WHO support to countries in the WHO support to countries in the area of medicinesarea of medicines
example of the African Regionexample of the African Region
WHO/EDM WHO/EDM Drug Action ProgrammeDrug Action Programme
Objectives of this sessionObjectives of this session
At the end participants will understand:At the end participants will understand:
the WHO global strategy for working with countriesthe WHO global strategy for working with countriesthe EDM strategy for country supportthe EDM strategy for country supporthow EDM work with countries is co-ordinated how EDM work with countries is co-ordinated
across WHO (country offices, regional offices, and across WHO (country offices, regional offices, and headquarters)headquarters)
the types of support to countries the types of support to countries how EDM works with other organisations to achieve how EDM works with other organisations to achieve
common goal common goal
Mission statement for country supportMission statement for country support
Provide appropriate support to countries Provide appropriate support to countries to build sustainable environment, to build sustainable environment, capacity and develop relevant policies capacity and develop relevant policies and programmes in order to ensure that and programmes in order to ensure that quality, safe and quality, safe and effective essential effective essential medicines are available, affordable to the medicines are available, affordable to the population and are used appropriately. population and are used appropriately.
WHO Medicines Strategy 2004-2007WHO Medicines Strategy 2004-2007Objectives & ComponentsObjectives & Components
PolicyPolicy Implementing & monitoring medicines policiesImplementing & monitoring medicines policies TRMTRM
AccessAccess Fair financing mechanisms & affordability of Fair financing mechanisms & affordability of
essential medicinesessential medicines Medicines supply systemsMedicines supply systems
WHO Medicines Strategy 2004-2007 WHO Medicines Strategy 2004-2007 Cont'dCont'd
Quality & SafetyQuality & Safety Norms and standards for pharmaceuticalsNorms and standards for pharmaceuticals Medicines regulation and quality assurance Medicines regulation and quality assurance
systemssystems Rational UseRational Use
Rational use by health professionals and Rational use by health professionals and consumersconsumers
Maximising Country SupportMaximising Country Support5 principles guiding WHO country support in 5 principles guiding WHO country support in
medicines:medicines:
1.1. Co-ordinated efforts within WHOCo-ordinated efforts within WHO
2.2. Enhanced expertise in country offices.Enhanced expertise in country offices.
3.3. Demand-needs drivenDemand-needs driven
4.4. Evidence based planning and interventionsEvidence based planning and interventions
5.5. Collaboration with partnersCollaboration with partners
1-Co-ordinated efforts within WHO1-Co-ordinated efforts within WHO
Headquarters:Headquarters:
Strategy & policy Strategy & policy makingmaking
Planning & Planning & monitoringmonitoring
Specific technical Specific technical & policy support& policy support
Strategy for Strategy for development & development & trainingtraining
Partnerships and Partnerships and collaborationcollaboration
Regional Office:Regional Office:
Oversee country Oversee country operationsoperations
Planning and Planning and monitoringmonitoring
Technical, policy Technical, policy and management and management supportsupport
Human resources Human resources development & development & trainingtraining
Partnerships and Partnerships and collaborationscollaborations
Country Offices:Country Offices:
Assess needs Assess needs and identify and identify priorities for priorities for technical supporttechnical support
Plan & Plan & implement WHO implement WHO workwork
Assist Assist CoordinationCoordination
Partnerships & Partnerships & collaborationscollaborations
Feed back and Feed back and reportreport
Ministries of Ministries of Health:Health:
Identify needs Identify needs & priorities& priorities
Plan, Plan, implement and implement and monitor actionmonitor action
Co-ordiate Co-ordiate with bilateral with bilateral and and multilateral multilateral agencies and agencies and CSOs.CSOs.
