Multi country studies on drug supply organisations : Multi country studies on drug supply organisations Learning objectives By the end of this session, participants should be able to : have knowledge of the 2 on going multi-country studies conducted by WHO be able to describe various strategies of drug supply systems


Slide2: Multi-country studies on (1) Faith-based drug supply organizations (2) Public medicines supply systems Sophie Logez, EDM/PAR, March 2004 Promoting use of effective medicines supply strategies in Africa: increasing access to best practices in medicines supply


Rationale for the multi-country studiesin Africa: Rationale for the multi-country studies in Africa Lack of access to essential medicines (less than 50% in some countries) Impact of new strategies to fight against high burden disease on medicines supply systems (GFATM, 3x5 initiative…) Need to review public medicines supply systems in Africa (strategies and reforms) to promote use of effective medicines supply strategies in Africa Contribution of the faith based supply organization from the Ecumenical Pharmaceutical Network (EPN)


(1) Multi-country study ondrug supply and distribution activities of faith-based drug supply organizations: (1) Multi-country study on drug supply and distribution activities of faith-based drug supply organizations Ecumenical Pharmaceutical Network – WHO collaboration Objectives Methodology Preliminary findings


Objectives of Study: Objectives of Study Document the various experiences and practices of faith-based (FB) DSOs Strengthen the EPN’s technical capacity to evaluate and compare drug supply systems existing in the Network Strengthen collaboration between WHO/EDM and EPN (WCC) in their official relationship


Study methodology: Study methodology Descriptive cross sectional study Sample: 16 Drug Supply Organizations (DSO) participating in the EPN in 11 African countries (reviewed by December 03) Data collection tool: 4 structured questionnaires (Government, funding bodies, DSO and clients) Data collection: Paired country assessments by Faith Based DSO staff Data management: database, country reports, global report


Slide7: Ghana Nigeria Tanzania Kenya Uganda Malawi Zambia Sth Africa Cameroon Rwanda DR Congo 11 Selected countries


Preliminary findings: Preliminary findings Role of DSOs Sustainability of DSOs Procurement (sources and prices) Customer’s opinion Government’s view


Role of Faith Based DSOs: Role of Faith Based DSOs FB DSOs fill supply gaps left by Government supply systems: overall public health sector: up to 40% in rural areas: up to 80 - 90%


Procurement (S&P): Procurement (S&P) One supplier set different conditions in the network of Faith Based DSOs, in terms of: Prices Credit terms and conditions Delivery times


Sustainability of Faith Based DSOs: Sustainability of Faith Based DSOs Revolving drug fund mechanism affected by: Drug donations distributed free-of-charge depressed DSO sales caused stock wastage and loss Reduced drug budget internal financial borrowing financial contributions to founding bodies


Customers’ opinion: Customers’ opinion Medicines requests not always met quantities range of items Need for technical assistance regular supervision training support


Governments’ view: Governments’ view Lack of formal reporting/communication Lack of formal collaboration Perceptions of governments: quality of medicines supplied by FB DSO questioned distribution of donated medicines not always found appropriate


The Steps: The Steps 11 preliminary country reports (January 04) Development of the database First draft of the global analysis EPN/WHO meeting with all study participants (May 2004) Final report and recommendations


Perspectives: Perspectives EPN/WHO Publications on Faith Based drug supply activities Proposals for further activities in the network Identification of further collaboration with WHO in some specific area of procurement and access


(2) Multi-country study on public medicines supply systems in Africa: (2) Multi-country study on public medicines supply systems in Africa Objectives Supply systems in selected countries Methods First steps


Objectives of the study: Objectives of the study Assess supply performance at technical and operative levels Document supply reform strategies by governments Generate guidance and medicines supply strategies best practices for policy and decision makers


First step: Start-up stakeholders meeting, Geneva, Dec. 2002: First step: Start-up stakeholders meeting, Geneva, Dec. 2002 Participants: International, national and NGO supply agencies Objectives: Update on national public drug supply experiences Discuss methodology framework and research questions


Slide19: Public medicines supply systems in 11 selected countries


Medicines supply system for public sector: Medicines supply system for public sector Central Medical Stores Centralized system for all supply activities Government is owner, manager and distributor Semi autonomous agencies Government is owner and has supervision function Management and distribution by private system Autonomous agencies Government has only supervision function Management, storage and distribution by private system


Study methodology: Study methodology Sample: 11 African countries Data collection tool: 3 structured questionnaires (Government, DSO, clients) Data collection: paired country assessments by DSO managers Data management: database, country report and global analysis


Data collection: Data collection Field test of questionnaires Morocco (March 2004) and Uganda (March 2004) Next countries to be assessed Tunisia (April 2004) Kenya (April 2004)