E-DRUG: African EDP Managers:pressrelease & recommendations
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[please find below the official press relase and the recommendations
of the 3rd Anglophone African EDP Managers meeting, held 12-17 March
2000 in Grabouw, near Cape Town, South Africa. WB]
WORLD HEALTH ORGANIZATION
REGIONAL OFFICE FOR AFRICA
P R E S S R E L E A S E
Temporary Office - Harare, Zimbabwe . P.O. Box BE 773 Belvedere,
Harare Tel (263-4) 703580 - 706951 - 707493 / Fax (263-4) 702177
025/22 March 2000
EXPERTS RECOMMEND WAYS TO IMPROVE ACCESS TO ESSENTIAL MEDICINES
Essential drugs programme managers from 16 African countries have
accepted the Intensified Essential Drugs Programme for the African
Region as an appropriate framework for addressing issues relating to
essential drugs.
They came to this decision last Friday after a five-day meeting in
Grabouw, Cape Town, South Africa, on the programme which had been
approved last September by the 49th session of the WHO Regional
Committee for Africa.
Among their recommendations, the drug experts urged their
governments to make access to essential medicines a priority,
allocate adequate budgets for them based on the needs of the people
and ensure that drugs for priority health problems were available,
affordable and accessible to those who need them.
To ensure effective implementation of the programme, they
recommended that the authorities should adopt good procurement
practices for essential drugs, capitalising on economies of scale,
and make pricing information available to drug prescribers,
dispensers, consumers and health insurance companies to enable them
to make informed decisions.
They also proposed that governments should encourage local
production of essential drugs and remove taxes on such drugs and the
raw materials for them.
The essential drugs managers endorsed the idea of joint bulk
purchasing of drugs for priority health problems by African
countries and called upon WHO to provide more information to member
states on the benefits and limitations of such schemes. However, they
insisted that local industries should not be put at an undue
disadvantage in the bidding for such purchases.
The drug experts acknowledged the role of traditional medicines in
health care in Africa and urged WHO to give support to its member
states in determining the optimal form in which they would be made
available.
The participants at the meeting also suggested that appropriate
information be disseminated on the concept and benefits of
harmonization of drug regulatory activities and the promotion of
common minimum standards in order to foster confidence in the
quality of services rendered.
They emphasised that easy access to reliable information on
pharmaceutical suppliers and pricing was of vital importance to
achieve optimal quality at affordable price and recommended the
establishment of a web site, to be coordinated by WHO, to make such
information freely available and keep it up to date.
In addition, they recommended that member states should strengthen
the capacity of drug regulatory agencies and grant them some degree
of autonomy to ensure effectiveness and efficiency.
They also recommended that member states should develop strategies
on rational drug use and incorporate the principle in the training
curricula for health workers.
Each country was requested to specify the activities it would carry
out to implement the Intensified Essential Drugs Programme to allow
WHO to make detailed plans for the support it would give.
In his remarks at the end of the meeting, the WHO Regional Adviser
for Africa on the Essential Drugs Programme, Dr Moses Chisale,
expressed the hope that the implementation of the programme would
"make a difference" in the efforts to improve the health situation
in the Region.
Already, work is going on at the Regional level with the
implementation of the Intensified Essential Drugs Programme.
Activities being undertaken by the WHO Regional Office include
training in good manufacturing practices, production of the AFRO
Essential Drugs Price Indicator, support to countries on
implementation of national drug policies, assessment of drug
regulatory capacity in member states and review of pharmaceutical
legislation.
The essential drug programme managers meeting, which was organised
by the WHO Regional Office for Africa, was attended by essential
drugs managers from Angola, Botswana, Eritrea, Ghana, Kenya, Lesotho,
Malawi, Mauritius, Namibia, Seychelles, South Africa, Swaziland,
Tanzania, Uganda, Zambia and Zimbabwe.
A similar meeting for essential drug managers from French-speaking
African countries will take place in July.
For further information, please contact
Mr Samuel T. Ajibola Public
Information and Communication Unit
WHO Regional Office for Africa
Harare, Zimbabwe.
Tel: (263-4 )703580; 706951; 707493; 705043
Fax:(263-4) 702177
E-mail: ajibolas@whoafr.org
All AFRO Press Releases can be found at the AFRO Home Page
http://www.whoafr.org/
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[the final draft recommendations are reproduced below; WB]
DRAFT RECOMMENDATIONS
This 3rd meeting of Essential Drug Programme Managers endorses the
Intensified Essential Drug Programme Implementation Strategy for the
African Region, and requests WHO and member states, to respond to
needs expressed within the IEDP framework
Component 1:
Capacity Building in Drug Regulation and Quality Assurance
1. Drug Regulatory Authorities themselves need to be harmonised in
terms of common minimum standards, to foster confidence in the quality
of services rendered. The participants also identified the need to
disseminate more information on the concept and benefits of
harmonisation of Drug Regulatory Activities. *WHO/AFDRAN Harmonisation
should be driven by public health interests, rather than the interest
of the pharmaceutical industry. (Combined first three bullets)
2. Set up a dedicated secretariat for AFDRAN. (WHO to
facilitate/accommodate)
3. Efforts to build capacity and strengthen DRA?s should be promoted
and supported, ideally in collaboration with regional bodies such as
AFDRAN.