2-Enhanced expertise in country offices2-Enhanced expertise in country offices
CCaammeerroooonn CChhaadd EEtthhiiooppiiaa GGhhaannaa KKeennyyaa MMaallii NNiiggeerriiaa SSeenneeggaall RRwwaannddaa TTaannzzaanniiaa UUggaannddaa
Medicines Advisors toMedicines Advisors to::Assist in planning, Assist in planning, implementation and implementation and monitoring of medicines monitoring of medicines policiespolicies
Assist in coordination of Assist in coordination of stakeholders involved in stakeholders involved in pharmaceuticals pharmaceuticals
There are 11 medicine advisors in AfricaThere are 11 medicine advisors in Africa
3-Driven by country needs & priorities3-Driven by country needs & priorities
Request from countryRequest from countryRequest from Request from
countries or regionscountries or regionsType A: Situation analysis & monitoringType A: Situation analysis & monitoring
assessment of pharmaceutical situation, identify ssessment of pharmaceutical situation, identify priority needs - recommendations for interventionspriority needs - recommendations for interventions
Type B: Specific Type B: Specific technicaltechnical supportsupport
Ad hoc or regular Ad hoc or regular support support
Usually focused on a Usually focused on a subset of the following subset of the following areas: policy; access; areas: policy; access; quality, safety & quality, safety & efficacy; andefficacy; and rational userational use
Type C: Comprehensive Type C: Comprehensive programme supportprogramme support
Time frame may cover Time frame may cover one or more bienniaone or more biennia
Usually involves a full-Usually involves a full-time pharmaceutical time pharmaceutical adviser in the country adviser in the country
Covers most or all of the Covers most or all of the following areas: policy; following areas: policy; access; quality, safety & access; quality, safety & efficacy; and rational useefficacy; and rational use
Type IC: IntercountryType IC: Intercountry Ad hoc or regular Ad hoc or regular
support support involving two involving two or more countries often or more countries often from the same region from the same region
Usually focused on a Usually focused on a subset of the following subset of the following areas: policy; access; areas: policy; access; quality, safety & quality, safety & efficacy; and rational efficacy; and rational useuse
4-Evidence based planning and 4-Evidence based planning and interventionsinterventions
Based on Based on assessing and assessing and monitoring the monitoring the pharmaceutical pharmaceutical situation, situation, objectives can be objectives can be established and established and targeted targeted interventions interventions plannedplanned
Interventions nterventions should be should be implemented in implemented in coordination coordination with partners, with partners, including including bilateral and bilateral and multilateral multilateral agencies, NGOs, agencies, NGOs, and other and other stakeholdersstakeholders
WHO has developed indicator-based tools to WHO has developed indicator-based tools to evaluate structures, processes, outcomes evaluate structures, processes, outcomes and several specific pharmaceutical and several specific pharmaceutical componentscomponents
Rationale for seeking evidenceRationale for seeking evidence Raise awareness about the realities (i.e. MOH, Raise awareness about the realities (i.e. MOH,
WHO)WHO) Provide “numbers for advocacy” to convince Provide “numbers for advocacy” to convince
policy-makers policy-makers Set priorities among possible areas for Set priorities among possible areas for
interventionintervention Assess country medicines situation and trends Assess country medicines situation and trends
over timeover time Measures impact of interventionsMeasures impact of interventions
Affordability of medicinesAffordability of medicines
Affordability of Treatment of Pneumonia in 5 African Countries: Average Number of Day's Wage of Lowest
Government Salary Needed to Pay for Treatment
1.6 1.41.53.3
0.4 0.7
5.8
1.3 1.4
10.5
1.1 1.3 1.5 1.4
02468
1012
Public Health FacilityPharmacies
Adults
Private Pharmacies Public Health FacilityPharmacies
Children
Private Pharmacies
Country 1 Country 2 Country 3 Country 4 Country 5
AffordabilityAffordabilityImprove access to price Improve access to price
information & monitoring of information & monitoring of drug pricesdrug prices
Ensure inclusion of TRIPS Ensure inclusion of TRIPS safeguards in intellectual safeguards in intellectual property legislationproperty legislation
Promote use of generic Promote use of generic medicines of assured qualitymedicines of assured quality
Interventions to improve Interventions to improve affordability of medicinesaffordability of medicines
2. Plan2. Plan3. Implement3. Implement
1.1. AssessAssess andand MonitorMonitor
Ongoing Support Provided from last yearOngoing Support Provided from last year
Support Provided during the last yearSupport Provided during the last year
PolicyPolicy Train data collectors in 11 ocuntries for Train data collectors in 11 ocuntries for BLS; stakeholders workshop supported; BLS; stakeholders workshop supported; NDPIP for Ethiopia, Mali, Senegal, NDPIP for Ethiopia, Mali, Senegal, Rwanda, Uganda & NigeriaRwanda, Uganda & Nigeria
AccessAccess 1.1. Planning & training workshops for Planning & training workshops for pricing surveys in Tunis and pricing surveys in Tunis and Tanzania.Tanzania.
