Essential medicines are integral components of health systems and play significant role in the delivery of health care services. In the context of strengthening health systems, the Program supports implementation of national medicine policies and strategies with the overall aim of improving access to affordable, quality and safe essential medicines and traditional medicines.
Medicine Pricing: The program provides information on procurement prices of essential medicines collected from public procurement agencies and international suppliers of generic medicines. A more user friendly system to capture tender prices from public procurement agencies is under development. Using the WHO and Health Action International standard survey methodology (PDF)
Essential medicines in public health facilities are not regularly available and people are obliged to pay higher prices for their medicines out of pocket from the private sector. Medicine prices vary within and across countries and are unaffordable especially in the private sector. The need for policy guidelines and options for countries to improve affordability and availability of essential medicines remains one of the priority areas.
Financing of medicines: Public sector per capita expenditure for medicines in many countries of the Region remains below US$ 2 and is far from adequate. In view of improving the availability and affordability of essential medicines, strengthening and exploring alternative medicines financing mechanism has been given paramount importance. The program works with the World Health Organization/Pan American Health Organization Collaborating Center in Pharmaceutical Policy (http://www.whoccpp.org/) to develop appropriate tools; carry out household surveys and analysis of data on access and use of medicines. Pilot household surveys were carried out in Gambia, Kenya and Uganda. Preliminary assessments were undertaken in 5 countries to explore potential areas of technical support to strengthen capacities of national health insurance schemes and expand the coverage of essential medicines. The first African course on pharmaceutical policy analysis and health insurance was held in 2008.
The development and implementation of appropriate policies and strategies including regulating medicine prices and expanding coverage of essential medicines under health insurance schemes are given due emphasis.
The focus in Medicines Regulation and Quality Assurance Systems is on establishing and strengthening national medicine regulatory authorities to develop norms and standards to ensure the quality, safety and efficacy of all pharmaceutical products and to put in place necessary infrastructures and procedures for quality assurance mechanisms. A regional framework to strengthen national medicine regulatory authorities was developed. Support is provided to medicine regulatory authorities to build their capacity, enforce national laws and regulations. The fight against circulation of substandard and counterfeit products is one of the priority areas. The Program advocates for effective enforcement of policies and regulations and promotes regional cooperation to combat the circulation and use of substandard and/or counterfeit medicines in partnership with relevant stakeholders in pharmaceuticals.
Apart from specific country support activities, the program collaborates with partners and Regional Economic Communities, among other things, on initiatives to harmonize medicine regulations. In order to enhance generation of scientific evidence on safety, efficacy and quality of traditional medicines for malaria, sickle cell diseases, diabetes and HIV/AIDS, the program has produced guidelines for clinical study on Traditional Medicines including protocols. Furthermore, capacity development and valuation of research results in pre-clinical and clinical evaluation of Traditional Medicines have been carried out. The Regional WHO collaborating centers for quality assurance of essential medicines in South Africa and Algeria provide technical support to countries as necessary.
The focus in National Medicine Policy is on supporting countries to engage in policy dialogue, policy development and analysis, preparation of implementation plans and ensuring the commitment of all stakeholders to national medicine and traditional medicine policies. Forty countries in the region have comprehensive national medicine policies; out of these countries, twenty one have developed implementation plans.
The Program collaborates with partners and stakeholders to strengthen human resource capacities; enhance implementation of national medicine policies and promote transparency and good governance in the pharmaceutical sector. Furthermore; providing support to countries to implement the global strategy and plan of action for public health, innovation and intellectual property. Information for the Pharmaceutical Sector is regularly collected and status of implementation of national medicine policies is monitored.
The focus in Procurement and Supply Systems is on regular availability of affordable and quality essential medicines plays key role in the delivery of health care services. The program supports public procurement and supply agencies to strengthen their capacity and improve efficiency in the procurement and supply management of essential medicines.
Using the regional training manual on management of essential medicines at health centre level, countries have been supported to organize training sessions on effective supply management systems. The revised version of the medicines management training manual will be made available by 2010. The program collaborates with other WHO programs in assisting countries to develop national medicine procurement plans.
National procurement and supply management systems have been assessed and a regional framework to strengthen their capacities in procurement and supply systems was developed in consultation with national authorities and stakeholders. In collaboration with WHO headquarter, comprehensive tools to assess the procurement and supply systems, map financial flow and partners were developed. Using the comprehensive tools, with WHO support, first round of ten countries have undertaken in-depth assessment of their procurement and supply systems, mapped partners and financial flow for essential medicines during the last three years. The program focuses to identify and document best practices in procurement and supply management to strengthen capacities for effective public procurement and supply systems. Local production capacities in the region for essential medicines have been assessed and a regional framework was developed to strengthen local production of essential medicines.
The focus in Rational use is on supporting countries to implement cost effective interventions aiming at improving the rational use of medicines and traditional medicines by health professionals and consumers.
With support from WHO, to-date, 39 countries in the region have developed essential medicines list linked to standard treatment guidelines for the most common diseases, and 25 countries have developed national medicine formularies. In many countries, national list of essential medicine are used to guide selection of medicines for procurement, good prescribing and dispensing practices mainly in the public sector.
Support is provided to countries to revise these tools regularly in order to meet changing public health needs. The program has developed guidelines for training of Health Science Students in Traditional Medicine and Traditional Health Practitioners in Primary Health Care. Implementation of appropriate policies and strategies to improve the rational use of essential medicines continues educate the public and to provide need based and patient centred pharmaceutical care in public health facilities in collaboration with, partners, professional associations, academia, consumer organizations and other stakeholders.