daughter was diagnosed with the same illness. The five-month-old baby was admitted to a TB hospital where she would receive treatment for seven months; Busisiwe, however, was turned away due to lack of space. Today, both mother and daughter are healthy. And, their experience with MDR-TB didn’t stop at their cure. Busisiwe went on to join Médecins Sans Frontières as a counselor for MDR-TB patients in her community, providing the support and medication counseling that she wished she had received during treatment.
My name is Tiglu. I was born and raised in Bahir Dar. When I first learned that I am living with the [HIV] virus, my mind went blank. I was depressed. After that, I started taking antiretroviral treatment. Then they found TB in me...
Meet Tiglu, a living example of how partnering for stronger health systems saves lives. In Ethiopia, about 790,000 people are living with HIV. Tiglu, a patient at the Bahir Dar Health Center in the Amhara Region of north-western Ethiopia, discovered he is HIV positive three years ago, and started on antiretroviral treatment (ART). He learned later he also has tuberculosis (TB).
“If it wasn't for the trainings given by MSH, patients like Tiglu wouldn't have received proper TB treatment,” said Sister Tiringo Zeleke, a nurse at Bahir Dar Health Center.
Ayelew Adinew was working as a pharmacist in a large public hospital in Addis Ababa, Ethiopia. He looked around and saw that the 100-year old pharmaceutical system was broken.
There was no transparent and accountable system for providing the information needed for effective monitoring and auditing of pharmaceuticals and other commodities. There was not sufficient documentation to track consumption, inventory discrepancies, wastage, product over-stock or under-stock. There were no procedures to ensure the availability of essential medicines. The regulations were outdated and there was no enforcement of the relevant regulations in place to protect the safety of clients, ensure proper utilization of resources, and deter professional malpractice.
A 27-week premature baby in an incubator at Kibuye Hospital, Karongi District, western Rwanda.Photo credit: Todd Shapera
November is Prematurity Awareness Month in the US, and the 17th is World Prematurity Day. But I never need any reminders about the importance of access to medicines and services for premature babies. Every November, I celebrate the birthday of my own little preemie. On November 30, 1997, I went into labor just after reaching 32 weeks. I was terrified. I had had a healthy second pregnancy up to that point and my doctor did not believe me at first when I told her I was in labor. After a somewhat traumatic trip to the clinic and then the delivery, my tiny bundle of joy arrived, weighing in at a meager 1.5 kg (3.3.lbs). We were so very lucky to have access to excellent health services, not just for delivery and newborn care, but for his whole first year or so of life, when visits to the doctor to check on his heart, lungs, eyes and overall development were a weekly occurrence.
Workshop participants discuss how local procurement practices affect access to quality maternal health medicines at the district level in Bangladesh.Photo credit: SIAPS Program/MSH.
Expanding access to essential maternal health medicines saves mothers’ lives. Access to life-saving maternal medicines requires an effective supply chain that delivers the right medicines to the right people at the right times. In many countries, weak pharmaceutical management systems are unable to meet the challenges of providing access to these essential medicines. While efforts to date have been focused on providing support to strengthen national level programs and procurement practices, there is growing evidence that suggests that local procurement (at the district, or hospital level) of these essential medicines is common in many countries.
Does antimicrobial resistance mean the end of modern medicine as we know it? Not quite yet. However, in a report recently released on global surveillance of antimicrobial resistance (AMR), the World Health Organization (WHO) warned that "a post-antibiotic era–in which common infections and minor injuries can kill–is a very real possibility for the 21st century."
The availability of new and essential medicines and other health technologies to treat life-threatening illnesses have helped millions of people lead long and productive lives. However, global availability does not necessarily mean access by the end-consumer to these lifesaving health products in low-and middle-income countries. Effective supply chains are needed to deliver these health products in hard-to-reach, resource-constrained settings that often times are inhospitable to collaborative, high-performing supply chain systems.
So how do we get safe, quality, essential medicines and commodities to the people who need them, at the right time and in the right quantities?