2.2. Pricing surveys underway in Pricing surveys underway in Cameroon, Chad, Mali, Tanzania & Cameroon, Chad, Mali, Tanzania & UgandaUganda
3.3. Training in medicines supply Training in medicines supply management (Ethiopia, Tanzania, management (Ethiopia, Tanzania, Uganda & Nigeria)Uganda & Nigeria)
4.4. TRIPS sensitisation to Nigeria, TRIPS sensitisation to Nigeria, Ghana & UgandaGhana & Uganda
Ongoing Support Provided from last yearOngoing Support Provided from last yearQuality AssuranceQuality Assurance 1.1. Drug registration in Ghana, Ethiopia, Drug registration in Ghana, Ethiopia,
Nigeria, Tanzania, Mali &KenyaNigeria, Tanzania, Mali &Kenya
2.2. Quality analysis of TB medicines in Quality analysis of TB medicines in Cameroon, Ghana,.Cameroon, Ghana,.
3.3. Procure monographs and reference Procure monographs and reference standards in Cameroon and Tanzaniastandards in Cameroon and Tanzania
4.4. Capacity building in quality analysis of Capacity building in quality analysis of ARV for Camroon, Nigeria.ARV for Camroon, Nigeria.
Rational Use of MedicinesRational Use of Medicines 1.1. Review of EML & STC in Chad, Ethiopia, Review of EML & STC in Chad, Ethiopia, Ghana, Kenya, Mali, Tanzania &Uganda Ghana, Kenya, Mali, Tanzania &Uganda (+ARV STG) (+ARV STG)
2.2. Staff from Chad, Mali, Senegal & Rwanda Staff from Chad, Mali, Senegal & Rwanda to RUM in Kigalito RUM in Kigali
3.3. Training in Ougadougou in Nov 2004 to Training in Ougadougou in Nov 2004 to sent participantssent participants
4.4. Support drug informations centres in Support drug informations centres in Burkina Faso & UgandaBurkina Faso & Uganda
5.5. Creation of DTC in Ethiopia, Kenya.Creation of DTC in Ethiopia, Kenya.
WHO policy and technical support on TRIPS to WHO policy and technical support on TRIPS to over 60 countries - health, trade and patent over 60 countries - health, trade and patent officialsofficials
Meeting on TRIPS in OAPI countries (Yaounde, May 2002) (15)
Meeting on the impact of globalization (Jakarta, May 2000) (9)
Briefing on TRIPS (SADC), (South Africa, June 2000) (7)
Workshop on TRIPS (Harare, August 2000) (4)
Participants in both, South Africa and Harare meetings (11)
Intercountry meeting on the TRIPS Agreement (Warsaw, September 2001) (22)
Country support (9)
World Health OrganizationWorld Health OrganizationHQHQ Regional Offices Regional Offices Country OfficesCountry Offices
CountriesCountries Ministries of HealthMinistries of Health
Partners in Country SupportPartners in Country Support
WHO operational WHO operational partnerspartnersUNAIDS, bilateral UNAIDS, bilateral and multilateral and multilateral agencies, public agencies, public interest NGOs in interest NGOs in health, UNDP, health, UNDP, UNFPA, UNCTADUNFPA, UNCTAD
WHO scientific WHO scientific partnerspartnersWHO Collaborating WHO Collaborating Centres in Centres in pharmaceuticals, pharmaceuticals, universities, universities, research centres, research centres, international international health professional health professional associationsassociations
WHO strategic WHO strategic partnerspartnersWorld Bank and World Bank and development development banks, banks, pharmaceutical pharmaceutical industry, WTO, industry, WTO, WIPO, EUWIPO, EU
5. Collaboration with partners5. Collaboration with partners
WHO/EDM-HAI Africa Regional WHO/EDM-HAI Africa Regional collaboration for action on essential collaboration for action on essential
medicines in Africamedicines in Africa1.1. Increased access to essential medicines through Increased access to essential medicines through
improved policies and practices - joint priority areas of improved policies and practices - joint priority areas of work: pricing and IPR issues work: pricing and IPR issues
2.2. Increased capacity and participation of NGOs and Increased capacity and participation of NGOs and consumers in the development and implementation of consumers in the development and implementation of medicines policymedicines policy
3.3. Expanded participation in and strengthened Expanded participation in and strengthened coordination of the HAI Africa Network coordination of the HAI Africa Network
4.4. Project countries: Uganda, Kenya and GhanaProject countries: Uganda, Kenya and Ghana
Rationale for WHO-CSO collaboration Rationale for WHO-CSO collaboration in countriesin countries
Synergy of expertise & know howSynergy of expertise & know how Complementary mandates and approaches Complementary mandates and approaches Enhance CSO participation in policy development & Enhance CSO participation in policy development &
implementationimplementation Empower CSO and build capacity in the medicines fieldEmpower CSO and build capacity in the medicines field Increase impact on decision & policy makersIncrease impact on decision & policy makers Forge dialogue & links-changed NGO-MOH dynamics - Forge dialogue & links-changed NGO-MOH dynamics -
helped close the “NGO credibility gap”helped close the “NGO credibility gap” Improve co-ordination and efficient use ofImprove co-ordination and efficient use of resources resources
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