E-drug: Bamako Initiative
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Dear colleagues,
I am quite surprised that there has not been any announcement of the
following event and I am therefore informing you. I would like to share
opinions with E-druggers on this issue through few questions:
Next week (8-12 March) there is an important conference in Bamako,
Mali, organised by the Government of Mali, WHO and UNICEF, on
"The Bamako Initiative: 10 years after". 46 countries from Africa and
other parts of the world will participate.
The objective of the Conference is to define achievements of the
Bamako Initiative since its implementation (1987), and to prepare
recommendations for new orientations to improve efficiency of health
systems.
Some key points of the Bamako Initiative have been:
- Decentralisation of decision making to the health district;
- Introduction and reinforcement of systems of co-management and
co-financing with communities;
- Procurement and distribution of essentials drugs.
I am interested to hear the opinion of E-druggers on achievements of
the Bamako Initiative in their respective countries, and what they see
as important remaining problems in the different countries.
The Bamakao Initiative has been implemented in Mali in 1989 and
in my opinion, the major impacts have been in the following areas
(for IB/drugs only):
- Definition of a National Drug Policy based on the procurement of
essential drugs;
- Access to essential drugs has greatly improved.
- Cost recovery is now widely practiced and generating funds to
buy drugs and to finance activities;
Remaining questions/problems are (in my view):
- Quality of care in health services;
- Improved access to essential drugs has led to inappropriate use of
drugs;
- Equity of the system;
- Establishment of a system of solidarity;
- Integration of the drug supply of vertical programmes.
NB: For information on the conference, please contact Mrs Flavienne
Issembe, WHO AFRO Harare, +263-4-706961
Best regards,
Dr Michel LALOGE
Technical adviser/National Drug Policy
MSPAS Mali
BP 115
Bamako Mali
Tel & Fax 00 223 23 24 63
e-mail: mlaloge@datatech.toolnet.org
[The issue of drug/health financing is very important. In June/July of
last year there was a series of postings on "Per capita allocation for
medicines". I posted a message on the importance of improving
quality of care and appropriate drug prescribing in developing health
financing systems. Deliberately provocative, I postulated that if
prescribing and diagnosing remained as poor as it is at the moment
in many health care systems in the world, any health financing
scheme will eventually become unsustainable and collapse.
There was very little response. I hope that Michel's message above
will generate a lively debate! Hilbrand Haak, E-drug moderator.]
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