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Ensuring access to essential medicines - framework for collective action

WHO Technical Briefing seminar Geneva, 01 – 05 November 2010. Access Framework & Challenges in Medicines Supply Systems Mrs Helen Tata (WHO/EMP). Ensuring access to essential medicines - framework for collective action. 1. Rational selection & use. 3. Sustainable financing. ACCESS.

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Ensuring access to essential medicines - framework for collective action

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  1. WHO Technical Briefing seminarGeneva, 01 – 05 November 2010. Access Framework & Challenges in Medicines Supply SystemsMrs Helen Tata (WHO/EMP)

  2. Ensuring access to essential medicines - framework for collective action 1. Rationalselection & use 3. Sustainablefinancing ACCESS 2. Affordableprices 4. Reliable health systems

  3. Assessment of medicines supply systems • 2007 AFRO/EDM and HQ/EMP developed tools to support countries in this activity • 1st stage • Map partners supporting medicines procurement and distribution • Financial flows • Warehousing • Distribution • 2nd stage • Look at issues around the medicines supply management cycle: • Selection • Procurement • Storage/stock management • Distribution • Financing • M & E

  4. Race to save lives • The rush

  5. Source: Bergis Schmidt-Ehry, GTZ

  6. Medicines supply systems in TANZANIA. 2007 United Republic of Tanzania ESSENTIAL MEDICINES ARVs MALARIA TB OI ARVs Ped REAGENT Blood safety (+ HIV test) VACCINES CONDOMS CONTRACEPTIVES MEDICAL SUPPLIES GOVERNMENT BILATERAL DONOR MULTILATERAL DONOR NGO/PRIVATE GLOBAL FUND C O L U M B I A C S S C W H O S I D A N O R A D C I D A H A V A R D P E P F A R CL I NTON A X I O S P F I Z E R J ICA C D C G A V I C U A M M U N I C E F U S A I D W B A B B O T T GOVERNMENT Source Of Funds Procurement Agent/Body C L I N T O N H A V A R D E G P A F A X I O S U N I C E F A B B O T T C U A M M C O L U M B I A U S A I D TEC & CCT MEDICAL STORE C R S S C M S MOH & SW J I C A G A V I CROWN AGENTS T M A P C D C Point of 1st warehousing TEC &CCT HOSPITAL CRS IMA MEDICAL STORE AXIOS COLUMBIA CUAMM HEALTH FACILITY HOSPITAL Point of 2nd warehousing REGIONAL/DISTRICT VACCINE STORE TEC &CCT ZONAL MEDICAL STORE HEALTH FACILITY HOSPITAL TEC &CCT Point of Distribution ZONAL BLOOD SAFETY CENTRE DISTRICT STORE HEALTH FACILITY PRIMARY HEALTH CARE FACILITY HOSPITAL PATIENT

  7. Systèmes d'approvisionnement des produits pharmaceutiques au BURUNDI. Juillet 2007 République du Burundi Ministère de la Santé Publique MEDICAMENTS ESSENTIELS ARVs PALUDISME TB IO ARVs Ped REACTIFS sécurité du sang (+ test HIV) VACCINS Préservatifs Contraceptifs Dispositifs Médicaux Etat Bailleurs bilatéraux Bailleurs multilatéraux ONG/Privé C A M E B U D F I D UE CL I NTON UN I TA I D GDF O M S U N I C E F MS F A C F PDM C I C R B M GTZ C E P B U U S A I D G V C G A V I C T B P S I C O R D A I D I PPF K F W C O N C E R N E T A T F N U A P FONDS MONDIAL Sources de Financement P N L T C A M E B U SEP/ CNLS G D F OM S M S F A C F P DM C I C R SEP/ CNLS G T Z C E P B U G V C C T B P S I C O R D A I D F N U A P IPPF G F A C O N C E R N C L I N T O N I P A U N I C E F Structure d'appro- visionnement 1er point de stockage MSF ACF PNLO CICR GVC CAMEBU PNLT PEV IMC CEPBU PSI ABUBEF PNSR CONCERN CORDAID 2ème point de stockage PNSR HÔPITAUX CNTS IMC ACF PRISON GVC CDS CPLS Site de prise en charge CDV BPS Grossiste Privé CORDAID Structure dispensatrice BPS CPLS CDV Site de prise en charge SNT/CNT CDT/CT CDS Détaillants COCOLS PATIENT

  8. Partner store within national store

  9. National Medicines stores

  10. Challenges (1) • Selection: • Supply outside the EML/STG still exists • Procurement of non registered medicines in countries still exists • Quantification: • CMS not always involved in forecasting/procurement • No coordination in quantification between MoH, CMS, partners resulting in: • stock-outs or • overstocking • expired products • Inadequate logistic information system

  11. Challenges(2) • Procurement: • Managed by various partners present in country. • National system hardly involved in program procurement Storage/stock management: • Inadequate storage capacity due to lack of coordination in procurement planning • Different stock management tools for the same product originating from different partners • Distribution: • Inadequate funds for distribution. • Uncoordinated distribution between different programs leading to high operational costs for all programs.

  12. Challenges(3)‏ Financing: • Funds available mainly for 3 disease programs • Other areas under funded • Financial figures not always available • Logistic support is under- funded Monitoring-Evaluation: • Each program may have a stand alone M&E • Different reporting tools • Burden of work for scare human resource at periphery high

  13. What can we do?

  14. Source: Bergis Schmidt-Ehry, GTZ

  15. Source: Bergis Schmidt-Ehry, GTZ

  16. Benefits • Platform for dialogue, information sharing and coordination • Joint M & E and reporting • Reduced workload • Health System strengthening • Timely delivery of medicines to target population • Cost savings

  17. Expectations • Adequate funding to medicines for priority disease to support distribution of all other categories of medicines • Stock management tools for medicines from various sources streamlined • No stock outs in any health facility • Un-interrupted access to medicines!

  18. Recap • Coordination, dialogue, information sharing • Joint M & E and reporting • Reduced workload • Health System strengthening • Timely delivery of medicines to target population • Cost savings

  19. Source: Bergis Schmidt-Ehry, GTZ

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