The need for a functional pharmaceutical industry in Sierra Leone: lessons from the COVID-19 pandemic (original) (raw)
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Local production of pharmaceuticals and health system strengthening in Africa: An Evidence Brief
2017
Industrial development in pharmaceuticals in Africa can support health system strengthening Developing local pharmaceutical production can improve access to medicines and help to generate the scientific, technological and skills base for building stronger and more resilient health systems. These health-industry mutual benefits also depend on funding and managing competent, inclusive, population-focused health services, and on effective industrial regulation for quality assurance. Local and global perspectives on emergency preparedness differ: both must be addressed Global health security frameworks focus on technologies for emergencies that threaten the wider world. African experts shift the focus onto breaking supply constraints for recurrent lethal emergencies by building local supply capacities and organisational expertise. Both contributions are needed to build medium-term health security. External actors can support an upward spiral of health-industry synergies An upward spiral...
Journal of Public Health Policy
The COVID-19 pandemic unveiled the vulnerability of many African healthcare systems, amplifying inadequacies and constraints in the supply chain for medical products and technologies on the continent. Disruptions in the global supply chain due to the pandemic resulted in the continent's population of over one billion people grappling with shortages in the supply of essential medicines. The shortages and their consequences set back achievement of Sustainable Development Goals and progress towards universal health coverage. A virtual meeting of global experts in medical products and supply chain identified as urgent the need for Africa to build capacity for a self-reliant public health system. Discussants challenged the governments of African countries to turn the continent from its current import driven economy to a continent of indigenous research and development, local production, and an exporter of its medical products and innovations.
Pharmacovigilance systems in resource-limited settings: an evaluative case study of Sierra Leone
Journal of Pharmaceutical Policy and Practice
Few low and middle-income countries (LMIC) have fully operational pharmacovigilance structures, systems and legal framework to collect and collate safety data and evaluate the risks and benefits by active and passive approaches. However, in a LMIC such as Sierra Leone, the capacity to manage the risks by taking appropriate preventative actions to help inform therapeutic decisions, promote rational use of medicines, guide risk management and communications is gradually growing but yet to be fully optimized. This study sought to assess the current status of pharmacovigilance in Sierra Leone since it became the 87th member of the World Health Organisation International Drug Monitoring Programme. This study evaluated the pharmacovigilance system in Sierra Leone through a comprehensive and system-based approach that covered the national medicines regulatory authority, health facilities and public health programmes. A descriptive cross-sectional study design was employed. Using a convenience sampling method, 14 respondents from the national medicines regulatory authority, six health facilities and six public health programmes were interviewed. Data were collected using a validated metric instrument: Indicator-Based Pharmacovigilance Assessment Tool. A scoring system was used for the quantification of assessment results with a score greater than 60% indicating that an organization has structural and policy frameworks to collect and collate safety data in a national database and evaluate the risks and benefits by both active and passive approaches. The study findings showed that the national medicines regulatory authority scored 79% and thus met the standard requirements of pharmacovigilance. On the other hand, the health facilities and public health programmes scored less than 60% indicating the need to fully operationalise pharmacovigilance frameworks at these levels. The study further demonstrated that the national medicine regulatory authority which hosts the national pharmacovigilance centre had functional pharmacovigilance structures and processes with potential to providing leadership in the implementation of pharmacovigilance in Sierra Leone.
The Impact of COVID-19 Pandemic on Pharmacy Practices in the Tropics: Nigeria as a Case Study
Texila International Journal of Public Health, 2021
As the pandemic was sudden and no time was given to prepare for the lockdown measure, pharmaceutical practices were significantly disrupted in the aspects of manufacturing and supplying drugs, sales, and profit-making. Therefore, this study assessed the impacts of COVID-19 crisis on pharmaceutical practices in Nigeria. A descriptive cross-sectional design survey was adopted to draw information from the pharmacists (respondents) among the targeted population. 1,200 professional and practice pharmacists were systematically and randomly selected across the six geopolitical zones in Nigeria, while 1,118 copies of the administered questionnaire were retrieved, coded, and analyzed using descriptive and inferential statistics aided by the Statistical Package for Social Sciences (SPSS) software version 23 to run the analyses. The findings showed that COVID-19 had negative impacts on pharmaceutical practices, especially in hospital and community practices. A 25%-49% decrease was highly indicated in sales, purchase orders, and profits, while the majority, 347 (31.04%) of the respondents, indicated that they had a 1%-24% decrease in their workforce. Also, total lockdown as a COVID-19 measure increased the level of insecurity and inflation during the pandemic. 75.13% of the pharmacists who represent the targeted population indicated that their place of work largely enforced COVID-19 basic preventive measures during the pandemic. This study concludes that necessary efforts should be put in place to ease the affairs of the pharmaceutical practices before, during, and after the pandemic.
