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Best Practices in Medical Donations Logistics, Safety and Distribution. Matthew Krzyston Chuck Clark Director Distribution Manager RPX Project HOPE Dr. Gil Irwin Steve Chupa Founder/President Director of Security Medical Missionaries J&J Worldwide Sec. The Common Goal.
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Best Practices in Medical DonationsLogistics, Safety and Distribution Matthew KrzystonChuck Clark Director Distribution Manager RPX Project HOPE Dr. Gil IrwinSteve Chupa Founder/President Director of Security Medical Missionaries J&J Worldwide Sec. RPX
The Common Goal All donations serve to provide valuable assistance to vulnerable populations. • Disaster Relief: • Rapid, focused response to WHO list and reality on the ground • Every disaster has it’s own ‘face’ • Response to bioterrorism will differ from tsunami relief • Missionary Support: • Assessment of professional capacity is critical. What is delivery mechanism? • Without assessment - Focus on basic supplies, over the counter treatments. • Single Disease Initiatives (TB, HIV, STD, Pneumonia): • Continuity is critical (3-5 year commitment). • Drug purchase may be required if break in continuity. • Institutional Support: • Focused on sustainable development, Requiring extensive in-country knowledge • Pharmaceutical Benefit Initiative: USAID funded program designed to support PHC, development of mandatory health insurance in Kyrgyzstan Not everyone shares this perspective… RPX
Potential vs. Perception Potential ‘Life saving assistance for vulnerable populations’ Perception ‘Expired Product’, ‘Diversion’, ‘Dumping’, ‘Dangerous’ Need best practices for everyone: NGOs, Donors, PQMD RPX
PQMD’s KEY COMPONENTS OF MEDICAL DONATIONS Useful NGO guidance on the following program elements: • NEEDS ASSESSMENT • APPROPRIATENESS OF THE DONATION • QUALITY AND QUANTITY • PACKAGING • TRANSPORTATION • UTILIZATION OF HUMAN RESOURCES • EVALUATION Action required from NGOs, Donors, and PQMD… RPX
NGO ACTIONTraits of Effective Distributions • Work with MOH (no parallel systems) • Pharmacist in selection process • Professional logistics mechanics (HOPE) • Knowledgeable MD in distribution • Accountability measures built-in • Patient-focused benchmarks (not $) • Justified Selection - V.E.N. (Focus on Essential) RPX
PQMD ACTIONPromoting Excellence • NGO Inclusiveness • Growth of PQMD will serve to advance best practices • Advocate for Donor best practices • Program threats can be reduced, and efficacy enhanced, through improved donor practices RPX
DONOR ACTIONDiminish Threat - Magnify Efficacy • Adopt Demand-driven giving policy • Filling more requests for essential drugs • Generous Dating • Give until it hurts….? RPX
FOUS ON SELECTION V.E.N. • Vital = Life saving medicines, targeted to urgent needs in hospital settings at tertiary and secondary health system levels. • Examples: I.C.U. drugs, cancer drugs, anesthesia • Essential = Important for chronic disease management, because interruption of treatment may lead to life-threatening complications. Critical for reducing hospitalization by providing good quality medical service at the PHC level. • Examples: some antibiotics, anti-hypertensive • Necessary = Medicines that address symptoms, but do not treat disease/illness. • Examples: oral analgesics, anti-diuretics RPX
FOCUS ON SELECTIONBest Option: Essential Medicines Donations of essential medicines are ‘always’ appropriate, providing the most effective assistance to both beneficiaries and the healthcare system as a whole. • Favored by WHO and MOH: Country EDL is on file with every MOH - Generic EDL issued by WHO • Vital Meds: Require training, fewer beneficiaries, threat of non-use/waste • Necessary Meds: Raise questions about cost benefit vs. local purchase RPX
POTENTIAL VS. PERCEPTIONAction Required… NGO Action • Professionalism – Best Practices PQMD Action • NGO Inclusiveness vs. Elitism Donor Action • Reduce Threat: Supply-driven vs. Demand-driven Everyone • Promote achievements and support one another RPX
Reality Check • If NGOs are unable to adhere to guidelines, they should bow out • Professionalism counts, NGO size does not • If Donors maintain supply-driven policies, they should not expect positive press • If PQMD does not promote inclusiveness and higher standards, standards will stall RPX