MSH Calls for a Systemic Approach to Pharmaceutical Management for HIV & AIDS

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.

Abstract In recent years, new global initiatives responding to the AIDS crisis have dramatically affected—and often significantly improved—how developing countries procure, distribute, and manage pharmaceuticals. A number of developments related to treatment scale-up, initially focused on AIDS-related products, have created frameworks for widening access to medicines for other diseases that disproportionally impact countries with limited resources and for strengthening health systems overall. Examples of such systems strengthening have come in the areas of drug development and pricing; policy and regulation; pharmaceutical procurement, distribution, and use; and management systems, such as for health information and human resources. For example, a hospital in South Africa developed new tools to decentralize provision of antiretroviral therapy to local clinics—bringing treatment closer to patients and shifting responsibility from scarce pharmacists to lower-level pharmacy staff. Successful, the system was expanded to patients with other chronic conditions, such as mental illness. Progress toward universal access to HIV prevention, treatment, care, and support will continue the push to strengthen pharmaceutical sectors that serve not only HIV-related needs but all health needs; health experts can likely take these achievements further to maximize their expansion into the wider health system. 

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*Center for Pharmaceutical Management, Management Sciences for Health, Arlington, VA †International Center for AIDS Care and Treatment Programs (ICAP), Columbia University Mailman School of Public Health, New York, NY