# \[e-drug\] Decentralising pharmaceutical services (cont) **URL:** \ **Category:** e-drug\ **Created:** [January 29, 2001, 4:31am UTC](https://talk.edrugplus.org/t/e-drug-decentralising-pharmaceutical-services-cont/10196 "2001-01-29T04:31:08Z")\ **Posts on this page:** 1\ **Page:** 1
**Author:** ![Francisco\_Rossi](https://avatars.discourse-cdn.com/v4/letter/f/50afbb/32.png) [@Francisco\_Rossi](https://talk.edrugplus.org/u/Francisco_Rossi)\ **Post date:** [January 29, 2001, 4:31am UTC](https://talk.edrugplus.org/t/e-drug-decentralising-pharmaceutical-services-cont/10196/1 "2001-01-29T04:31:08Z")
E-drug: Decentralising pharmaceutical services (cont) --------------------------------------------- Dear Wilbert and e-druggers: First of all I think is necessary to be clear about a point. Decentralization is always not a health sector initiative, but a global government decision. In other words is a democratization, human rights, and social participation discussion, and not a health, pharmaceutical or administrative discussion. It means that our position usually is not if we agree or not about it. In reality I think we need to prevent the most frequent risks, and take care of the predictable problems. Standardization of a restrictive list of essential drugs, and enforcement of the regional control authorities is probably an essential need. If the country has a national supply system, there are a lot of success decentralization experiences in Latin America. In the other hand, there are also a lot of "disasters". Most of them goes on the way of build a commercial relation between institutions or regions, and the national office. And of course every institution have the funds for drugs and the decision about what, how much and to whom buy. Colombia, a well calificated country in the recent "world health report" of WHO, has a decentralized system, where every hospital is a social public enterprise with his own budget. There is a national formulary and is widely used by doctors. But in the past 5 years, we developed a regional hospital association model in hospital cooperatives, that combines scale economies with a very efficient management. Maybe is an interesting experience with success results. I'm sure we need to follow up the health sector reforms and its impact in drugs. Decentralization is a core issue. But usually the question is when, how and in which way, and not yes or no. I believe. Good Luck Dr Francisco Rossi "Francisco Rossi" \ [Please include current affiliation and address with each message.BS] -- Send mail for the `E-Drug' conference to `e-drug@usa.healthnet.org'. Mail administrative requests to `majordomo@usa.healthnet.org'. For additional assistance, send mail to: `owner-e-drug@usa.healthnet.org'.