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FROM POLICY TO ACTION An account of the Implementation of the Fiji National Drug Policy: 

FROM POLICY TO ACTION An account of the Implementation of the Fiji National Drug Policy Peter Zinck Chief Pharmacist Fiji Pharmaceutical Services This presentation will probably involve audience discussion, which will create action items. Use PowerPoint to keep track of these action items during your presentation In Slide Show, click on the right mouse button Select “Meeting Minder” Select the “Action Items” tab Type in action items as they come up Click OK to dismiss this box This will automatically create an Action Item slide at the end of your presentation with your points entered.

Status Summary: 

Status Summary National Drug Policy (NDP) developed in 1994 and approved by Cabinet in 1995. Final Document approved by ALL stakeholders through a workshop Fiji NDP: Macro-plan for improving availability and rationalising the use of drugs Fiji NDP: broad policy objectives which have been translated into the Fiji Pharmaceutical Services Plan 42% implementation of the NDP A number of policy areas will be discussed to illustrate the progress to implementation date.

Achievements and Progress: 

Achievements and Progress Legislation and regulation Review of legislation Pharmacy Bill Therapeutics and Poisons Bill Factors that made progress possible Donor Support for Technical assistance WHO and AUSAID MoF funding developments approved for the set of a: drug registration system staffing for the Inspectorate and Regulatory Affairs (IRA) Section

Achievements and Progress: 

Achievements and Progress Drug Selection Establishment of a National Drugs and Therapeutics Committee Development of the Fiji Essential Drug List Reviewed every 2 years (1994,1996,1998) 2000 (did review but could not implement owing to funding) Factors that made progress possible Implemented prior to the official launch of the NDP Chairmanship Vision and leadership role

Trends in Major Causes of Morbidity 1995-1999: 

Trends in Major Causes of Morbidity 1995-1999

Achievements and Progress: 

Achievements and Progress Procurement, Distribution and Storage Review of Operations: AUSAID led to renaming from Government Pharmacy to Fiji Pharmaceutical Services Funding of new computerized warehouse: JICA: Approval for a FMIS with an emphasis on Inventory Management System (IMS) Factors that made progress possible Political commitment to address and strengthen the logistics/distribution function of the medical supplies services.

Achievements and Progress: 

Achievements and Progress Rational Drug Use Review of undergraduate curricula to introduce RDU concepts (Dental, Medical, Pharmacy and nursing students) Development of STG’s (Antibiotics, Cardiovascular, Diabetes, Emergency and etc,) Establishment of a Drug Information Service at Divisional Hospitals Monthly newsletter: FPS (Pharmanews) Factors that made progress possible Funding and technical assistance through donor support

Achievements and Progress: 

Achievements and Progress Financial Resources: Public Health Expenditure as % of total government expenditure: 8% Total health spending- 3% of GDP Per capita health expenditure- $170 per annum Drug Budget Trends: 1991: F$2.4 million to 1998: F$7.3 million 2002: F$8.3 million per capita expenditure from F$3 in 1991 to F$10.5 per capita in 2002 (the public sector)

Trends in Recurrent Health Expenditure: 

Trends in Recurrent Health Expenditure

National Health Expenditure: Public vs Out Of Pocket (source Walters Report WHO 2001): 

National Health Expenditure: Public vs Out Of Pocket (source Walters Report WHO 2001)

Separation of financing and provision / shift from direct payment to prepay /: 

Separation of financing and provision / shift from direct payment to prepay / Individuals Providers Pay for services needed Services are delivered Health Insurance Premium Payment Health services

Risk sharing under different financing methods: 

Risk sharing under different financing methods Public Private Private Mixed Public Out of pocket Private insurance Community financing Social Health Insurance Government Risk sharing and pooling resources Pooling Self Reliance

Achievements and Progress: 

Achievements and Progress Human Resources: Profession: Amendment of the Pharmacy and Poisons Act to enable registration of Pharmacists from the Fiji School of Medicine Undergraduate/Post Graduate Fiji School of Medicine: School of Pharmacy Bridging Course Certificate course upgraded to a Diploma Course 2005: Upgrade to a four year Bachelor of Pharmacy Set up of a Curriculum review Committee Distance learning with the University of Otago of a Post Graduate Diploma in Clinical Pharmacy

Health Resources (Human-1999): 

Health Resources (Human-1999)

Attention Areas: 

Attention Areas Delays in the tabling of the Pharmacy and Therapeutic & Poisons Bills Development of an appropriate computerized inventory software Sustainable financing (drug budget) High staff turnover: HRM Research Corrective actions Seek an audience with the Minister to retable a Cabinet paper to the new Government Home made/custom made versus ready made Software Explore alternative forms of HCF approaches Development of retention strategies of HRM Establish a research secretariat within the MoH

Schedule: 

Schedule Retable Cabinet paper before year end Pharmacy and Therapeutics & Poisons Bills to be tabled early next year 2003. Construction of new warehouse should start in November with a likely completion date in Feb 2004. FMIS (IMS) to parallel with construction but run live in March 2003. HCF: Concept paper to be tabled to Cabinet paper before year end. Public Service Commission: Job Evaluation Review (JER) 2003. Develop a retention strategy paper to be endorsed by the MoH to address this issue before JER commences

Resources to Implement NDP: 

Resources to Implement NDP A body responsible for the implementation of the Fiji NDP has not been established. Policy directives been implemented using existing human and financial resources contributed by both Government and Donor Support Dedicated (full-time) resources lack of resources, alternatives proposed Part-time work on an extra-mural basis Twinning arrangement with mentoring organisations Buddy system of technical assistance with a broad view capacity building in management and technical areas

Summary: 

Summary NDP is a long term plan NDP is a commitment to guide policy makers NDP is a sounding board for the development of legislative and policy instruments to improve RDU and EDL concepts. Some progress has been made Once regulatory frame work is in place significant advances in implementation will be made.

THANK FOR YOUR ATTENTION: 

THANK FOR YOUR ATTENTION

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