Uganda: MSH Launches the SURE Essential Medicines Program

[A National Medical Store in Uganda. Photo Credit: MSH Staff.]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. To achieve that goal, the SURE team will assist the Government of Uganda, first, in reforming its policy, legal, and regulatory framework to provide stability and sustainability and, next, in improving the capacity and performance of government staff to manage the pharmaceutical supply chain.

Our first step will be to conduct an options analysis to identify the policy and finance reforms and supply chain improvements needed to make the pharmaceutical system more efficient. This analysis will combine three activities: political mapping, evaluation of both the system’s performance and citizens’ access to essential medicines, and investigation of the operating costs and efficiency in the supply chain. The analysis will define the changes needed to remove roadblocks, determine the feasibility of particular changes, and provide the basis to obtain necessary commitments to change from stakeholders.

We will base our capacity-building process on MSH’s monitoring-training-planning (MTP) approach, which we have applied widely in Africa and which has already proven effective in improving pharmaceutical management practices in Uganda. The MTP methodology strengthens human resource capacity by giving local facility staff the skills and tools to identify, analyze, and tackle problems using existing resources.

After facilities incorporated MTP in Uganda, 50 percent of them institutionalized the use of standard operating procedures, reduced stock-outs of antiretrovirals by 15 percent, and reduced expired medicines by 27 percent. At the national and local levels, SURE will focus its capacity-building efforts on calculating medicine needs and procurement, warehousing and distribution, financial management and using management information systems, as well as on organizational management and strategic planning for senior managers.

SURE will integrate Uganda’s currently fragmented supply chain and establish a pharmaceutical management information system that provides transparency to minimize medicine stock-outs and waste. We will help the government determine which current practices are working well and standardize best practices among the different levels of the health system. The National Medical Stores, as the planned hub of the supply chain, will receive special attention.

As SURE’s Program Director, Dr. Birna Trap brings 25 years of expertise in the pharmaceutical sector to the program. Dr. Trap has worked on projects in 75 countries in collaboration with numerous governments, implementing partners, and donors. Saul Kidde, who has been leading MSH’s work in Uganda for the past few years, will bring his local expertise to the SURE Program as the Technical Advisor for Supply Chain Operations.

The SURE team of MSH, Euro Health Group, Fuel Group/Pharmaceutical Healthcare Distributors, and Makerere University in Kampala, Uganda, will build the capacity to manage medicines from the top of Uganda’s health system to the bottom and integrate its parallel supply systems. SURE’s legacy will be a functional supply chain system with the tools, approaches, skills, and coordinating mechanisms to allow the Government of Uganda to maintain and expand on these investments.