EDM Strategy for Working with Countries: the Uganda Example

1. EDM Strategy for Working with Countries: the Uganda Example Mr Martin Oteba Chief Pharmacist MOH UGANDA 29 September 2004

2. Expected Outcomes and Activities 2003 • Policy and Management: • Report of the assessment of the Pharmaceutical Situation • Organize consultative workshop to review draft report; Finalize draft report; and Print and disseminate final report • Stakeholders sensitised on public health issues on TRIPS/IPR • Organise preparatory meeting for workshop; and Organize workshop for stakeholders • Access: • Improved drug management at district level • Identify relevant courses for training in drug management; and Organise attendance to courses for district health personnel • Availability of key essential medicines monitored • Develop assessment tool; Collect data and Produce monthly reports

3. Expected Outcomes and Activities2003 • Quality Assurance: • Quality monitoring of the quality of TB medicines at national level • Collect & transmit samples for lab. analysis; and Receipt and provision of analysis results to national authorities • Quality of drugs at national level monitored • Collect drug samples and send for analysis • Rational Use of Medicine: • Guidelines for the rational use of ARVs developed • Drafting and field test guidelines; Consultative workshop to adopt final guidelines; and Adopted guidelines printed • Support provided for creation of a Drug Information Centre (DIC) • Identify and procure reference materials; and Deliver reference materials to DIC • Guidelines for establishment of Hospital DTCs developed • Prepare TOR for committee; Create committee; and Draft guidelines

4. Activity Implementation and Achievement of Expected outcomes • Policy and Management: • Report of the assessment of the Pharmaceutical Situation • Consultative workshop held in July 2003; Draft report ready in Nov 2003; and Final report printed and disseminated in Dec 2003 • Stakeholders sensitised on public health issues on TRIPS/IPR • Preparatory arrangements completed in Aug 2003; and Workshop & Report completed in Dec 2003 • Access: • Improved drug management at district level • 3 courses and content identified in June 2003; 152 health personnel trained by Nov 2003; and Training report ready in Nov 2003 • Availability of key essential medicines monitored • Monthly reports of availability of key essential medicines from MOH HMIS data made for the period Jan – July 2003

5. Activity Implementation and Achievement of Expected outcomes • Quality Assurance: • Monitoring of the quality of TB medicines at national level • No funding; Activity re-scheduled to 2004 • Quality of drugs at national level monitored • No funding; Activity re-scheduled to 2004 • Rational Use of Medicine: • Guidelines for the rational use of ARVs developed • Draft guidelines field tested in May 2003; Consultative workshop held in Aug 2003; and Printed Guidelines available in Dec 2003 • Support provided for creation of a Drug Information Centre • List of reference materials ready in May 2003; Procurement delayed; and Activity re-scheduled to March 2004 • Guidelines for the establishment of Hospital DTCs developed • TORs developed & Committee set up proposed in Jun 2003; Drafting of guidelines re-scheduled to 2004

6. TRADITIONAL MEDICINE • Support to the development of the TRM National Plan of Action: • Support TRM Working Group to develop National TRM Plan of Action • No Funding; Activity re-scheduled to 2004 • TRM Day celebrated: Delivered • Support to the TRM Working Group to organize and commemorate the Inaugural Africa TRM Day • TRM Day celebrated on 01 November 2003

7. COMPONENT POLICY 10 000 10 000 (100%) 10 000 (100%) 0 PLANNED BUDGET ACCESS 6 000 6 000 (100%) 6 000 (100%) 0 QUALITY ASSURANCE 6 000 0 0 0 ALLOCATED RATIONAL USE 19 000 19 000 (100%) 7 000 (37%) 12 000 (63%) TRADITIONAL MEDICINE 10 000 3 000 (30%) 3 000 (100%) 0 UTILISED TOTAL 51 000 38 000 (75%) 26 000 (68%) 12 000 (32%) BALANCE Utilization of Funds

8. CONSTRAINTS / LESSONS LEARNT • Constraints: • Lack of an appropriate structure & human resources in MOH to coordinate the pharmaceutical sector • Inadequate funding • Lessons Learnt: • Need to increase funding for essential medicines • Availability of medicines and their rational use is improved by strengthening human resources capacity for drug management

9. CONCLUSION / RECOMMENDATIONS • Focus support on procurement management and pricing, quality, safety and rational use of medicines including traditional medicines • Support national efforts to scale up access to essential medicines for priority diseases (HIV/AIDS, TB and Malaria) and for the establishment of a reliable drug management information system

10. PROPOSEDEXPECTED OUTCOMES MAY-DECEMBER 2004 • Policy: • National mechanism for M & E the NDP 2002 established • National capacity for NDP implementation strengthened • Access: • Pricing for essential medicines surveyed • Strengthened capacity for district drug procurement and management • Quality Assurance • National Quality Control Lab. staff capacity in GLP strengthened • Quality of medicines at national level monitored • Rational Use • Guidelines for establishment of Hospital DTCs developed • Priority requirements for establishment of the National DIC procured • Traditional Medicine • National TRM Plan of Action developed • Guidelines for registration of local TRM finalized and disseminated