4. Member States should grant some degree of autonomy to DRA?s to
ensure effectiveness and efficiency. The appropriateness of the
degree of autonomy may differ greatly among member states.
5. Alternative, more cost-effective ways of information sharing need
to be investigated, and the necessary capacity must be built in all
participating member states
COMPONENT 2: Information exchange to improve policy implementation
and cost control.
1. The culture of monitoring and evaluation should be fostered.
2. Member states should collaborate and define appropriate
indicators and share information in this regard. Who should take an
active role in supporting member states in this regard.
3. WHO should facilitate the establishment of an exchange forum for
the African region in the form of a web-site.
4. The issue of illicit trade in drugs needs to be explored and
member states need to take the necessary measures to address it
appropriately.
COMPONENT 3: Achieving better access to essential drugs; improving
drug supply
1. Pricing issues in developing countries are complex and require
active support from WHO to enable these countries to develop
appropriate pricing policies covering all key issues.
2. Equity pricing should be high on the agenda of WHO and member
states.
3. Governments should make access to medicines a high priority and
allocate sufficient budgets based on the needs of the population.
4. Member States recognised the need for consumers to be involved in
key decision making processes to ensure political accountability (in
terms of budgets).
5. Good procurement practices for appropriate drugs, capitalising on
economies of scale and tax exemption not only on essential drugs but
also on raw materials for essential drugs, should be implemented in
all member states.(rephrase)
6. WHO is requested to provide appropriate assistance to member
states to ensure that they become TRIPS compliant by 2006 without
compromising access to essential drugs.
7. The importance of good generic policies was reiterated, and all
member states should now formulate enabling legislation to promote
implementation of this useful tool. (Re-phrase)
8. Easy access to reliable information on pharmaceutical suppliers
and pricing is of vital importance to achieve optimal quality at
affordable cost. A web-site would be the ideal way of making this
information freely available and keeping it up-to-date.
9. We recommend that WHO co-ordinates this web-site and receives
information from the member states and suppliers.
10. It was recognised that decentralisation of services may have a
positive impact on access to medicines. However, if any component of
the Drug Supply Management Cycle is not adequately managed, supply
shortages will most certainly occur. Decentralisation should
therefore be encouraged and maintained only if adequate capacity can
be either achieved in decentralised units.
11. WHO should take an active role in providing more information to
member states on the concept benefits and limitations of bulk
purchasing schemes.
12. WHO should take an active role in providing more information to
member states on the concept benefits and limitations of local
manufacturing.
13. A need for more information on the concept, benefits and
limitations of local manufacturing has been identified. WHO should
take an active role in supporting assisting member states in this
regard.
14. The role of traditional medicines in health care and the optimal
form under which they are made available should be explored/studied.
WHO should take an active role in supporting assisting member states
in this regard.
COMPONENT 4: Improving rational use of drugs by prescribers,
dispensers and the public.
1. EDP managers recognise the fact that the concept of Rational Drug
Use is a good philosophy, yet often neglected.
2. Member states should develop RDU strategies to ensure training and
supervisory support to groups and individuals.
3. The value of an operational Pharmacy (Pharmaco-) Therapeutics
Committee is recognised, and it is recommended that they be
implemented at all levels of care.
4. Member states should recognise the role and value of consumers in
the formulation and implementation of NDPs and health care delivery.
5. Member states should develop IEC strategies to improve the use of
medicines by consumers.
6. The principles of Rational Drug Use should be incorporated in the
training curricula of health care workers.
7. Medical Insurance Companies and other private sector bodies should
be involved in the development and implementation of RDU strategies.
COMPONENT 5: Building institutional capacity in Africa.
1. Member states should promote the training of pharmacy technicians
in the region and agree on minimum training standards. Member states
to facilitate the registration of Pharmacy Technicians with their
professional bodies.
2. This Meeting recognises the need for orientation (training) of
pharmacists in management and public health. Member states should
incorporate this in the basic training of pharmacists and consider
establishing post-graduate training programmes in the region. WHO to
support the development of appropriate modules in the curricula and
support training where such programmes are already established.
3. Regional expertise should be identified and the information be
made available (on the web-site) for member states to be able to
collaborate and draw on other's experience and expertise.
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