E-DRUG: WHO/AFRO report 2002 on essential medicines
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[The WHO/AFRO regional director has published his report on the work of WHO
in the African region in 2002. Below sections 49-56 on essential drugs. The
full report is at http://www.whoafr.org/rc53/home.html. WB]
Essential drugs and medicines policy (EDM)
49. In Africa, 50% of the population, mostly the poor and disadvantaged, do
not have access to existing essential medicines, and many more cannot access
the new medicines for treating common diseases like malaria and HIV. Where
essential medicines are available, their efficacy is doubtful due to poor
quality, unethical promotion and irrational drug prescription and use.
Recent global trade agreements also pose a threat to accessing essential
medicines in the Region.
50. For effective support in implementation of national medicines policies,
it was necessary to strengthen human resource capacity both at the Regional
Office and in some countries. During the period under review, ten national
programme officers were recruited to strengthen capacity in country offices;
an EDM coordinator and two short-term professionals were recruited to
strengthen capacity in the Regional Office. Guidelines for the formulation,
implementation, monitoring and evaluation of national medicines policies
were published and disseminated to countries.
51. Support was provided to Botswana, Burkina Faso and Nigeria to review and
update their national medicines policies and essential medicines lists. The
state of pharmaceuticals was assessed in Chad, Ethiopia, Ghana, Nigeria,
Tanzania and Uganda. A sensitization workshop on Trade-Related Aspects of
Intellectual Property Rights (TRIPS) was held for policy-makers from
francophone countries to enable them to incorporate TRIPS safeguards in
public health legislation on pharmaceuticals.
52. Equatorial Guinea and Mauritania were supported to establish central
medical stores. A regional workshop on strengthening national medicines
supply systems was organized and held for participants from anglophone
countries.
53. To help countries improve quality of drugs, guidelines for the
inspection of pharmaceutical products were field-tested, finalized and used
in eight countries.
(Benin, Burkina Faso, Cameroon, Chad, C�te d�Ivoire, Guinea, Mauritania,
Togo. )
Pharmacy inspectors in Cameroon, Gambia, Lesotho and Nigeria were trained
in inspection of pharmaceutical establishments such as pharmacies, factories
and storage facilities. The WHO computer-assisted model for drug
registration (SIAMED) was installed in Central African Republic.
54. A training manual on the management of drugs at health centre level was
finalized and is now in use in countries. Participants from seven countries
(Algeria, Central African Republic, Chad, Guinea, Mali, Rwanda, Togo) were
supported to attend a regional training course in rational medicines use. A
pilot study on quality screening of chloroquine and sulphadoxine
pyrimethamine was conducted in collaboration with Roll Back Malaria and HQ.
Deficiencies in active ingredient and dissolution profiles of these
medicines were revealed (see Figure 2). These deficiencies could explain the
therapeutic failures of choroquine and sulphadoxine pyrimethamine which have
been observed in most African countries. Samples were judged to have
�failed� if content was <93% or >107%, and dissolution <80% in 45 minutes.
55. Similarly, to assure the quality, safety and efficacy of traditional
medicines, generic protocols were developed and approved by the Regional
Expert Committee on Quality screening for traditional antimalarial
medicines. The protocols are necessary for documenting ethnomedical evidence
and clinical evaluation of traditional medicines used for the management of
HIV/AIDS, sickle-cell anaemia and diabetes. 56. General guidelines for
documenting African traditional medicine were developed and made available
to countries. Technical support was provided to 10 countries12 for either
evaluation of traditional medicines or development of their traditional
medicine programmes. The inauguration of an African Traditional Medicine day
for advocacy was approved; the first ATM day will be commemorated on 31
August 2003 with the theme �Traditional Medicine; Our Culture, Our Future�.
Access Essential Drugs Monitor #32 at http://www.who.int/medicines/mon/mon32.shtml
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