E-drug: Decentralising pharmaceutical services (cont)
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In theory decentralization may work well, where decision making
process can be made close to the field situation and needs. In the
real world, however, decentralization in pharmaceutical sector, based
on wide experiences always bring more problems. Manpower capacity is
only one problem that need to be addressed cautiously.
Even if we have prepared with trained manpower, the economic
incentives and dis-incentives from the market, often beyond our
control. The experiences from Indonesia have shown when the money for
medicines are made available in health centres. Many of these
facilities use the money to purchase medicines from local suppliers,
often drugs outside the essential drug list and at higher prices.
These facilities will have more profits by buying non-essential
medicines. District warehouse with essential drugs where they could
compete with private suppliers should be available.
Budiono Santoso
WHO/WPRO
Budiono Santoso <SANTOSOB@wpro.who.int>
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