Journal of Pharmaceutical Policy and Practice, 2018
A strong pharmaceutical sector is a precondition for effective and efficient health care and financing systems, and thus for achieving the best possible health of a population. Supported by visionary, long-term donor funds, in conjunction with mutual trust, the USAID-funded Securing Ugandans Rights to Essential Medicines (SURE) and Uganda Health Supply Chain (UHSC) program engaged in a close, more than 10 year-long (in 2018) collaboration with the Ministry of Health of Uganda. Over time, the partnership implemented numerous multi-pronged comprehensive changes in the pharmaceutical sector and conducted research to document successes and failures. We describe the evolution and key characteristics of the SURE/UHSC interventions.
Human Resources for Health, 2009
Background: East African countries have in the recent past experienced a tremendous increase in the volume of antiretroviral drugs. Capacity to manage these medicines in the region remains limited. Makerere University, with technical assistance from the USAID supported Rational Pharmaceutical Management Plus (RPM Plus) Program of Management Sciences for Health (MSH) established a network of academic institutions to build capacity for pharmaceutical management in the East African region. The initiative includes institutions from Uganda, Tanzania, Kenya and Rwanda and aims to improve access to safe, effective and quality-assured medicines for the treatment of HIV/AIDS, TB and Malaria through spearheading in-country capacity. The initiative conducted a regional assessment to determine the existing capacity for the management of antiretroviral drugs and related commodities. Methods: Heads and implementing workers of fifty HIV/AIDS programs and institutions accredited to offer antiretroviral services in Uganda, Kenya, Tanzania and Rwanda were key informants in face-to-face interviews guided by structured questionnaires. The assessment explored categories of health workers involved in the management of ARVs, their knowledge and practices in selection, quantification, distribution and use of ARVs, nature of existing training programs, training preferences and resources for capacity building. Results: Inadequate human resource capacity including, inability to select, quantify and distribute ARVs and related commodities, and irrational prescribing and dispensing were some of the problems identified. A competence gap existed in all the four countries with a variety of healthcare professionals involved in the supply and distribution of ARVs. Training opportunities and resources for capacity development were limited particularly for workers in remote facilities. On-thejob training and short courses were the preferred modes of training. Conclusion: There is inadequate capacity for managing medicines and related commodities in East Africa. There is an urgent need for training in aspects of pharmaceutical management to different categories of health workers. Skills building activities that do not take healthcare workers from their places of work are preferred.
Business strategy and access to medicines in developing countries
Global Health Governance, 2010
The availability of generic ARVs was important for the expansion of treatment in developing countries. This paper argues that it is therefore imperative to examine which factors have shaped generics companies' decisions to supply these drugs. This will help us better understand the development of the global AIDS response in the past and how to address some of its future challenges. This paper illustrates the value of combining the investigation of political and economic dynamics with a focus on how they affect the commercial considerations of companies that supply products required by society. In doing so it contributes to the existing literature on business in global governance, which tends to focus on how business affects states' decision-making but neglects how global governance influences companies' decisions to produce some goods and not others.
Health Policy and Planning, 2018
The benefits of local production of pharmaceuticals in Africa for local access to medicines and to effective treatment remain contested. There is scepticism among health systems experts internationally that production of pharmaceuticals in sub-Saharan Africa (SSA) can provide competitive prices, quality and reliability of supply. Meanwhile low-income African populations continue to suffer poor access to a broad range of medicines, despite major international funding efforts. A current wave of pharmaceutical industry investment in SSA is associated with active African government promotion of pharmaceuticals as a key sector in industrialization strategies. We present evidence from interviews in 2013-15 and 2017 in East Africa that health system actors perceive these investments in local production as an opportunity to improve access to medicines and supplies. We then identify key policies that can ensure that local health systems benefit from the investments. We argue for a 'local health' policy perspective, framed by concepts of proximity and positionality, which works with local priorities and distinct policy time scales and identifies scope for incentive alignment to generate mutually beneficial health-industry linkages and strengthening of both sectors. We argue that this local health perspective represents a distinctive shift in policy framing: it is not necessarily in conflict with 'global health' frameworks but poses a challenge to some of its underlying assumptions.